Urology Video Journal (Dec 2020)
Glansectomy in a young Asian man: Preservation of length and function
Abstract
Introduction: Glansectomy and split skin graft (SSG) reconstruction is an organ sparing surgical technique that is indicated for clinically T1 and T2 disease involving the glans penis. Depending on the grade of tumor, a negative surgical margin of 3 – 8mm is acceptable, and the local recurrence rate of 4 – 9% approximates that of partial penectomy [1–4]. In this video, we present the surgical technique of glansectomy and SSG in a young Asian male, who was able to preserve penile length and function post-operatively. Materials and methods: Our patient was a 42-year-old Chinese male. He had an uncircumcised penis with a stretched penile length of 9cm. He presented with a 3cm warty well-differentiated squamous cell carcinoma (SCC) involving the prepuce and glans from 7 to 12 o'clock position. We performed glansectomy and SSG similar to the technique described by Bracka [5]. Results: The final histology showed well-differentiated SCC involving the corpus spongiosum and a 3mm negative margin (pT2G1). The patient had a partial graft loss at 2 weeks that healed without any intervention. Functionally, he had a stretched penile length loss of only 2 cm from 9 cm to 7 cm. He had a normal post-operative erectile function and no bothersome urinary symptom. There was no local recurrence or distant metastasis at 10 months post-operation. Conclusion: In eligible patients, glansectomy and SSG achieves good oncological outcomes with a low complication rate. In this case, we were able to demonstrate good cosmetic satisfaction, preservation of penile length, and excellent functional outcomes.
