To evaluate the incidence of venous thromboembolism (VTE) after penile cancer surgery using national hospital data and to assess current thromboprophylaxis practices across UK specialist centres.
A retrospective cohort study was conducted using Secondary Uses Service (SUS) data on penile cancer surgeries performed in NHS hospitals in England between 2015 and 2024. A national survey of UK Penile Cancer Network (UK PeCaN) surgeons was undertaken to assess current thromboprophylaxis practice. The primary outcome was symptomatic VTE within 180 days of surgery, identified using International Classification of Diseases, 10th Revision (ICD-10) codes. Cumulative incidence of first postoperative VTE was analysed using patient-level time-to-event methods, with censoring at second surgery, 180 days or administrative end of follow-up. Survey responses were summarised using descriptive statistics.
In this observational population-level study, 4310 patients underwent 5903 penile cancer-related procedures. A total of 143 VTE episodes were recorded over the 9-year period, corresponding to an overall crude incidence of 2.5%. In patient-level time-to-event analysis, the cumulative incidence of first postoperative symptomatic VTE was 0.21% at 30 days, 0.69% at 90 days and 1.08% at 180 days. Descriptive procedure-level analyses suggested higher unadjusted VTE rates following more extensive procedures, including lymph node dissection and total penectomy, although these estimates should be interpreted cautiously because of staged procedures and unmeasured patient-level confounding. Most VTE events occurred after hospital discharge. The survey, comprising 24 responses from 10 specialist centres, revealed substantial variation in thromboprophylaxis practice, with 71% of surgeons not using formal VTE risk assessment tools.
Venous thromboembolism is an important postoperative complication after penile cancer surgery, particularly after more extensive procedures and staged treatment pathways. Current prophylaxis practices are inconsistent. These findings support the further collection and analysis of disease-specific and the development of procedure-specific guidelines recommending extended thromboprophylaxis in high-risk patients.
BJU international. 2026 Jul 02 [Epub ahead of print]
Aishwarya Kaur, Omar El-Taji, Hussain Alnajjar, Benjamin Ayres, Michelle Christodoulidou, Ian Eardley, Mamoun Elmamoun, Johnathan Goddard, Patrick Gordon, Paul Hadway, Odunayo Kalejaiye, Philip Keegan, Vivekanandan Kumar, Maurice Lau, Aditya Manjunath, Luke McGuinness, Colin Mulholland, Asif Muneer, Christopoulos Panagiotis, Karen Randhawa, Varun Sahdev, Chitranjan Shukla, Nicholas Watkin, Ashwin Sachdeva, Arie Parnham, Vijay Sangar
Department of Urology, The Christie NHS Foundation Trust, Manchester, UK., Department of Urology, University College London Hospitals NHS Foundation Trust, London, UK., Department of Urology, St George's University Hospitals NHS Foundation Trust, London, UK., Department of Urology, Leeds Teaching Hospitals NHS Trust, Leeds, UK., Department of Urology, University Hospitals of Leicester NHS Trust, Leicester, UK., Department of Urology, North Bristol NHS Trust, Bristol, UK., Department of Urology, Sunderland Royal Hospital, Sunderland, UK., Department of Urology, Norfolk and Norwich University Hospitals NHS Foundation Trust, Norwich, UK., Department of Urology, Altnagelvin Hospital, Londonderry, UK., Department of Urology, Western General Hospital, Edinburgh, UK.