title: Refashioning of phallus stumps and phalloplasty in the treatment of carcinoma of the penis.
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.
mesh_terms: D002944:Circumcision, Male; D006801:Humans; D008297:Male; D010412:Penile Neoplasms / Q000601:surgery*; D010413:Penis / Q000601:surgery*; D013518:Surgery, Plastic / Q000379:methods*