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Genital area of male after partial penectomy.

Not to be confused with Castration.

Penectomy is the surgical removal of the penis for medical or personal reasons.

Medical reasons for penectomy

Cancer, for example, sometimes necessitates removal of part or all of the penis.^[1] The amount of penis removed depends on the severity of the cancer. Some men have only the tip of their penis removed. For others with more advanced cancer, the entire penis must be removed.^[2]

In very rare instances, botched circumcisions have also resulted in full or partial penectomies, as with David Reimer.

Fournier gangrene can also be a reason for penectomy and/or orchiectomy.

Support following penectomy

Because of the rarity of cancers which require the partial or total removal of the penis, support from people who have had the penis removed can be difficult to find locally. Website support networks are available.^[2] For instance, the American Cancer Society's Cancer Survivors Network website provides information for finding support networks.^[3]

Sexual support following penectomy

Sexual support therapists and specialists are available nationally and can be accessed through the specialist cancer services.^[2] Many surgeons or hospitals will also provide this information post operatively. Local government health services departments may be able to provide advice, names, and contact numbers.

Personal reasons for penectomy

Genital surgical procedures for trans women undergoing sex reassignment surgery do not usually involve the complete removal of the penis. Instead, part or all of the glans is usually kept and reshaped as a clitoris, while the skin of the penile shaft may also be inverted to form the vagina (some more recently-developed procedures, such as that used by Dr. Suporn Watanyusakul use the scrotum to form the vaginal walls, and the skin of the penile shaft to form the labia majora). When procedures such as this are not possible, other procedures such as colovaginoplasty are used which may involve the removal of the penis.

Issues related to the removal of the penis appear in psychology, for example in the condition known as castration anxiety, which happens as a result of a man having anxiety as to whether he may at some point become castrated.

Some men have undergone penectomies as a voluntary body modification, but professional opinion is divided as to whether or not the desire for penile amputation is a pathology, thus including it as part of a body dysmorphic disorder. Usually fantasy, as in castration, but at other times gender confusion or hatred, or even psychosis can result in penectomy. A eunuch adds:

"Removal of the penis is desired by some gay males, usually those already made eunuchs. Some eunuchs later desire penis removal only after having been eunuchs for several years. Removal of the penis is involved and requires significantly greater skill than removal of the testes. Use of elastrator bands is recommended to prevent loss of blood. Advanced techniques of nullification include severing the suspensory ligaments to drop the penis before amputating it, to produce a urinary outlet lower down for convenience. A new urinary opening may be made between the root of the penis and the anus, but this involves advanced incision and suturing skills. Such an opening reduces the need to remove more of the penis itself to lower the urinary opening for convenience. Preservation of the penis in formalin results in a leathery gray rod and retention of the thickness and volume of the original organ is usually not satisfactory as a display keepsake. Few accounts exist on the eating of the amputated penis and no reliable data exists as to its texture or taste." ^[4]

Males who consider themselves third sex will sometimes want an emasculation, i.e., they opt to have their penis and/or testicles removed.

References

^ Korets, Ruslan; Koppie, Theresa M.; Snyder, Mark E.; Russo (2007). "Partial Penectomy for Patients With Squamous Cell Carcinoma of the Penis: The Memorial Sloan-Kettering Experience". Annals of Surgical Oncology 14 (12): 3614–3619. doi:10.1245/s10434-007-9563-9. ISSN 1068-9265. PMID 17896151.
^ ^a ^b ^c Kennard, Jerry (2006-07-22). "Penectomy: Partial and Total Removal of the Penis". About.com. http://menshealth.about.com/od/cancer/a/Penectomy.htm. Retrieved 2011-09-25.
^ "Cancer Survivors Network". American Cancer Society. http://csn.cancer.org/. Retrieved 2011-09-25.
^ Penectomy. "BMEzine Encyclopedia". http://wiki.bmezine.com/index.php/Penectomy

UpToDate Contents

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1. 陰茎癌：診断、治療、および予後 carcinoma of the penis diagnosis treatment and prognosis
2. 男性における尿道癌 urethral cancer in men
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English Journal

A urologist's contemporary guide to penile cancer.

Jakobsen JK1.
Scandinavian journal of urology.Scand J Urol.2015 Aug 27:1-6. [Epub ahead of print]
Few urologists deal with penile cancer on a daily basis. Owing to the rarity of the disease and its diversity in presentation, clinical experience accumulates slowly and new paradigms spread sporadically. This review provides a concise update on the background, clinical features and multidisciplinar
PMID 26313403

A urologist's contemporary guide to penile cancer.

Jakobsen JK1.
Scandinavian journal of urology.Scand J Urol.2015 Aug 14:1-6. [Epub ahead of print]
Few urologists deal with penile cancer on a daily basis. Owing to the rarity of the disease and its diversity in presentation, clinical experience accumulates slowly and new paradigms spread sporadically. This review provides a concise update on the background, clinical features and multidisciplinar
PMID 26271526

Usefulness of sonourethrography for penile abscess as a result of xanthogranulomatous granuloma in the corpus cavernosum of an adult: A case report.

Minagawa T1, Kato H1, Ogawa T1, Uehara T2, Ishizuka O1.
International journal of urology : official journal of the Japanese Urological Association.Int J Urol.2015 Aug;22(8):788-90. doi: 10.1111/iju.12816. Epub 2015 May 26.
A 75-year-old man presented with a 4-month history of a swollen and painful penis. Computed tomography showed a round-shaped mass measuring 3 × 2 cm in the corpus cavernosum. Percutaneous drainage of the penile mass was carried out and a course of antibiotics was prescribed. Viral, fungal and
PMID 26011679

Japanese Journal

陰茎全摘術を余儀なくされた陰茎海綿体膿瘍の1例

小山淳太朗,並木俊一,神山佳展 [他]
泌尿器科紀要 = Acta urologica Japonica 61(3), 109-114, 2015-03
NAID 40020413753

TIP (Paclitaxel, Ifosfamide, Cisplatin) 療法が著効した鼠径リンパ節転移を有する陰茎癌の1例

久保田恵章,仲野正博,永井真吾,松岡加恵,荒川裕貴,堀江憲吾,出口隆,加藤久和
泌尿器科紀要 = Acta urologica Japonica 61(1), 33-37, 2015-01
… Penile cancer (clinical stage T3N3M0, 7th edition TNM classification) was diagnosed, and partial penectomy and right inguinal biopsy were performed. …
NAID 120005539307

陰茎壊死, 敗血症をきたした輪ゴムによる陰茎絞扼症の1例

佐々木雄太郎,小田眞平,藤方史朗,谷本修二,菅政治
泌尿器科紀要 = Acta urologica Japonica 60(3), 155-157, 2014-03
… Gangrene of the penis continued and he did not recover from sepsis, so we performed partial penectomy. …
NAID 120005439492

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