A Comparative Study of Two Types of Organ-Sparing Surgeries for Early Stage Penile Cancer: Wide Local Excision vs Partial Penectomy - Beyond the Abstract

Penile cancer is a devastating and rare disease of the industrialized world. However, in the developing world, such as, in some regions of Africa, and South America, penile cancer accounts for 20–30% of cancers in men and is currently a leading and severe problem.

Although the traditional radical penectomy can achieve a good tumor-free survival, it affects patients‘ sexual ability, voiding while upright, penis appearance, genital sensibility, and self--psychology. Organ-sparing surgery can achieve good outcomes, with respect to aesthetics, function, and quality-of-life.

All patients who underwent these two types of surgeries experienced satisfactory outcomes. The patients who underwent wide local excision performed relatively better, in terms of their sexual functions, urinary functions, and Health-related quality of life (HRQOL), but no statistically significant differences were observed in the data collected via the IIEF-15, SEAR, EDITS, and EORTC-QLQ-C30 questionnaires and urodynamic determinations (p>0.05), except in the data corresponding to the orgasmic function (p=0.033).

Patients who underwent the “more conservative” type of surgery, i.e. wide local excision, achieved better orgasmic function than those who underwent the “more aggressive” type of organ-sparing surgery i.e. partial penectomy. Resection of the glans exerted a negative impact on the orgasmic function. Our results are consistent with those of a previous report that assessed the sexual performance for patients who underwent either local excision surgery or partial penectomy.

The results of our study suggest that both of the surgery can achieve good outcomes but the losses in orgasmic function seen in patients who underwent penectomies for treatment of their penile cancers need to be addressed.

Written by: Hai-Jun Yao and Zhong Wang, Department of Urology, Shanghai Ninth People’s Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China

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