A penectomy procedure—partial or complete removal of the penis—can be performed for a variety of reasons. If a child’s penis is injured beyond repair during a circumcision, if penile cancer necessitates removal or if a male pursues gender reassignment surgery, a penectomy in full or in part may be included in treatment. In spite of the psychological issues surrounding this kind of surgery, many variations on the penectomy exist, sometimes allowing for a male to be left with a part of the penis that may later be surgically reconstructed.
Partial penectomies are intended to save as much of the penis as possible in order to allow normal sexual and urinary function. They are usually performed in cases of penile cancer. During a partial penectomy the anesthetist will administer medicine to numb the affected area. Urinary function is diverted to the area between the scrotum and the anus for the course of the procedure. A partial penectomy may remove any part of the penis—often the head, or the glans, of the penis is the part removed in this type of procedure, but doctors have recently tried to preserve as much of the glans and shaft as possible to allow for normal urination and sexual function. Several centimeters of healthy tissue are usually removed along with the cancer to avoid recurrence. Plastic surgery may be attempted later to restore functionality to the penis.
Total, or radical, penectomies involve the removal of your whole penis. While the procedure is relatively similar to a partial penectomy in some ways, surgeons must make special allowances in this type of surgery to ensure that bodily functions continue to work properly. For example, urinary diversion to the area between the scrotum and the anus is made permanent. If the bladder is removed, a catheter must often be placed through the body via the small intestine to allow urination to occur. Urine is then collected in a bag outside the body that can usually be worn underneath clothing. Plastic surgery is rarely attempted following this type of surgery, but at times doctors will attempt to reconstruct the penis using skin from a patient’s forearm to create a new penis.
Some penectomy patients want genital surgery to “reassign” their physical sex. People who are born male but identify as females might follow up a penectomy with a vaginoplasty in order to experience womanhood to a fuller degree. In cases of sexual reassignment, a total penectomy is usually not required. Rather, a doctor will divert urinary function, use the shaft of the former penis to create a vagina, and use the glans of the penis to form a sexually functional clitoris. Alternative types of vaginoplasty are available that do require full removal of the penis. Such radical types of body modification are not usually recommended by doctors, as the risks are high and the realization of fully functioning sexual organs following such procedures is difficult.