Organ Sparing Surgery for Penile Cancer: The Radical Circumcision

A. Folcia, N. Schifano, M. Coschignano, S. Baldini, I. Zais, A. Villano, P. Capogrosso, G. Antonini, F. Dehò

Penile Cancer, Organ Sparing Surgery, Elderly

Avoiding emasculating procedures in penile cancer surgery helps prevent perceived feminization, loss of sexual function, and psychological distress. This video abstract presents an 84-year-old man with a 3 cm verrucous preputial lesion, strongly motivated to avoid mutilating surgery. After clinical and radiological assessment excluded invasion, he underwent a radical dorsal-slit circumcision, achieving complete excision while preserving penile anatomy. Histology confirmed T1a verrucous squamous cell carcinoma, HPV-negative, with clear margins. The patient reported maximum satisfaction on the VAS scale and remains disease-free at one year, fully compliant with EAU–ASCO 2025 follow-up. This case illustrates how, when properly indicated and combined with high follow-up adherence, organ-sparing surgery can maintain oncologic safety while preserving psychological well-being and quality of life, even in elderly patients where the impact of radical surgery is often underestimated.

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