Penis problems can vary greatly in nature and severity, from superficial issues such as benign neoplasms to urinary tract issues like urethral strictures and penile cancer. Dr. Hayden will consult with each patient to determine to best surgical course of action.
Circumcision (sleeve method)
Circumcision is the surgical procedure of removing the foreskin from the end of the penis. Adult circumcision is a common practice, either for voluntary reasons or to treat conditions such as phimosis (narrowing of the tip of the foreskin) and recurrent balanoposthitis (inflammation of the foreskin and glans). Dr. Hayden will consult with each patient about getting circumcised, and will employ the sleeve method (where the foreskin is removed from its retracted position) should circumcision be the desired course of surgical intervention. The recovery time from adult circumcision is about 10 days (for regular physical activity) and 6 weeks (for sexual activity). Please note that according to law, circumcision on boys younger than 16 years may only be performed for medical (and in some cases for religious) reasons and not upon parent’s request.
Excision of benign neoplasms
Superficial penis problems include benign tumours (also called benign neoplasms) and other non-cancerous skin lesions. These are collections of cells and other forms of tissue proliferation (such as moles and lipomas) that lack the ability to invade neighbouring tissue or to metastasize. Dr. Hayden will have to consult with each patient on an individual basis, but the excision of benign neoplasms from the penis is usually a relatively straight-forward surgical procedure. Recovery time from the removal of non-cancerous skin lesions from the penis is swift.
Glansectomy / partial penectomy for penile cancer
If a patient has been diagnosed with penile cancer they will be advised by Dr. Hayden on their surgical options. If the affected area is limited to the glans (the bulbous tissue at the end of the penis), then a glans amputation (glansectomy) might be enough to stop the spread of greater male organ cancer. Penile shaft tumours may benefit from a partial penectomy with glans reconstruction. Recovery time from this partial penectomy procedure (the removal of a section of the penis) will vary, and regular follow-up tests will be mandatory to ensure the success of the glansectomy or partial penectomy.
Total penectomy with perineal urethrostomy
In cases of severe or advanced penile cancer, Dr. Hayden might consult with the patient about a total penectomy (complete amputation of the penis for carcinoma). This surgical penectomy procedure may be crucial in stopping the spread of male organ cancer from the penis. If Dr. Hayden proceeds with total penectomy surgery, he will also perform a perineal urethrostomy (the creation of a permanent hole in the urethra to remove obstructions to urine flow). Recovery time from a total penectomy with perineal urethrostomy for carcinoma procedure will vary greatly from patient to patient, and will require consistent follow-up tests to ensure its success. A penectomy is often accompanied by a groin lymphnode removal procedure.
Urethroplasty for urethral strictures
A urethral stricture is the narrowing of the urethra (perhaps due to scarring or injury), resulting in blockages of the normal flow of urine. In severe cases, or if endoscopic methods (such as optic urethrotomy or urethral dilation) have been unsuccessful, Dr. Hayden might advise urethroplasty as a surgical form of urethral stricture treatment. This urethral stricture surgery involves a penile or perineal incision, before the urethra is reconstructed in a process of urethroplasty. The recovery time from a urethroplasty for urethral strictures procedure is 2-4 weeks.
A hypospadias is a rare penis condition where the urethral meatus, the opening in the penis that allows urine to flow out, is not located in its usual place (at the tip of the glans). A distal hypospadias is when the urethral meatus is located on the underside of the penis near the tip or glans. Recovery from hypospadias repair is usually 2-4 weeks, and will initially involve the fitment of a urinary catheter to manage pain and discomfort.
There are three main reasons for circumcision, which includes:
- In babies, the foreskin and glans may develop as one, only separating during childhood. Therefore, the foreskin of the child may be tight, inelastic and cause urinating problems.
- When the glans and/or foreskin are frequently inflamed.
- In adults, circumcision may be indicated when the foreskin is tight, resulting in painful sex.
Circumcision in infancy, but not in adulthood, may reduce the risk of penile cancer. Infants are not necessarily routinely circumcised due to the operative and anaesthetic risks involved.
Possible early risks or complications of penectomy include:
- Excessive bleeding
- Urinary tract infection
- Infection at the site of surgery
- Lymphedema (swelling) of the legs and/or scrotum