Does Penile Cancer Mean the Penis Has to Be Removed?
Being told that you may have penile cancer can immediately raise a frightening question: “Does this mean my penis will have to be removed?”
For many men, the answer is no.
Modern penile cancer treatment aims to completely treat the cancer while preserving as much normal penile tissue, urinary function and sexual function as is safely possible. Current international guidelines recommend penile-preserving treatment when it is oncologically appropriate.[1]
However, penile cancer is not one single situation. The treatment required depends on where the cancer is located, how deeply it has grown, its grade and stage, and whether it has spread to lymph nodes.
Does Penile Cancer Always Require Penectomy?
No.
A penectomy means surgical removal of part or all of the penis. Although this remains an important treatment for some penile cancers, it is not automatically required simply because penile cancer has been diagnosed.
For appropriately selected early or localised cancers, treatment may include:
Circumcision
Local removal of the tumour
Glans resurfacing
Partial glansectomy
Total glansectomy with reconstruction
Other penile-preserving approaches
Radiotherapy in selected patients
The goal is to remove or control the cancer without unnecessarily removing uninvolved penile tissue.[1,2]
You can read more about the broader treatment pathway on the Penile & Testicular Cancer page.
What Determines Whether the Penis Can Be Preserved?
One of the most important factors is how deeply the cancer has invaded.
Very superficial disease
Some abnormal penile cells remain within the surface layers rather than invading deeper tissues. This is sometimes called penile intraepithelial neoplasia (PeIN).
Depending on the location and extent, management can include circumcision, topical or local treatments, or removal and reconstruction of the affected surface of the glans.
Cancer confined to the foreskin
A small cancer limited to the foreskin may sometimes be adequately treated by circumcision, provided pathological assessment confirms appropriate clearance.
Cancer confined to the glans
Even invasive cancer involving the head of the penis does not necessarily require removal of the penile shaft.
Options can include removing the tumour with a margin of normal tissue or removing part or all of the glans while preserving the shaft.[1-3]
Following glansectomy, reconstruction can sometimes be performed to create a new surface over the end of the penis.
Deeper cancer involving the erectile bodies
More extensive surgery becomes more likely when cancer has grown deeply into the penis.
In particular, invasion into the corpora cavernosa — the erectile bodies within the shaft — is an important threshold. Current guidelines recommend partial penectomy for many cancers involving these deeper structures when adequate cancer clearance cannot be achieved with a penile-preserving operation.[1]
Large or very advanced local tumours
A total penectomy may occasionally be necessary when a tumour is too large or extensive for a safe partial operation.
This is generally reserved for circumstances in which removing less tissue would not provide adequate cancer treatment.[1]
What Is Penile-Preserving Surgery?
Penile-preserving surgery is not one operation. It describes several techniques designed to remove cancer while retaining as much functional penis as possible.
Wide local excision
A small tumour may sometimes be removed along with a margin of normal-looking tissue.
Modern understanding of penile cancer has allowed surgeons to use more conservative margins in appropriately selected cases rather than routinely removing a large additional length of penis.[1,3]
Glans resurfacing
For selected superficial cancers or precancerous changes affecting the glans, the abnormal surface can sometimes be removed while preserving the deeper glans tissue.
A skin graft is commonly used to resurface the area.
Glansectomy
If cancer has invaded more deeply into the glans but remains suitable for organ-preserving treatment, part or all of the glans may be removed.
The remaining penile shaft is preserved, and reconstruction may be performed to create a new end or “neoglans”.
A systematic review of glansectomy for penile cancer found that this approach can provide cancer control while preserving penile length and function in appropriately selected patients.[3]
If penile or genital reconstruction may be relevant, further information is available under Penile, Genital & Urinary Reconstruction.
Can You Still Urinate Normally After Penile-Preserving Surgery?
Many men undergoing penile-preserving surgery are able to continue passing urine through the end of the penis.
The exact result depends on the operation performed.
After procedures such as glansectomy and reconstruction, urinary spraying or narrowing of the urinary opening can occur. However, many patients remain able to urinate while standing.[4-6]
A 2026 systematic review examining 327 glansectomy procedures reported that approximately three-quarters of patients in the included studies were able to void while standing.[4]
These figures describe groups of patients in published studies. They cannot predict an individual patient's result, and outcomes depend on the tumour, operation, previous treatment, healing and other individual factors.
What About Erections and Sexual Function?
This is understandably one of the most important concerns for many men.
Penile-preserving surgery is intended, where safely possible, to retain enough penile tissue to preserve sexual and urinary function.
Studies suggest that erectile function can often be preserved after organ-preserving procedures, although sensation, penile appearance, sexual confidence and sexual satisfaction can all change following treatment.[4-6]
A recent systematic review of glansectomy reported preserved erectile function in many patients, but the authors also emphasised that the available studies are relatively small and use different ways of measuring outcomes.[4]
It is therefore important not to interpret published percentages as a guarantee of what will happen after surgery.
The likely effect on:
Penile length
Erections
Sensation
Ejaculation
Penetrative intercourse
Urination
Appearance
should ideally be discussed before treatment whenever circumstances allow.
Is Penile-Preserving Surgery as Safe for Cancer?
The central priority remains cancer control.
Penile-preserving surgery may have a higher risk of the cancer returning locally on the penis than more extensive surgery. This is why careful patient selection and regular follow-up are important.[1,2,7]
In one large historical series, local recurrence was more common after penile-preserving treatment than after partial or total penectomy. However, in appropriately selected patients, penile preservation was not associated with worse cancer-specific survival after adjustment for other factors.[7]
A large systematic review has similarly supported penile-preserving treatment as an appropriate option for selected patients, while emphasising the limitations of the available evidence.[2]
This balance is important:
Preserving more penile tissue can offer functional and psychological advantages, but it may require closer surveillance and acceptance of a greater risk of local recurrence.
For some men, more extensive surgery provides the safest cancer treatment.
Why Do the Groin Lymph Nodes Matter?
The amount of penis that needs to be removed and whether the cancer has spread are related questions, but they are not the same question.
Penile cancer commonly spreads first to lymph nodes in the groin.
Depending on the tumour stage, grade and examination findings, lymph-node assessment may therefore be an important part of treatment planning.[1]
A relatively small penile tumour can occasionally have features that make lymph-node investigation important, while a larger local tumour may still have no lymph-node spread.
Appropriate management of the groin lymph nodes is one of the major factors influencing outcomes in penile cancer.[1]
When Is Partial Penectomy Necessary?
A partial penectomy removes the cancer and part of the penile shaft while retaining as much usable penile length as is safely possible.
It may be recommended when:
The cancer extends too deeply for a local operation
The erectile bodies are involved
An adequate cancer-free margin cannot otherwise be achieved
A tumour has returned after previous penile-preserving treatment
The size or position of the cancer makes preservation unsafe
The urinary opening is reconstructed at the end of the remaining penis.
How much length can be preserved varies considerably between patients.
When Is Total Penectomy Necessary?
A total penectomy means removal of the penis and is generally reserved for more extensive local disease where adequate cancer clearance cannot safely be achieved with a partial operation.[1]
When this is required, the urethra can usually be redirected to an opening in the perineum, called a perineal urethrostomy, allowing urine to pass while sitting.
For a patient facing this possibility, discussions about urinary function, sexual function, body image, psychological support and possible reconstructive considerations are important parts of treatment planning.
Does Reconstruction Have a Role?
Yes, in selected situations.
Reconstructive techniques may be incorporated into penile-preserving cancer surgery. Examples include skin grafting following glans resurfacing or glansectomy and reconstruction of the end of the penis.
Reconstructive options depend heavily on:
What tissue needs to be removed
Previous operations
Previous radiotherapy
Tissue quality
Cancer stage
Urinary function
Individual priorities
Reconstruction should never compromise adequate cancer treatment.
More information is available on the Penile, Genital & Urinary Reconstruction page.
What If I Have Just Been Diagnosed With Penile Cancer?
Before assuming that the whole penis will need to be removed, it is useful to establish several details:
Has the diagnosis been confirmed by pathology?
Where exactly is the cancer located?
How deeply has it invaded?
What grade is the tumour?
Are the erectile bodies involved?
Do the groin lymph nodes need assessment?
Is a penile-preserving operation oncologically appropriate?
What are the expected urinary, sexual and reconstructive consequences of each option?
Treatment should be individualised rather than determined by the word “cancer” alone.
Take home message
Penile cancer does not automatically mean the penis has to be removed.
For selected localised cancers, modern treatment can include circumcision, local excision, glans resurfacing, glansectomy and other penile-preserving approaches.
For deeper or more extensive disease, partial penectomy may provide the safest cancer treatment while still preserving some penile length. Total penectomy is generally reserved for tumours that cannot be adequately treated with less extensive surgery.[1]
The appropriate balance between cancer control and preservation of penile function depends on the individual tumour and should be discussed after appropriate examination, pathology review and staging.
Seeking Assessment for Penile Cancer
If you have been diagnosed with penile cancer, have received an abnormal penile biopsy, or have a persistent penile lesion that has not healed, specialist assessment can help clarify the diagnosis, stage and available treatment options.
Dr Jack Crozier provides assessment and surgical care for penile cancer in Brisbane, including consideration of penile preservation and reconstruction where clinically appropriate.
Learn more about Penile Cancer Care
Request an Appointment
Patients travelling from interstate or overseas can also review International Patient Information.
References
Parnham A, Albersen M, Ayres B, Crook J, Johnstone PAS, Oliveira P, et al. European Association of Urology and American Society of Clinical Oncology Guidelines on Penile Cancer: a summary of the 2026 guidelines update. Eur Urol. 2026;90(1):60-71. doi:10.1016/j.eururo.2026.03.022.
Sakalis VI, Campi R, Barreto L, Garcia Perdomo H, Greco I, Zapala Ł, et al. What is the most effective management of the primary tumor in men with invasive penile cancer: a systematic review of the available treatment options and their outcomes. Eur Urol Open Sci. 2022;40:58-94. doi:10.1016/j.euros.2022.04.002.
Pang KH, Muneer A, Alnajjar HM. Glansectomy and reconstruction for penile cancer: a systematic review. Eur Urol Focus. 2022;8(5):1318-1322. doi:10.1016/j.euf.2021.11.008.
Pang KH, Alnajjar HM, Muneer A. Functional outcomes of glansectomy to treat localised penile cancer: a systematic review. Int J Impot Res. 2026;38(3):206-213. doi:10.1038/s41443-025-01062-1.
Croghan SM, Cullen IM, Raheem O. Functional outcomes and health-related quality of life following penile cancer surgery: a comprehensive review. Sex Med Rev. 2023;11(4):441-459. doi:10.1093/sxmrev/qead021.
Falcone M, Preto M, Gül M, Şahin A, Scavone M, Cirigliano L, et al. Functional outcomes of organ sparing surgery for penile cancer confined to glans and premalignant lesions. Int J Impot Res. 2025;37(9):736-744. doi:10.1038/s41443-024-00967-7.
Djajadiningrat RS, van Werkhoven E, Meinhardt W, van Rhijn BWG, Bex A, van der Poel HG, et al. Penile sparing surgery for penile cancer—does it affect survival? J Urol. 2014;192(1):120-125. doi:10.1016/j.juro.2013.12.038.
Medical Disclaimer
This article provides general educational information only and does not constitute individual medical advice, diagnosis or a recommendation for a particular treatment. Penile cancer treatment depends on factors including examination findings, pathology, tumour stage and grade, lymph-node assessment, previous treatment and individual circumstances. Potential benefits, risks and outcomes of surgery vary between patients. Anyone concerned about a penile lesion or diagnosed with penile cancer should seek assessment from an appropriately qualified medical practitioner.
