Long-term side effects of penile cancer treatment
Penile cancer and its treatment can sometimes lead to long-term side effects.
Effects on urination
Most men can still control the start and stop of urine flow after surgery. They are still continent. But if the surgery removes part of the penis (partial penectomy) or the entire penis (total penectomy), how a man urinates can be affected. In some cases, a partial penectomy leaves enough of the penis to allow relatively normal urination. But men who have had a total penectomy often must sit to urinate.
Effects on sexuality
If cancer of the penis is diagnosed early, treatments other than penectomy can often be used. Conservative techniques such as circumcision, local therapy other than surgery (laser ablation, topical chemotherapy), or Mohs surgery may have little effect on sexual pleasure and intercourse once you have fully recovered.
Removing all or part of the penis can have a huge effect on a man’s self-image and ability to have sexual intercourse. You and your sexual partner may wish to consider counseling to help understand the impact of treatment for penile cancer and to explore other approaches to sexual satisfaction.
Satisfying intercourse is possible for many, but not all men after partial penectomy. The remaining shaft of the penis can still become erect with arousal. It usually gains enough length to achieve penetration. Although the most sensitive area of the penis (the glans, or “head”) is gone, a man can still reach orgasm and ejaculate normally. His partner should also still be able to enjoy intercourse and often reach orgasm.
Normal intercourse is not possible after total penectomy. Some men give up sex after the surgery. Since cancer of the penis is most common in elderly men, some are already unable to have intercourse because of other health problems. If a man is willing to put some effort into his sex life, however, pleasure is possible after total penectomy. He can learn to reach orgasm when sensitive areas such as the scrotum, skin behind the scrotum, and the area surrounding the surgical scars are caressed. Having a sexual fantasy or looking at erotic pictures or stories can also increase excitement.
A man can help his partner reach orgasm by caressing the genitals, by oral sex, or by stimulation with a sexual aid such as a vibrator. The activity some couples enjoy after total penectomy can give hope to those coping with fewer changes in their sex lives.
After total penectomy, surgical reconstruction of the penis might be possible in some cases. If you are interested in this, ask your doctor if this might be an option for you.
Removing all or part of the penis can also have a devastating effect on a man’s self-image. Some men might feel stressed or depressed, or might not feel “whole” after the operation. These are valid and understandable feelings, but they can often be helped with counseling or talking with others. For more on this, see the section “How might having penile cancer affect your emotional health?”
For more information on sexuality after cancer, see Sexuality for the Man with Cancer.
The lymph nodes in the groin area normally help excess fluid drain out of the lower part of the body and back into the bloodstream. If the groin lymph nodes are removed or treated with radiation, it can sometimes lead to problems with fluid drainage in the legs or scrotum, causing abnormal swelling. This condition is called lymphedema.
This problem was more common in the past because more lymph nodes were removed to see if the cancer had spread. Now fewer lymph nodes are usually removed, which lowers the risk of lymphedema. But lymphedema can still occur even with less treatment. For more on this, see Understanding Lymphedema: For Cancers Other than Breast Cancer.
Last Medical Review: 03/30/2015
Last Revised: 02/09/2016