Refashioning of phallus stumps and phalloplasty in the treatment of carcinoma of the penis

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Abstract
The surgical management of 41 patients with carcinoma of the penis is presented. Conservative surgery in the form of a circumcision or a glansplasty was done in eight patients with one recurrence. Circumcision as an adequate procedure is advocated for lesions near the apex of the preputial sac permitting a 2 cm clearance; glansplasty after local excision requires further evaluation. The details of technique of lengthening and refashioning of the residual phallic stump after partial amputation in a further 20 patients is described using a technique which leaves a satisfactory penile stump in patients who would normally be candidates for a total amputation. In a third group of patients requiring a total amputation of penis, reconstruction was done in two stages using scrotal flaps in four with satisfactory results. The reconstructed phallus was adequate as a urinary conduit but was unsuitable for sexual function. A one stage procedure involving covering of the urethra with scrotal flaps appears an attractive alternative to the staged procedure. Conventional multistage reconstructions are not recommended.

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