This information has been provided to give you guidance about having a procedure known as a glansectomy. Your consultant and team will have discussed this with you verbally during your consultation in clinic, which this information will support.
What is a glansectomy?
A glansectomy is a surgical procedure that is performed to remove cancer which is believed to be confined to the head of the penis. The surgical technique removes the head of the penis, known as the glans, which is believed to be affected. There is likely to be a loss of length of around 2 cm and a skin graft is taken from your thigh, to cover the end of the penis. This is performed in order provide a reasonable cosmetic appearance. In addition, as part of the procedure you are likely to have a circumcision at the same time if you have not been previously circumcised.
Why is this necessary?
The glansectomy has been recommended by your team to treat the cancer that has grown on the head of your penis. Your cancer is a small one and is amenable to removal of just the head of the penis. Your treatment will have been discussed within a multidisciplinary team which includes surgeons, oncologists, radiologists, pathologists and nurses and they feel that the glansectomy is the best option for treating your tumour. Your surgeon will discuss this with you, and outline other options, if they are potentially suitable.
Admission Hospital for your operation
On the day of your clinic appointment you will be asked to attend the pre-assessment clinic to assess whether you are fit for the proposed surgery. You will have questions asked about your general health and fitness, you will have blood tests taken and potentially will have an ECG.
On some occasions it will be necessary for you to return at a separate date to have this pre-assessment appointment.
On the day of your operation you will be admitted to the admission lounge early in the morning, when you will have a further opportunity to talk to the surgeon and the anaesthetist about your procedure. The ward staff will familiarise you with the routine of the ward and show you where the facilities are.
Your operation
The surgery will be performed under a general anaesthetic, where the surgeon will remove the cancer from the head of your penis. A skin graft will be taken from the upper aspect of your thigh and a dressing will be stitched in place over the skin graft in order to hold it in place. You will have a catheter inserted. There will also be a dressing on your thigh, covering the site where the skin graft has been taken from.
After your operation
When your surgery is finished you will be taken to the recovery area, where you will be monitored until your condition is stable.
Then you will be allowed to go back to the ward. When you get back to the ward you will be able to eat and drink normally and you will be given pain killers, as needed on a regular basis. It is important that you feel as comfortable as possible after the surgery and so you should ask for pain killers if you are feeling any discomfort.
Initially the dressing, which is stitched onto the end of the penis will look bloody and then will become more black and crusty. This is the normal appearance and should not concern you. The dressing on your penis and the catheter will remain in place for 7-10 days to allow the skin graft to heal.
Back to topPreparation for discharge
The ward staff will check your wound regularly whilst you are on the ward and the doctors will see you on a daily basis to assess your progress. When they are happy with your recovery you will be allowed to go home. It is usual to be able to go home on the day after a glansectomy (length of stay 24-48 hours).
You will be given painkillers to take with you and we would advise that you take them as prescribed in order to prevent pain. Please do not exceed the stated dose on the pack. Generally, the discomfort will take a few days to go away and can often be associated with the dressing on the tip of the penis.
The dressing and the catheter will remain in place for 7-10 days. You will return to clinic 7-10 days later for the catheter and for the penile dressing to be removed (the nurse specialist will liaise with you and arrange this – sometimes once you have been discharged).
- There is a dressing stitched onto the end of your penis – this will look black and crusty – that is normal.
- It is quite blunt, but is meant to help and reassure you that what looks and smells awful is actually quite normal when you have had this type of surgery.
- There is also a dressing on your leg where the skin graft was taken from, it is covered with a bandage. It is important that this is not disturbed until you return to the clinic.
- You will be shown how to look after the catheter by the nursing team on the ward before you go home.
Follow up after glansectomy
You will be given an appointment to come to the clinic within 7-10 days of your operation. At that appointment, you will have the catheter and the dressing removed from your penis. The nurse who removes the catheter and dressing will explain to you how to look after the skin graft and will ensure that you are able to pass urine before you go home. You will be seen 7 days later to have the dressing removed from the skin graft site on your thigh. If you travel a long way, there is potential this could be removed by your practice nurse. Discuss with the CNS regarding this.
You will be able to shower once the first dressing on your penis has been removed. However try to avoid direct contact with soap products. It is important that at first you dry the skin graft site very carefully so as not to dislodge the skin graft itself. A hair dryer is often helpful in this respect but if you are drying the wound then pat the wound dry with a cloth that does not shed fibres.
The area on your thigh will need a waterproof dressing covering it when you are showering or until the dressing is removed after two weeks.
If the bandage to your leg comes off at home, do not worry, this does not need to be reapplied.
It is however important that the plaster to your leg remains untouched, if this starts to be come loose, DO NOT remove this, simply apply other plasters/dressings over the top. Removal of this dressing too soon can lead to slow healing and possible wound infections.
Both the wound on your thigh and the wound on the penis can become smelly. This is often part of the normal healing process and is usually nothing to worry about. If you do have concerns, please contact either the nurse specialist at the Hospital. You will be seen by a consultant to discuss the results of the biopsy and your on-going progress within within 4-6 weeks, this will happen in the outpatient department
If you have any problems or worry before that appointment then you can phone the clinical nurse specialist. This is an answer-phone service and please leave a message with your name and telephone number and she will call back to you. Alternatively you can contact the consultant’s secretary.
Back to topWhat are the risks of the operation?
Any surgical intervention can pose risks. However for the majority of patients, this is a straightforward procedure and the risk of any side effects is low.
In the short term risks include bleeding from the wound, wound infection, poor healing of the wound, bruising, swelling and blood clots in the lower leg.
This last potential complication is rare and is called a deep vein thrombosis. We will provide you with elasticated stockings before your surgery as a means to trying to prevent this complication and we will also arrange for you to have injections of a special drug into your abdomen on a daily basis as a means of trying to prevent this complication while you are in hospital.
In the long-term the operation will affect the way that you pass urine and will affect sexual function. These issues are discussed in more detail below.
How will my body be affected by the operation?
The cosmetic result after this operation can never be perfect but the intention is that the penis looks as close to normal as is possible given that the head of the penis has been removed.
Contact numbers:
Urology Nurse Specialists
Jo Stead, Betty Jackson and Victoria Washington. The Urology Nurse Specialists can be contacted via the link below.
Secretary
Mr Eardley / Mr Gordon / Mr Elmamoun
Leeds Cancer Support
Leeds Cancer Support complements care provided by your clinical team.
We offer access to information and a wide range of support, in a welcoming environment for you, your family and friends.
We can be found in the information lounges in Bexley Wing and also in the purpose built Robert Ogden Macmillan Centre.
Back to topContact numbers for Leeds Cancer Support
Information Centre, Level 1 Outpatients Department
Information Lounge, Level 2 Radiotherapy Department
Sir Robert Ogden Macmillan Centre
All the above services can be emailed via the link below.
Leeds Cancer SupportThe Sir Robert Ogden Macmillan Centre
The Centre is on the St James’s Hospital site and offers a variety of support services including counselling, support groups and complementary therapies. These therapies include Reiki, relaxation and visualisation, hand and foot massage and many others. You can just drop in for a coffee and a chat anytime.
Health Talk support service
Health talk is an online service where you can find information and support by seeing and hearing patients real life experiences.
In co-ordination with researchers from the Centre for Men’s Health at Leeds Metropolitan University spoke to 27 men in their own homes. You can explore what these people felt about issues such as symptoms, treatment, body image and sex. We hope you find the information helpful and reassuring.
www.healthtalk.org Back to topWhere can I find more Information?
Maggie’s Yorkshire
Charity providing free cancer support and information.
Macmillan Cancer Support
Freephone:
References:
Orchid male cancer support 2017. Partial Penectomy
Orchid male cancer support 2017. Total Penectomy
The Christie Patient Information Service May 2015
CHR/SUR/600/17.06.08 version 4
Back to top