A penectomy is the surgical removal of part or all of the penis. This surgery may be required in order to remove cancerous tissue in the penis, or it can be elected as part of a sex reassignment surgery. In rare cases, a penectomy is performed accidentally during circumcision.
Penectomy, or penis amputation, is a common treatment for penile cancer. If at all possible, the surgeon will aim 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 the man to continue urinating standing up and have a full, though changed sex life. A man with a partial penectomy can still get an erection and ejaculate, though 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.
During a radical penectomy, the entire penis, from the tip to inside the pelvis is removed. Cancer patients may also have the lymph nodes in the groin extracted to deter the spread of cancer into the rest of the body. Men who have this surgery will pass urine through a new opening for the urethra, so their regular bathroom habits may change. These men may also have to experiment to find ways to a satisfying sex life post-operation.
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 in 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 of the penis is affected, the patient may be able to just have the tumor and a small amount of the healthy surrounding tissue removed, but amputation is the most effective treatment. The patient will also receive radiotherapy as a security against the cancer’s spreading. Rare but possible complications of partial or total penectomies include persistent penis discomfort, increased sensitivity, decreased sensitivity, difficulty maintaining an erection, and infection.
Sometimes, but not usually, penis amputation is part of a sex reassignment surgery called vaginoplasty for trans women. The more common surgery is called penile inversion, in which just the erectile tissue is removed, while the glans remains intact and is sometimes used to construct a clitoris. The rest of the penis is inverted into the body to create a simulated vaginal canal. The other type of vaginoplasty, colovaginoplasty, does require penectomy and uses a piece of the colon to simulate the vaginal canal. This is a much riskier surgery and doctors prefer not to perform it if there is any other alternative.