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Penile preserving and reconstructive surgery in the management of penile cancer
1Johns Hopkins School of Medicine, Department of Urology, 600 North Wolfe Street, Baltimore, Maryland 21287, USA.
Abstract:
A major paradigm shift has occurred in the clinical management of penile cancer: the adoption of alternative, less-invasive surgical strategies to address the primary tumour. Such penile-preserving approaches aim to retain aspects of penile function and improve quality of life outcomes by reducing penile alterations and sexual dysfunction incurred by historical surgical approaches without compromising oncological control. Novel options include wide local excision, glansectomy, and glans resurfacing, and these strategies are now included in the spectrum of interventions available to treat penile cancer. Surgical reconstructive techniques have also advanced to include primary closure, closure using skin flaps and grafts, penile lengthening and/or enhancement, and neophalloplasty. All of these options can be readily applied in the risk-informed patient after establishing disease-risk variables and instituting protocols for close surveillance and prompt action for possible disease recurrence.
Insights
Penile cancer treatment now favors less-invasive, penile-preserving surgeries. These approaches maintain function and quality of life without compromising cancer control, offering better patient outcomes.
Area of Science:
- Oncology
- Urology
- Surgical Innovation
Background:
- Traditional penile cancer surgeries often led to significant functional deficits and reduced quality of life.
- There was a need for oncologically sound treatments that also preserved penile function.
Purpose of the Study:
- To highlight the paradigm shift towards less-invasive surgical strategies in penile cancer management.
- To discuss novel penile-preserving surgical options and reconstructive techniques.
- To emphasize risk-informed patient selection and surveillance protocols.
Main Methods:
- Review of current clinical practices and advancements in penile cancer surgery.
- Description of penile-preserving techniques such as wide local excision, glansectomy, and glans resurfacing.
- Overview of reconstructive options including skin flaps, grafts, and neophalloplasty.
Main Results:
- Adoption of less-invasive surgical strategies is a major shift in penile cancer care.
- Penile-preserving approaches aim to reduce functional loss and improve quality of life.
- Advanced reconstructive techniques enhance functional and aesthetic outcomes.
Conclusions:
- Novel surgical techniques offer oncological control with improved functional preservation for penile cancer.
- Risk stratification and close surveillance are crucial for managing patients undergoing these advanced procedures.
- These advancements represent a significant improvement in the clinical management of penile cancer.
