Treatment Options and Outcomes for Men with Penile Intraepithelial Neoplasia: A Systematic Review

Eur Urol Focus. 2022 May;8(3):829-832. doi: 10.1016/j.euf.2021.04.026. Epub 2021 May 11.


Penile intraepithelial neoplasia (PeIN) is a rare skin condition with potential to progress to invasive penile cancer. We performed a systematic review of treatment options and outcomes for PeIN. Topical agents showed response and recurrence rates of 40-100% and 20% for imiquimod, and 48-74% and 11% for 5-fluorouracil, respectively. Discontinuation of topical agents because of side effects was observed in 12% of cases. Response rates for laser therapies were 52-100%, with recurrence in 7-48% of cases and a change in penile sensitivity in 50%. Circumcision cleared preputial PeIN. Rates of recurrence after surgical treatment of glans PeIN were 25% for wide local excision, 4% for Mohs surgery, 5% for total glans resurfacing, and 10% for glansectomy. There are limited data on factors predictive of treatment response and on sequencing of treatment options. PATIENT SUMMARY: Several treatment options are available for men with precancerous lesions of the foreskin or glans. Close follow-up is necessary as lesions can recur or progress to invasive penile cancer.

Keywords: Cancer; Glans resurfacing; Glansectomy; Imiquimod; Laser; PeIN; Penile; Topical; hpv.

Publication types

  • Review
  • Systematic Review

MeSH terms

  • Carcinoma in Situ* / pathology
  • Carcinoma in Situ* / surgery
  • Carcinoma, Squamous Cell* / pathology
  • Humans
  • Male
  • Penile Neoplasms* / pathology
  • Penile Neoplasms* / surgery
  • Penis / pathology
  • Penis / surgery
  • Precancerous Conditions* / pathology
  • Precancerous Conditions* / surgery