Penectomy: What You Need to Know About This Life-Saving Surgery

Talking about intimate health conditions can feel difficult and uncomfortable. If you or someone you care about is facing a serious diagnosis like penile cancer, your doctor might recommend a surgical procedure called a penectomy. Learning about this operation helps you understand what to expect and gives you confidence as you talk with your care team.

We want you to feel informed, supported, and never alone on this medical journey. Let us walk through everything you need to know about penectomy surgery in clear, simple everyday English.

What is a Penectomy?

A penectomy is a surgical procedure where a surgeon removes part or all of your penis. Doctors divide this surgery into two main types:

• Partial Penectomy: The surgeon removes only the diseased portion of your penis. They always try to save as much healthy tissue as possible.
• Total Penectomy: The surgeon removes your entire penis, including the base attached to your lower pelvic region.

Doctors perform this surgery as a vital treatment for severe medical conditions affecting the penis.

Why Do You Need This Surgery?

The main and most common reason for a penectomy is penile cancer. This surgery stands out as a highly successful cancer treatment. Your doctor usually recommends this procedure when:

• The cancer tumor is very large.
• The cancer has spread into nearby tissues.
• The cancer carries a high risk of returning after other treatments.

While cancer is the primary reason, rare conditions can also require this surgery. For example, a severe bacterial infection called Fournier’s gangrene—where body tissue dies rapidly—or a severe physical injury to the penis may make a penectomy necessary.

How Common Is This Surgery?

To be honest, a penectomy is a rare surgical procedure because penile cancer itself is uncommon. In North America and Europe, fewer than one in 100,000 men develop this cancer each year. Before suggesting surgery, doctors always explore other cancer treatments first. Examples include:

• Ablation therapy: Using intense heat or cold to destroy cancer cells.
• Chemotherapy: Giving powerful cancer-fighting medicine.
• Radiation therapy: Using high-energy rays to kill cancer cells.
• Topical therapy: Applying cancer-fighting creams directly onto your skin.

How to Prepare for Your Surgery

Before your surgery, you will meet with your medical team to discuss your care. They will run several tests to find the exact type and stage of your cancer.

After reviewing these test results, your doctor will discuss whether a partial or total penectomy is best for you. They will also check your basic health, including your body temperature, pulse, and blood pressure, to ensure you are strong enough for surgery.

Tell your doctor about any allergies you have, such as food allergies, latex, medicines, or skin cleaners like iodine. You will also receive instructions to stop eating and drinking after midnight on the night before your surgery. This prevents food or liquid from entering your lungs while you are under anesthesia. If you must take an essential pill, swallow it with only a tiny sip of water.

How the Surgery Happens

Your surgical team usually includes a urologist (a urinary system surgeon), an anesthesiologist, and specialized nurses.

First, your anesthesiologist gives you medicine to put you completely to sleep. You feel no pain and remain completely unconscious during the operation.

Next, nurses place a thin tube called a urinary catheter through your urine pipe into your bladder. This tube drains urine and helps your surgeon easily locate your urinary path during the operation.

• During a Partial Penectomy: The surgeon removes the diseased tissue while saving as much healthy shaft as possible. The main goals are letting you stand up to urinate and keeping some sexual function. If the tip of your penis must be removed, surgeons sometimes use a skin graft taken from your thigh to rebuild a new tip.
• During a Total Penectomy: The surgeon removes your entire penis along with the base connected to your pelvic bone.

If cancer caused your surgery, your doctor may also remove lymph nodes in your groin area to test them for cancer cells. The surgery usually takes less than two hours.

What Happens After Surgery?

Once surgery ends, nurses cover your surgical area with bandages or a special skin glue. As your anesthesiologist stops the sleep medicine, you wake up slowly over several minutes, feeling a bit groggy.

Nurses wheel you to the recovery room and monitor your vital signs closely. Once you are fully awake, nurses give you pain relief medicine. Some patients feel sick to their stomach from the anesthesia, and nurses can give you medicine for that too.

In the days following your surgery, you can expect:

• Staying in the hospital for one to three days.
• Keeping a urinary catheter in place for about two weeks.
• Having a small surgical drain tube to remove fluid from the wound.
• Eating your regular meals normally.
• Having swelling around the surgical site for a short while.

How Do You Urinate After a Total Penectomy?

During a total penectomy, your surgeon connects your urine pipe to a new spot. They create a new urinary opening in the area between your anus and your scrotum, known as the perineum. This procedure is called a perineal urethrostomy, and it means you will sit down to urinate.

Can You Rebuild a New Penis?

While doctors cannot always do this, plastic surgeons sometimes use skin and tissue from other parts of your body, like your arm or thigh, to build a new penis. This complex procedure is called a phalloplasty.

Risks and Complications

Like any major surgery, a penectomy carries benefits and potential risks.

The primary benefit is that it stands as a highly successful treatment for penile cancer, offering the highest chance for long-term survival.

Potential Risks and Complications

Effects on Mental Health

Emotional recovery is often the biggest challenge of this surgery. Even when your physical body heals, the emotional impact can run deep. A healthy penis plays an important role in a person's sexual and emotional well-being. Changes in your body appearance and how you urinate can heavily affect your self-confidence and self-esteem. As a result, you might experience:

• Anxiety .
• Depression .
• Stress .
• Feelings of grief or frustration .

Understanding that these feelings are completely normal helps you navigate your healing journey.

Your Sexual Life After Surgery

Many patients worry about how this surgery affects their intimate life.

Remember that intimacy goes far beyond penetrative intercourse. You can express affection in many other ways. Talking with a sex therapist helps you work through these challenges. Sharing your feelings openly with your partner and exploring non-penetrative intimacy, like kissing and cuddling, keeps your emotional bond strong.

Recovery Time and What to Expect

Everyone heals at their own pace, but here is a general timeline for your recovery:

Facing this type of surgery brings up many heavy emotions. Feeling angry, lonely, sad, or upset is completely normal. The most important thing to remember is that you are not alone on this journey. Talk openly with your family, friends, and doctors. Consider reaching out to a professional mental health counselor for extra support.