Partial penectomy with reconstruction using a split-thickness skin graft: a multicenter experience.

BACKGROUND

Penile cancer is a relatively rare neoplasm in developed countries, with the majority of newly diagnosed cases presenting as organ-confined, with a 5-year survival rate of 90%. Therefore, it is crucial to consider the impact of penile tumor resection on sexual and urinary function. Regrettably, the literature is devoid of comprehensive, step-by-step video instructions for the surgical procedure of partial penectomy with reconstruction using a split-thickness skin graft (0.3 mm). This study aimed to demonstrate a step-by-step video of the partial penectomy technique with reconstruction using a split-thickness skin graft and to present the outcomes of this procedure.

METHODS

This multicenter study was initiated in April 2019 and completed in February 2023, enrolling 54 male patients who underwent partial penectomy and reconstruction using a split-thickness skin graft (0.3 mm). The study collected data on the local recurrence rates, overall survival, sexual and voiding functions and complications.

RESULTS

The average patient age was 61.26 years old (range: 26-82 years). Following penile-sparing surgery, a substantial proportion of patients exhibited favorable results. Among the 54 patients, 37 (68.5%) were classified as sexually active and 50 (92.6%) demonstrated good voiding function. Excellent cosmetic outcomes were achieved in 52 patients (96.3%), and the average size of the negative resection margins was 4.75±4.162 mm (range: 0.5 to 20 mm). Notably, no positive margins were observed. Patient outcomes depend on the tumor stage and histologic grade rather than the size of the surgical margin.

CONCLUSIONS

Partial penectomy with reconstruction using a split-thickness skin graft has excellent oncological, functional, and cosmetic outcomes.