What is a penectomy?

Penectomy involves removing part or all of the penis.

A penectomy is the surgical removal of part or all of the penis. This surgery may be necessary to remove cancerous tissue from the penis or it may be chosen as part of a sex reassignment surgery. In rare cases, a penectomy is performed accidentally during circumcision.

Penectomy, or amputation of the penis, is a common treatment for penile cancer. If possible, the surgeon will try to leave as much of the penis intact as possible. A surgery in which only part of the penis is removed, usually just the tip, is called a partial penectomy and allows a man to continue to urinate while standing and have a full, albeit altered, sex life. A man with a partial penectomy can still have an erection and ejaculate, although the most sensitive part of the penis is missing. Still, sex life after a penectomy can be challenging and benefits from open lines of communication between partners and talking to a sexual support therapist.

A penectomy, the surgical removal of all or part of the penis, may be necessary to remove cancerous tissue.

During a radical penectomy, the entire penis, from the tip to the inside of the pelvis, is removed. Cancer patients may also have their groin lymph nodes removed to prevent the cancer from spreading to the rest of the body. Men who undergo this surgery will let urine pass through a new opening in the urethra, so their regular toileting habits may change. These men may also have to experiment to find ways to have a satisfying sex life post-op.

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Having a sex life after a penectomy can be a challenge.

Penile cancer is uncommon in South America and Africa and very rare in Europe and North America. The cancer is typically a squamous cell carcinoma originating from the glans, a vascular section in the head of the penis or foreskin. Symptoms include a lump on the penis, redness, irritation, or a sore on the penis.

Depending on how much the penis is affected, the patient may be able to remove only the tumor and a small amount of surrounding healthy tissue, but amputation is the most effective treatment. The patient will also receive radiation therapy as a guarantee against the spread of the cancer. Rare but possible complications of partial or total penectomies include persistent penile discomfort, increased sensitivity, decreased sensation, difficulty maintaining an erection, and infection.

A penectomy may be the first step in sex reassignment surgery.

Sometimes, but not usually, amputation of the penis is part of a sex reassignment surgery called vaginoplasty for trans women. The most common surgery is called penile inversion, in which only the erectile tissue is removed, while the glans remains intact and is sometimes used to build a clitoris. The rest of the penis is inverted in the body to create a simulated vaginal canal. The other type of vaginoplasty, colovaginoplasty, requires a penectomy and uses a piece of colon to simulate the vaginal canal. This is a much riskier surgery and doctors prefer not to perform it if there is another alternative.

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