Long-term side effects of penile cancer treatment
Effects on urination
Most men are still continent after surgery -- that is, they can still control the start and stop of urine flow. In certain cases, a partial penectomy leaves enough of the penis to allow relatively normal urination. Many men who have undergone a total penectomy 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 topical chemotherapy, Mohs surgery, and laser 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 devastating 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 still becomes 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 may be possible in some cases. If you are interested in this, ask your doctor if this might be an option for you.
For more information on these topics, see our document, Sexuality for the Man with Cancer.
Last Medical Review: 12/06/2013
Last Revised: 02/06/2014