Aesthetic neo-glans reconstruction after penis-sparing surgery for benign, premalignant or malignant penile lesions

Arab J Urol. 2011 Jun;9(2):115-20. doi: 10.1016/j.aju.2011.06.013. Epub 2011 Sep 15.

Abstract

Purpose: To describe the technique and results of penis-sparing surgery combined with a cosmetic neo-glans reconstruction for benign, pre-malignant or malignant penile lesions.

Patients and methods: Twenty-one patients (mean age 61 years) with penile lesions with a broad spectrum of histopathology underwent organ-sparing surgery with neo-glans reconstruction, using a free split-thickness skin graft harvested from the thigh. Three patients were treated by glans-skinning and glans-resurfacing, 10 by glansectomy and neo-glans reconstruction, four by partial penectomy and a neo-glans reconstruction, and four by neo-glans reconstruction after a traditional partial penectomy.

Results: The mean follow-up was 45 months; all patients were free of primary local disease. All patients were satisfied with the appearance of the penis after surgery, and recovered their sexual ability, although sensitivity was reduced as a consequence of glans/penile amputation.

Conclusion: In benign, premalignant or malignant penile lesions, penis-sparing surgery combined with a cosmetic neo-glans reconstruction can be used to assure a normally appearing and functional penis, while fully eradicating the primary local disease.

Keywords: Carcinoma; Glans reconstruction; LS, lichen sclerosus; Lichen sclerosus; Penis; SCC, squamous cell carcinoma; STSG, split-thickness skin graft; Squamous cell.