Glansectomy / Split Skin Graft
The following type of surgery for penile cancer will affect the appearance of the penis and it is important for men and their partners to:
- Ask their surgeon or health professional to give them as much information as possible with regard to the possible change in appearance of their penis following surgery. This will help prepare them for any change in body image.
- Men should ask their specialist nurse to discuss the treatment that they are having and what to expect immediately after, and in the long term following treatment. If possible they should try and involve their partner and family as they will be affected by the changes too.
- If men are having difficulty in preparing for their treatment either emotionally or psychologically they can ask their specialist team about counselling; talking to a healthcare professional to express their fears or concerns.
Glans resurfacing and split skin graft
This involves removing the surface tissue of the glans while taking biopsies from deeper within the penile tissue to check for cancer. A small section of skin will usually be removed from a man’s thigh to act as a skin graft and will be used to replace the area of the penile tissue that has been removed. This is termed a split skin graft as only the surface cell layers of the skin will be used. In general post-operative care will be similar to Glansectomy (below).
This is performed for cancer that is confined to the penis and is a surgical technique to remove the area from the glans of the penis that contains cancer.The amount of tissue removed will depend on the extent of the cancer that is present, however to ensure there will be less chance of having cancer left behind, about 2mm of surrounding tissue will also be removed (this is called a surgical margin). To make the penis look as normal as possible after the procedure skin may be taken from the thigh and grafted over the area where the tissue was removed (see Fig. 1). Alternatively the foreskin may be used instead (Fig. 2).
To protect the urethra from becoming damaged during the procedure a catheter (urine drainage tube) will be inserted into the bladder. This will need to stay in place for 5 – 7 days.
For information on catheter care please click here
- Painkillers will be given on a regular basis for any pain men may experience. It is important that men take painkillers regularly and not just when they have pain.
- Men will need to remain in bed for up to 48 hours after the operation (this is called bed rest) to allow the skin graft to join onto the remaining tissue of the penis.
- The penis will have surgical dressings over it which will usually be left in place for up to 5 days. Doctors and nurses will check these dressings and the site of the operation regularly for any abnormalities such as possible bleeding or infection. Baths or showers should be avoided during this time and men may be advised to have a salt bath after 14 days. They should pat the operation site dry with a clean towel or gauze and avoid any material that may leave fibres on the site. Alternatively a hairdryer on a cold setting can be used to gently dry the area.
- If a graft has been taken from the thigh a waterproof dressing will be applied which will need to remain in place for 2-weeks.As the site of the skin graft heals it may cause an unusual odour which can cause alarm but this is us a result of the natural haling process.
- Stitches will be dissolvable but may take 4 – 6 weeks to fully disperse.
- Men will need a minimum 4 weeks off work.
A follow up appointment will usually be made within a few weeks to check that the operation sites are healing satisfactorily and to discuss the results of surgery.
Men should be aware that the colour of the skin graft may be a different colour to the penile skin when fully healed.
Tips for surgery
- Always ask the healthcare team exactly what the surgery will involve and what to expect after the operation.
- Plan ahead with regard to time off work and allowing for the healing process.
- Try and maximise health prior to the operation by eating healthily and taking steady exercise.
- Try and get into the habit of moving feet when at rest and not crossing legs. This will help prevent possible blood clots forming in the legs which can occur when mobility is reduced.
To view and download a leaflet on this procedure please click here
Reviewed March 2021. Next review 2022.