Urology Expert Forum
What happens after amputation?
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What happens after amputation?

I am 49 years and and have just been diagnosed with penile cancer.  I am scheduled for total amputation on December 3rd.  My doctor tells my my testicles will be saved, but I am concerned about what will happen to my sex drive after the amputation.  Will I still have urges and then be unable to climax?  Or will my urges disapper completely?
If anyone else has been through this already, I would really postings from you.  I know this is a very rare disease, but hopefully someone else can come forward so I can have someone who completely understands to talk with.  Thank you.
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Dear Jim,
Cancer of the penis accounts for 0.3 to 0.6 percent of all malignancies in males.  The most common type is squamous cell carcinoma.  For most patients surgical excision is the most effective means of controlling the tumor, and for some unfortunate men like yourself, a total penectomy is the only option.  If partial penectomy with a 2 cm margin is not possible, or if the tumor invades the proximal shaft, total penectomy with creation of a perineal urethrostomy is indicated.  For extensive, proximal primary tumors, total emasculation consisting of total penectomy, scrotectomy, and orchidectomy is recommended.  More extensive procedure have also been proposed but I will not go into further detail.
In regards to your sexual function, since your testicles are being spared, and presumably your are not going to have the entire urethra removed,  your ability to achieve climax and ejaculate will still be present.  When the penis is removed, the sensory nerves from the shaft will be destroyed, however, perineal stimulation may cause a climax and ejaculation.  An electrical stimulation test could be performed to obtain semen for fertility purposes if desired.  In terms of libido (desire), this should not be affected, other than the psychological impact of the surgery.  Sensation and ejaculation may feel much different due to the new anatomy after the procedure.  I would discuss with your doctor your thoughts and wishes before the surgery.  
This information is provided for general medical educational purposes only.  Please consult your physician for diagnostic and treatment options pertaining to your specific medical condition.  More individualized care is available at the Henry Ford Hospital and its satellites (1 800 653-6568).


Sincerely,
HFHS M.D.-AK
*keyword:Penile cancer
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