Functional outcomes of glansectomy to treat localised penile cancer: a systematic review

TL;DR

This study reviews the functional outcomes of glansectomy for penile cancer, showing high satisfaction and preserved function, but highlights the need for standardized reporting guidelines.

Contribution

The paper systematically reviews functional outcomes of glansectomy and identifies the lack of standardized assessment tools as a key limitation.

Findings

Glansectomy preserved erectile function in 91.1% of patients.

86.3% of patients reported satisfaction with the overall appearance post-surgery.

Recurrence rate was 9.1% with a mean follow-up of 40.7 months.

Abstract

Glansectomy with or without a neoglans reconstruction is commonly performed for invasive penile cancer confined to the glans penis. The aim of penile-preserving procedures is to maintain sexual and urinary function without compromising oncological outcomes. A systematic review was performed to evaluate the functional outcomes following glansectomy. Overall, 14 studies which included 327 glansectomy procedures were analysed. At a mean follow-up of 40.7 (range, 13–52) months, the recurrence rate was 9.1% (0–25%) and the disease-specific survival rate was 87.5–100%. Partial graft loss and meatal stenosis occurred in 6.1% (0–17.6%) and 8.1% (0–14.3%) respectively. 91.1% (50–100%) had preserved erectile function and 62.5% (33.3–100%) were sexually active. 75.6% (66.7–100%) of patients were voiding whilst standing up and 83.7% (63.6–91.2%) had maintained glans sensation. Satisfaction with the overall appearance was achieved in 86.3% (68.2–100%). The reporting of functional outcomes was heterogenous with a limitation that there are no standardised guidelines on the assessment of functional outcomes following glansectomy. Further research should focus on identifying appropriate tools for reporting functional outcomes following glansectomy and standardising reporting.

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