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Penis Resection

Implementation

Small tumors are removed under local anesthesia, block anesthesia, or general anesthesia/spinal anesthesia.

  • A penile block is performed. The anesthesia is injected at the root of the penis.
    • Find the edge of the pubic bone.
    • Perform the injection deep into the pudendal nerve and the dorsal nerve of the penis. Inject slowly.
    • Allow the anesthesia to work for 10 minutes.
    • Inject local anesthesia around and under the tumor. Allow it to work for 2 minutes.
    • Check with forceps whether the anesthesia is adequate.
  • Squeeze the glans/distal penis and apply a tourniquet to stop blood flow. 
  • Mark the borders of the resection (free margins) to the sides and in depth).  
  • Resect with good margins around the tumor.
  • Inspect the specimen for macroscopically involved margins.
  • Orient the specimen and mark with sutures toward the meatus and dorsally.
  • Place the specimen in a cup with formalin.
  • Assess whether it is necessary to repair the defect on the glans with a transplant.
  • Release the tourniquet and stop blood flow with diathermy, or possibly with small suture ligatures.
  • Suture the incision or transplanted epithelia from the prepuce/mouth/skin.
  • Apply a vaseline bandage.
  • Pull the prepuce forward.
  • Insert a thin catheter. (Ch 10 -14)
  • Bandage with mild compression.   

 

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