A 50-year-old man infected with human papilloma virus (HPV) recently underwent a total penectomy operation, or total penile resection, after being diagnosed with squamous cell carcinoma of the penis — the most common type of penile cancer.
According to Yuan Rung Hospital urologist Lu Lieng-yi (盧令一), who treated the patient, the man only resorted to medical assistance after his penis started to severely fester and bleed.
A tissue biopsy showed that the man had long been infected with HPV. A lack of timely treatment allowed the sexually transmitted disease to develop into penile cancer, Lu said.
 
                    Photo: Ruan Yi-yu, Taipei Times
The patient, who said that he had a history of multiple sexual partners, said he was unaware of his physical illness until recently, when he went to the bathroom and noticed that there was blood coming from his penis.
However, as the man did not feel any itchiness or pain inside or outside his reproductive organ, which he could not directly see because of his oversize abdomen, he failed to seek any therapy, Lu said.
Lu said that although the man had not engaged in sexual intercourse for some time, the HPV, which can lead to genital warts, could only be treated, but not fully eradicated. The virus would remain in the human body and trigger a relapse when the infected patient’s immune system started to weaken.
The majority of men with penile cancer only require partial penectomy and most maintain their sexual and urinary functions after such surgery, as the disease is inclined to develop around the glans only.
However, the primary infected part of the man was at the center of his penis, which meant that he required a total penectomy to keep the cancerous tumor from further spreading.
Lu said that he was at first concerned the patient would not be willing to allow such an extreme operation, but it took the man less than a day to decide to undergo the resection surgery.
“I had tried everything I should and everything I should not have, and now, in order to save my own life, it would not be much of a pity anymore to remove it,” Lu quoted the patient as saying.
On the patient’s postoperative recovery, Liu said the man would have to receive urethral reconstruction between his testicles to restore his urinary function, but he would only able to urinate in a squatting position for the rest of his life.
However, Liu said that the operation would not cost the patient his masculinity, as his testicles, which are responsible for producing sperm and testosterone, would remain intact.
“Although the patient is given the option to receive genital reconstruction surgery at a later date to restore the best possible appearance, his sexual function is not likely to be recovered,” Lu said.
The most effective preventive measure of sexually transmitted diseases remains avoiding risky sexual behavior such as having multiple sexual partners or engaging in unprotected sexual activity, Lu said, adding that people who experienced bleeding from their reproductive organs are advised to seek immediate medical consultation.

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