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Penectomy

Penectomy is the surgical procedure to remove all or part of the penis. This procedure is mainly used as treatment against penile cancer, a collection of malignant, or cancerous, cells either inside or on the surface tissue of the penis, and also in few cases of penile trauma.

What happens before the procedure?

The treatment will depend on the size and location of the tumour.If Dr. Raghunath has recommended you penectomy, he will explain you what kind of technique will be involved. It can be total or partial, and may include additional procedures. They will also counsel you regarding the possible effects and life after surgery.
His team will take a note of your existing medications, which may interfere with the surgery outcomes and may ask you to modify your timings or discontinue for sometime before surgery. You will be asked not to eat or drink anything after midnight on the evening prior to your surgery. You may brush your teeth in the morning but not swallow the water.
Surgery
Surgery

What happens during penectomy?

Total penectomy involves the removal of your whole penis. The procedure usually takes around 2 hours. This may be done under either general or spinal anesthesia.
Your position on the table will be supine (flat on your back) or in the lithotomy position (on your back with your legs elevated in holsters called stirrups). A catheter is inserted into the urethra (tube through which you urinate) and into the bladder to help the doctor identify the urethra during surgery. In a partial penectomy, the individual parts of the anatomy are all identified and divided at a point that leaves a planned width of normal tissue between the tumor and the remaining healthy tissue while attempting to spare as much penile length as possible.


The incision is closed and the new end of the urethra is brought through an opening in the skin. In total penectomy, after the penis is removed, Dr. Raghunath brings the urethra to a new opening in the skin of the perineum.
Further steps may include removal of the testicles and scrotum, and the lymph nodes, but this is usually done only in the case of very advanced cancers. In certain situations, where the cancer is invading deep tissue, it may be necessary to remove some of your lymph nodes.
To assess whether or not the sentinel lymph node is affected, a sentinel lymph node biopsy may be done. Depending on the results, if cancer is found, other lymph nodes will also be taken out. If no cancer is found, further surgery isn’t required.

What happens after the procedure?

Recovery from a penile surgery may require you to stay in the hospital for one to two nights depending on the procedure you had. You may have a temporary urinary catheter to drain urine from your bladder. You will be taught how to care for the catheter. There will be a gauze dressing wrapped around the penis or behind the scrotum.

Dr Raghunath will give you information about the medications you will be taking, such as those for prevention of pain, blood clots, infection, and constipation, along with medications that treat other conditions. He will also explain to you about any activity restrictions you will have to follow. You can get back to work at least after 3-4 weeks.

Surgery
Surgery

What are the risks associated with penectomy?

Having a penectomy may include some risks or complications.
Surgery related complications include:
• Anesthesia complications
• Excessive bleeding
• Risk of infection
Procedure related complications include:

• Chronic pain or localized discomfort
• Infection of the wound site
• Narrowing or obliteration of urethra
• Formation of blood clots
• Inability to urinate in standing posture
• Obstruction or inflammation of lymph vessels leading to lymphedema
• Sexual dysfunction
Some complications may only be temporary, but others may be permanent. Dr. Raghunath and his team will counsel you to deal with above complications, if it happens.

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Frequently Asked Questions

Most patients can resume normal activities within one week, including driving, walking up stairs, light lifting, and work. You are encouraged to engage in light activity while at home after surgery. Speak to your doctor before carrying out any strenuous work.
Laparoscopic adrenal gland removal is minimally invasive and more commonly followed these days. Common advantages are:
• Smaller incisions
• Shorter hospital stay
• Les postoperative pain
• Better cosmesis
• Reduced risk of herniation or wound separation
• Faster recovery & return to normal activity

In a small number of patients the laparoscopic method cannot be performed. In that situation, the operation is converted to an open procedure. The decision to perform the open procedure is a judgment decision made by Dr. Raghunath either before or during the actual operation. When the surgeon feels that it is safest to convert the laparoscopic procedure to an open one, this is not a complication, but rather sound surgical judgment. The decision to convert to an open procedure is strictly based on patient safety.
Contact Dr. Raghunath and his team right away if you experience any of the following post discharge:
• Persistent fever over 101 degrees F
• Bleeding
• Increasing abdominal swelling
• Pain that is not relieved by your medications
• Persistent nausea or vomiting
• Chills
• Persistent cough or shortness of breath
• Pus from any incision
• Redness surrounding any of your incisions that is worsening or getting bigger
• You are unable to eat or drink liquids

Disclaimer Statement

This website is built with intention of providing basic details about the various diseases. The contents of the website is not meant to replace an in-person consultation. Please follow the advise of your doctor via in-person consultation. This website will not assume any legal responsibility for the patient’s medical condition.
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