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Penectomy, or the surgical removal of part or all of the penis, is a treatment option primarily for penile cancer or can be part of gender affirmation surgery. This article will cover why a penectomy may be necessary, what the procedure involves, the expected recovery process, and what patients should know about life after surgery.
Synopsis
What is a Penectomy?
A penectomy is a surgical procedure that removes part (partial penectomy) or all (total penectomy) of the penis. The penectomy surgery can be done for a couple of main reasons: to treat penile cancer or as a part of gender affirmation or gender nullification.
Why is a penectomy performed?
1. Penectomy for Cancer Treatment
Penile cancer is a rare condition, but it can be life-threatening if untreated. Penectomy is often the best option for those with larger tumours or invasive cancer that has spread deeper into tissue. The procedure allows doctors to remove cancerous tissue, giving the patient the best chance of survival.
Penile cancer is more common in people who:
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Are smokers.
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Are uncircumcised.
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Have a history of HPV or AIDS.
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Are over 50.
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Have had UV light treatment for psoriasis.
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Have skin issues, such as phimosis or smegma buildup.
2. Penectomy for Gender Affirmation or Gender Nullification
Some transgender women or nonbinary individuals opt for a penectomy as part of their gender affirmation journey, which aligns their physical appearance with their gender identity. Others may choose gender nullification surgery, which involves the complete removal of external genitalia, resulting in a smooth and gender-neutral appearance. Gender-affirming surgeries, like vulvoplasty or vaginoplasty, may also be performed alongside a penectomy to create feminine genitalia.
Consult our Oncology Hospital in Jaipur if you need Penectomy Surgery.
What to Expect: The Procedure
Before the penectomy surgery procedures, your doctor will discuss your options and what to expect. It’s essential to work with an experienced surgeon, especially for these specialised procedures.
During the surgery:
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Penectomy for Cancer:
If the cancer is small or located at the tip of the penis, the surgeon may only remove that part in what’s called a glossectomy. If cancer has spread more extensively, a partial or total penectomy may be required. For a full penectomy, the entire penis, including the root, is removed. The surgeon will reroute the urethra (the tube you pee from) to a small opening in the perineum, the area between the scrotum and anus. This is known as a perineal urethrostomy, and you’ll need to sit down to urinate.
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Penectomy for Gender Affirmation:
If a penectomy is part of gender-affirming surgery, there are a few options to achieve a more feminine appearance:
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Vulvoplasty creates a vulva (outer genitalia) using existing tissue to form parts like the mons, labia, and clitoris.
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Vaginoplasty forms a vaginal canal, using tissue to create a functioning vagina.
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Gender Nullification results in a smooth, level area with no external genitalia.
Recovery After Penectomy
The length of recovery varies depending on the type of surgery and the individual, but some general recovery guidelines apply.
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Hospital Stay: Expect to stay in the hospital for 2-3 days after surgery.
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Urinary catheter: A catheter will help drain urine for up to two weeks.
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Healing Process: Take at least a month off work to allow for healing. Avoid lifting heavy objects for four to six weeks.
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Swelling and Pain: Swelling is normal and should subside gradually. Some patients may also need compression stockings or medication to reduce the risk of blood clots.
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Follow-Up Care: Regular follow-ups are essential to ensure proper healing and discuss any concerns.
If you’ve had a vaginoplasty, additional care instructions will be provided. You may need to use a dilator to help maintain the shape of your new vagina and prevent it from closing.
Risks and Benefits of Penectomy
Like any surgery, a penectomy has potential benefits and risks.
Benefits:
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For Cancer Patients: Removing cancerous tissue can save lives.
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For Gender Affirmation: Aligning physical appearance with gender identity can greatly improve quality of life and mental health.
Risks:
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Infection: The surgical site may become infected if not properly cared for.
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Excessive Bleeding: Some patients may experience unusual bleeding post-surgery.
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Lymphedema: Fluid buildup in the legs or scrotum may occur if lymph nodes are removed.
Your doctor will discuss these risks in detail and provide steps to minimise complications.
Life After Penectomy: What About Sexuality?
The impact on sexuality after a penectomy depends on the type of surgery.
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For cancer Patients: If only part of the penis is removed, sexual function may be preserved to some extent. However, with a total penectomy, penetrative sex won’t be possible, though there are many ways to maintain intimacy with a partner.
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For Gender-affirming Surgeries: patients who undergo vaginoplasty may find that sexual satisfaction improves as they align their physical body with their gender identity. Studies generally report high satisfaction rates, and counselling can be helpful in addressing any concerns about body image or intimacy.
When to Contact Your Doctor
Following penile cancer surgery, it’s essential to keep an eye out for any unusual symptoms. Call your oncologist if you experience:
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A high fever.
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Excessive bleeding.
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Pain that doesn’t improve with prescribed medication.
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Any new or worsening symptoms.
Conclusion
A penectomy is a significant procedure, but with the right care and support, recovery is possible. Whether for cancer treatment or gender affirmation, a penectomy can offer patients a new lease on life, improving their health and sense of self.
If you’re considering a penectomy, talk with a healthcare provider to fully understand your options and plan a path that feels right for you.
FAQ's
It's the surgical removal of part or all of the penis, usually for treating penile cancer or as part of gender-affirming surgery.
It's performed mainly to treat penile cancer or to align physical characteristics with gender identity.
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Partial Penectomy: Only part of the penis is removed.
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Total Penectomy: The entire penis is removed, often requiring a new way to urinate.
Yes, but if you have a total penectomy, your urethra is rerouted, and you’ll need to sit to urinate.
Partial penectomy may preserve some sexual function. With total penectomy, penetrative sex is no longer possible, but other forms of intimacy can be explored.
Some pain and discomfort are expected, but it can be managed with prescribed pain medication.
Recovery usually takes 4-6 weeks, with a hospital stay of 2-3 days.
Risks include infection, bleeding, swelling, and possible changes in sexual function.
Yes, especially if the surgery was for cancer, to monitor for any recurrence or complications.
Keep the area clean and dry, avoid heavy lifting, and follow all post-surgery instructions from your doctor.
Yes, adjusting to changes can be challenging. Therapy or support groups can be helpful during recovery.
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