Distal Urethral Reconstruction of the Glans for Penile Carcinoma: Results of a Novel Technique at 1-Year of Followup

Gulino, Gaetano; Sasso, Francesco; Falabella, R.; Bassi, Pier Francesco

doi:10.1016/j.juro.2007.05.059

Cited by 57 publications

(24 citation statements)

References 19 publications

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“…On the other hand, the negative impact of the erectile function can be explained by the penile shortening as demonstrated by our study, leading to difficult vaginal penetration, and the strong psychological consequences of the glans removal. Our results are in contrast with the study by Gulino and colleagues, 23 which reported no differences in postoperative IIEF score, ejaculation or orgasm activity in a series of 14 patients undergoing glansectomy with urethral glanduloplasty.…”

Section: Discussioncontrasting

confidence: 99%

“…Organ-sparing surgery preserves penile length and shape, with satisfying recovery of the sexual function and acceptable psychological repercussions, while not jeopardizing oncological safety. 14,23 Even the recent update of EAU guidelines underlined the need of as much organ preservation as possible, while removing the primary penile lesion. 12 As an alternative to radical approaches, several surgeons have employed techniques of glansectomy without glans reconstruction with acceptable aesthetic results.…”

Section: Discussionmentioning

confidence: 99%

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Sexual function after surgical treatment for penile cancer: Which organ-sparing approach gives the best results?

Sedigh

Falcone

Ceruti

et al. 2015

CUAJ

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E423Cite as: Can Urol Assoc J 2015;9(7-8):E423-7. http://dx.doi.org/10.5489/cuaj.2801 Published online July 17, 2015. AbstractIntroduction: We compared the postoperative sexual function of patients who underwent wide local excision (WLE) and glansectomy with urethral glanduloplasty for penile cancer. Methods: We retrospectively reviewed clinical data of 41 patients affected by superficial, localized penile cancer (≤cT2a) between 2006 and 2013. Patients with severe erectile dysfunction and not interested in resuming an active sexual life were selected for penile partial amputation. Patients with preoperative satisfying erectile function and concerned about the preservation of their sexual potency were scheduled for WLE (Group A) or glansectomy with urethral glanduloplasty (Group B). Sexual function was assessed with the International Index of Erectile Function (IIEF) questionnaire and the Sex Encounter Profile (SEP). At 1 year, patients were asked to complete the questionnaires again and were questioned about their genital sensibility and ejaculatory reflex persistence. Postoperative complications were reported according to the Clavien-Dindo classification. Statistical analysis was performed by two-tailed test: Student t-test and chi-square. Results: Among the 41 patients enrolled, 12 underwent WLE (29.2%), 23 glansectomy with urethral glanduloplasty (56%) and 6 with penile partial amputation (14.6%). A decrease in postoperative IIEF was recorded in both groups, but was statistically significant only in Group B (p = 0.003). As for the SEP, while no significant changes were recorded postoperatively in Group A, a marked reduction was reported for Group B, with a statistically significant decrease in the possibility of achieving penetrative intercourse (p = 0.006) and in the perceived satisfaction during sexual activity (p = 0.004). Conclusions: WLE lead to better sexual outcomes and less postoperative complications as compared to glansectomy with urethral glanduloplasty.

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Section: Discussioncontrasting

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Sexual function after surgical treatment for penile cancer: Which organ-sparing approach gives the best results?

Sedigh

Falcone

Ceruti

et al. 2015

CUAJ

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“…Encouraging results were described by Romero et al 23. and Gulino et al 24. In the study by D’Ancona's group,25 who used the Overall Sexual Functioning Questionnaire (OSFQ), nearly 36% of patients had no sexual function or moderately to severely reduced sexual function.…”

Section: Discussionmentioning

confidence: 91%

Sexual outcomes after partial penectomy for penile cancer: results from a multi-institutional study

et al. 2017

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Penile cancer is an uncommon malignancy. Surgical treatment is inevitably mutilating. Considering the strong impact on patients’ sexual life we want to evaluate sexual function and satisfaction after partial penectomy. The patients in this study (n = 25) represented all those who attended our institutions and were diagnosed and treated for penile cancer from October 2011 to November 2013. All patients underwent partial penectomy and followed-up (mean: 14 months; range: 12–25). Sexual presurgical baseline was estimated using the International Index of Erectile Dysfunction 15 (IIEF-15). Sexual outcomes of each patient were estimated considering four standardized and validated questionnaires. We analyzed the means and ranges of IIEF-15 including erectile function (IIEF-1–5 and -15), orgasmic function (IIEF-9 and -10), sexual desire (IIEF-11 and -12), intercourse satisfaction (IIEF-6–8), and overall satisfaction (IIEF-13 and -14). Then, we also used Quality of Erection Questionnaire (QEQ), Erectile Dysfunction Inventory of Treatment Satisfaction (EDITS) and Self-Esteem and Relationship (SEAR) to evaluate the sexual function and satisfaction of our patients. The final results showed that penile cancer leads to several sexual and psychosexual dysfunctions. Nevertheless, patients who undergo partial penectomy for penile cancer can maintain the sexual outcomes at levels slightly lower to those that existed in the period before surgery.

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“…The most common procedure for PSS is glansectomy, which was first described in 1996 [22]. The recurrence rates for glansectomy are less than 4%, with excellent oncologic outcomes [2324252627]. Philippou et al [28] demonstrated that the rates of local recurrence and 5-year CSS after penile-sparing surgery were 8.9% and 91.7%, respectively, during a mean follow-up of 26 months.…”

Section: Discussionmentioning

confidence: 99%

Clinicopathologic Characteristics and Treatment Outcomes of Penile Cancer

Nam

Lee

Park

et al. 2017

World J Mens Health

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PurposeThe aim of this study was to assess the clinicopathologic characteristics of penile cancer, including patterns of therapy, oncologic results, and survival.Materials and MethodsBetween January 2005 and July 2015, 71 patients at 6 institutions who had undergone penectomy or penile biopsy were enrolled. Their medical records were reviewed to identify the mode of therapy, pathology reports, and cancer-specific survival (CSS) rate.ResultsClinicopathologic and outcome information was available for 52 male patients (mean age, 64.3 years; mean follow-up, 61.4 months). At presentation, 17 patients were node-positive, and 4 had metastatic disease. Management was partial penectomy in 34 patients, total penectomy in 12 patients, and chemotherapy or radiotherapy in 6 patients. The pathology reports were squamous cell carcinoma in 50 patients and other types of carcinoma in the remaining 2 patients. Kaplan-Meier survival analysis showed a 5-year CSS rate of 84.0%. In univariate and multivariate analyses, the American Joint Committee on Cancer (AJCC) stage and pathologic grade were associated with survival.ConclusionsPartial penectomy was the most common treatment of penile lesions. The oncologic outcomes were good, with a 5-year CSS of 84.0%. The AJCC stage and pathologic grade were independent prognostic factors for survival.

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Distal Urethral Reconstruction of the Glans for Penile Carcinoma: Results of a Novel Technique at 1-Year of Followup

Abstract: Reconstructive glanuloplasty with distal urethra in penile tumor surgery is an innovative, easy and rapid surgical technique with appreciable functional and esthetic results.

Cited by 57 publications

References 19 publications

Sexual function after surgical treatment for penile cancer: Which organ-sparing approach gives the best results?

Sexual function after surgical treatment for penile cancer: Which organ-sparing approach gives the best results?

Sexual outcomes after partial penectomy for penile cancer: results from a multi-institutional study

Clinicopathologic Characteristics and Treatment Outcomes of Penile Cancer

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