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Inicio Actas Urológicas Españolas (English Edition) Partial penectomy and penile reconstruction. Initial surgical management of loca...
Journal Information
Vol. 38. Issue 1.
Pages 62-65 (January - February 2014)
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Vol. 38. Issue 1.
Pages 62-65 (January - February 2014)
Casuistry
DOI: 10.1016/j.acuroe.2013.10.010
Partial penectomy and penile reconstruction. Initial surgical management of localized penile cancer
Penectomía parcial y reconstrucción peneana. Manejo quirúrgico inicial del cáncer de pene localizado
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J. Pérez-Niñoa,??
Corresponding author
jaime.perez@javeriana.edu.co

Corresponding author.
, N. Fernándezb, G. Sarmientoc
a Urólogo, Profesor Asistente Facultad de Medicina Pontificia Universidad Javeriana, Hospital Universitario San Ignacio, Bogotá, Colombia
b Residente III de Urología Pontificia Universidad Javeriana, Estudiante de Doctorado (PhD) Ciencias Básicas, Pontificia Universidad Javeriana, Hospital Universitario San Ignacio, Bogotá, Colombia
c Urólogo, Clínica Ardila Lulle, Profesor Universidad Autónoma, Bucaramanga, Colombia
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Abstract
Introduction

Surgical management for penile carcinoma is mutilating and affects significantly quality of life. Hereby we present our experience on penile reconstruction (PR) immediately after oncologic resection.

Materials and methods

We included all patients from January 2007 until April 2012 who underwent PR after partial penectomy (PP). Patients included in the study were seen at four different hospitals. All procedures were done by the same surgeon. Information included were: oncological status at the moment of surgery, surgical technique used for reconstruction. Each case was also registered photographically. On follow-up visits data about outcome and patient's satisfaction were registered.

Results

During the study period 15 patients underwent PR. Average age at the moment of surgery was 49 years. Average follow-up was 15 months. In 12 patients PR was made at the same time as PP. Of those, four cases underwent glans resurfacing, 2 glandectomy, 6 partial penectomy, and the remaining 3 have had PP in a different time in the past. Every case underwent a split thickness graft procedure. Only 2 patients had postoperative complications. One of them presented urethral stricture and the other had graft ischemia. Three patients had positive nodes at the moment of PP and two during the follow-up. None of the cases have presented local recurrence and only one died. On follow-up the remaining patients refer a good quality of life and felt happy with esthetic results.

Conclusions

Given the results presented hereby we propose that PR must be part of the same procedure as the PP.

Keywords:
Penile carcinoma
Reconstruction
Graft
Resumen
Introducción

La cirugía para el cáncer de pene (CP) es mutilante y afecta significativamente la calidad de vida de los pacientes. Mostramos nuestra experiencia en reconstrucción peneana (RP) y proponemos el manejo reconstructivo simultáneamente con el oncológico.

Materiales y métodos

Se registraron todos los pacientes llevados a RP en 4 hospitales universitarios de Colombia por el mismo cirujano (JPN), desde 2007 hasta abril de 2012. Las variables analizadas fueron: indicación de la reconstrucción, estado oncológico del paciente, técnica quirúrgica y seguimiento. Se documentó fotográficamente cada caso.

Resultados

Se realizaron 15 RP, edad promedio 49 años y seguimiento promedio 15 meses. En 12 pacientes se hizo el procedimiento oncológico y la reconstrucción simultáneamente, 4 con desepitelización (resurfacing) del glande, 2 con glandectomía y 6 con penectomía parcial; los 3 restantes tenían penectomía previa. Todos los injertos fueron de piel de espesor parcial y el sitio donante la cara externa de la cadera. Hubo 2 complicaciones relacionadas con la reconstrucción, una estrechez del meato uretral y otro caso con isquemia en el 30% del injerto. En 3 pacientes se encontró enfermedad ganglionar desde el diagnóstico inicial y en 2 durante el seguimiento; ninguno ha tenido recaída local y uno murió por su enfermedad de base. Los demás han reportado calidad de vida adecuada con buenos resultados cosméticos y funcionales.

Conclusiones

La reconstrucción del pene debe ser propuesta simultáneamente con la penectomía parcial y en un mismo tiempo quirúrgico.

Palabras clave:
Carcinoma de pene
Reconstrucción
Injerto

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