Reconstructive Technique for Partial Penile Amputation

Abstract

Partial or total penile amputation with resection of the corpora cavernosa and the urethra is a common and effective surgical procedure used to treat squamous cell cancer infiltrating the deep tissues of the penis. We describe an original method that allows for an aesthetic and functional restoration of the partially or total amputated penis.

Surgical technique

We performe a reconstructive technique for partial penile amputation by releasing the scarring tissue adhesions with cavernosal lysis and by advancing the penile stump with dissection of the suspensory ligament; implantation of soft but axially firm endocavernosal elastomer prostheses to maintain the corpora cavernosa extended; placement of split-thickness skin grafts to cover the shaft skin defects and glanduloplasty with oral mucosa grafting. In cases of total penile amputation, the method begins with the reconstruction of a new phallus using a rectoabdominalis flap; the new penis is then covered with split-thickness skin grafts and finally, at a later date, soft but axially firm endocavernosal elastomer prostheses are implanted.

Results

The success rate as be excellent compared with other complex reconstructive and remodelling procedures for the penis and the glans after partial or total penectomy described by several authors.

Conclusions

In cases of total or subtotal penile amputation, the use of our techniques provides satisfactory aesthetic and functional results, thus we consider it to be a simple solution since it is not too invasive, it is quick and can be carried out by urologists without recourse to sophisticated microsurgery techniques.