Radical Penectomy

Why is it done?

• Confirmed penis cancer, infiltrating most of the penis.
• Cancer involving the base of the penis.
• Lymph nodes are palpable, could also be draining pus.

How is it done?

• This procedure is done under general anesthetic.

• Supine position.
• The whole penis is removed, sparing the proximal urethra, (if not involved).
• The urethra is opened onto the perineum (perineostomy).
• Hemostatic dressings are placed.
• Specimen is sent to a histopathologist.
• An indwelling catheter will be inserted.
• A dressing is then applied, which should be removed after 72 hours.

What to expect after the procedure?

• Any anesthetic has its risks, and the anesthetist will explain such risks.
• Bleeding is a possible complication.
• Your catheter will be removed on Day 3.
• Long-term risk of a urethral opening stenosis.
• An infection of the wound may occur and requires immediate attention.
• DANGER SIGNS: A wound that swells immediately, fever, and puss. Contact Dr Schoeman or the hospital immediately as this occurs in up to 15–20% of all cases.

What next?

• Dressings should be kept dry for the initial 72 hours after surgery and soaked off in a bath thereafter.
• The dressing may sometimes adhere to the wound causing slight bleeding on removal. Don’t panic, the bleeding will stop.
• The catheter will be removed after 3 days.
• On discharge, a prescription for 4 weeks of Antibiotics will be issued for patients to collect
• Betadine sit baths are advised.
• Patients should schedule a follow-up appointment with Dr Schoeman 4-6 weeks after the procedure.
• At this stage you will be scheduled for a superficial and deep inguinal node dissection.
• If your nodes are positive for cancer, Radiation and Chemotherapy will be discussed by an Oncologist.
• There will be signs of bruising for at least 10 days.
• PLEASE CONTACT THE HOSPITAL DIRECTLY WITH ANY POST-OPERATIVE CONCERNS AND RETURN TO THE HOSPITAL IMMEDIATELY SHOULD THERE BE ANY SIGNS OF SEPSIS.

Complication of Inguinal Node dissection

• Any anesthetic has its risks, and the anesthetist will explain such risks.
• Bleeding is a possible complication.
• Longterm leg lymphedema, requiring compression stockings.
• Lymphoedema requires attending Lymphoedema Clinics.
• Wound dehiscence’s and poor healing.
• An infection of the wound may occur and requires immediate attention.
• DANGER SIGNS: A wound that swells immediately, fever, and pus. Contact Dr Schoeman or the hospital immediately.

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Wes Penectomy Radical