title: Glansectomy and Split-thickness Skin Graft for Penile Cancer.
abstract: Penile cancer is a rare malignancy that is confined to the glans in up to four out of five cases. Although descriptions of glansectomy exist, there are no contemporary video explanations or large published single centre series.
  
  
  
  To show the efficacy and safety of glansectomy and split-thickness skin graft (STSG) reconstruction.
  
  
  
  Data were collected retrospectively for patients identified from surgical theatre diaries between February 2005 and January 2016. 177 patients with histologically proven squamous-cell carcinoma on the glans underwent glansectomy and STSG at a tertiary referral centre in the UK. The median follow-up was 41.4 mo.
  
  
  
  The skin is incised at the subcoronal level and deepened onto Buck's fascia. Dissection is performed over or under Buck's fascia, depending on suspicion of invasion or risk of disease. The glans is excised and a neoglans is created using a STSG.
  
  
  
  Local recurrence, cancer-specific survival, overall survival, and complications.
  
  
  
  Sixteen out of 172 patients (9.3%) experienced local recurrence during the follow-up period. Eighteen out of 174 (10.7%) patients died of penile cancer, while 29 patients in total died during the follow-up period. Of 145 patients, 9% required operative intervention for complications, including graft loss and meatal stenosis. Limitations include the retrospective data collection and the lack of functional and sexual outcomes.
  
  
  
  Glansectomy and STSG comprise a safe procedure in terms of oncologic control and complications for patients with penile cancer confined to the glans penis. Further studies are required to assess functional and sexual outcomes in these patients.
  
  
  
  We report on the management of penile cancers confined to the head of the penis using glansectomy and a split-thickness skin graft to recreate the appearance of a glans. This technique is safe and effective, with limited complications.
authors.affiliation: Department of Urology, University College London Hospital, London, UK.
authors.forename: Arie S
authors.initials: AS
authors.lastname: Parnham
authors.affiliation: Department of Urology, University College London Hospital, London, UK; Department of Urology, University Hospitals Leuven, Leuven, Belgium; Department of Development and Regeneration, Leuven University, Leuven, Belgium.
authors.forename: Maarten
authors.initials: M
authors.lastname: Albersen
authors.affiliation: Department of Urology, University College London Hospital, London, UK.
authors.forename: Varun
authors.initials: V
authors.lastname: Sahdev
authors.affiliation: Department of Urology, University College London Hospital, London, UK.
authors.forename: Michelle
authors.initials: M
authors.lastname: Christodoulidou
authors.affiliation: Department of Urology, University College London Hospital, London, UK; Department of Urology, The Royal Surrey County Hospital, Guildford, UK.
authors.forename: Raj
authors.initials: R
authors.lastname: Nigam
authors.affiliation: Department of Urology, University College London Hospital, London, UK; Department of Urology, The Royal Berkshire NHS Foundation Trust, Reading, UK.
authors.forename: Peter
authors.initials: P
authors.lastname: Malone
authors.affiliation: Department of Histopathology, University College London Hospitals, London, UK.
authors.forename: Alex
authors.initials: A
authors.lastname: Freeman
authors.affiliation: Department of Urology and NIHR Biomedical Research Centre at University College London Hospitals, London, UK. Electronic address: asif.muneer@uclh.nhs.uk.
authors.forename: Asif
authors.initials: A
authors.lastname: Muneer
mesh_terms: D002294:Carcinoma, Squamous Cell / Q000601:surgery*; D006801:Humans; D008297:Male; D008875:Middle Aged; D010412:Penile Neoplasms / Q000601:surgery*; D010413:Penis / Q000601:surgery*; D012189:Retrospective Studies; D016038:Skin Transplantation; D016896:Treatment Outcome; D013521:Urologic Surgical Procedures, Male / Q000379:methods
keywords: Complications; Glansectomy; Penile cancer; Recurrence; Split-thickness skin graft; Survival; Technique