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

Palminteri E, Fusco F, Berdondini E, Salonia A - Arab J Urol (2011)

Bottom Line: 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.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.

View Article: PubMed Central - PubMed

Affiliation: Center for Urethral and Genitalia Reconstructive Surgery, Arezzo, Italy.

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.

No MeSH data available.


Related in: MedlinePlus

Glans skinning and glans resurfacing: LS and carcinoma in situ involving the glans penis: the significant tissue changes due to LS create a serious situation of functional disability and disfigurement of the penis (A). Penile appearance 6 months after surgery (B).
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f0010: Glans skinning and glans resurfacing: LS and carcinoma in situ involving the glans penis: the significant tissue changes due to LS create a serious situation of functional disability and disfigurement of the penis (A). Penile appearance 6 months after surgery (B).

Mentions: In this context, when using total glans skinning and resurfacing, the epithelium is completely removed, thus reducing the potential risk of either disease recurrence or progression in different sites, as compared with the primary lesion [3]. On the other hand, the partial repair of the glans could easily create a disfiguring and dysfunctional scar. Moreover, for LS which involves the male genitalia, a progressive crippling disease scar has been frequently described, with subsequent phimosis that might promote poor local hygiene and chronic inflammatory conditions, potentially being the aetiological factors promoting penile malignancy (Fig. 2). In this case, LS is frequently associated with dysplasia, thus some authors have suggested that LS should be considered as a formal pre-cancerous lesion [11–13,18]. In particular, in the present series, in 23% of patients the tumour was associated with LS, confirming a close correlation between these penile pathologies. Thus, in cases of LS, total excision of the dysplastic glandular epithelium reduces the risk of cancer developing; likewise, this approach might solve the problem of discomfort during sexual intercourse, which is frequently a consequence of the scarred glans.


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

Palminteri E, Fusco F, Berdondini E, Salonia A - Arab J Urol (2011)

Glans skinning and glans resurfacing: LS and carcinoma in situ involving the glans penis: the significant tissue changes due to LS create a serious situation of functional disability and disfigurement of the penis (A). Penile appearance 6 months after surgery (B).
© Copyright Policy - CC BY-NC-ND
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4150571&req=5

f0010: Glans skinning and glans resurfacing: LS and carcinoma in situ involving the glans penis: the significant tissue changes due to LS create a serious situation of functional disability and disfigurement of the penis (A). Penile appearance 6 months after surgery (B).
Mentions: In this context, when using total glans skinning and resurfacing, the epithelium is completely removed, thus reducing the potential risk of either disease recurrence or progression in different sites, as compared with the primary lesion [3]. On the other hand, the partial repair of the glans could easily create a disfiguring and dysfunctional scar. Moreover, for LS which involves the male genitalia, a progressive crippling disease scar has been frequently described, with subsequent phimosis that might promote poor local hygiene and chronic inflammatory conditions, potentially being the aetiological factors promoting penile malignancy (Fig. 2). In this case, LS is frequently associated with dysplasia, thus some authors have suggested that LS should be considered as a formal pre-cancerous lesion [11–13,18]. In particular, in the present series, in 23% of patients the tumour was associated with LS, confirming a close correlation between these penile pathologies. Thus, in cases of LS, total excision of the dysplastic glandular epithelium reduces the risk of cancer developing; likewise, this approach might solve the problem of discomfort during sexual intercourse, which is frequently a consequence of the scarred glans.

Bottom Line: 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.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.

View Article: PubMed Central - PubMed

Affiliation: Center for Urethral and Genitalia Reconstructive Surgery, Arezzo, Italy.

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.

No MeSH data available.


Related in: MedlinePlus