Zygmunt Dobrowolski 1, Jacek Kusionowicz 1, Mieczysław Gałęzia 2, Bolesław Papla 3, Piotr Faron 1
- 1 Klinika Urologii Collegium Medicum Uniwersytetu Jagiellońskiego
Kierownik Kliniki: dr hab. med. Zygmunt Dobrowolski
2 Oddzial Urologii Szpitala w Czerwonej Górze
Ordynator dr med. Mieczysław Gałęzią
3 Katedra Patomorfologii Collegium Medicum Uniwersytetu Jagiellońskiego
Kierownik Kliniki: prof, dr hab. med. .1. Stachura
penis, cancer, treatment
- Introduction. Penis carcinoma is a neoplasm revealing itself in men over the age of 60. In Poland the incidence of this neoplasm amounts to 0.8 per 100 000 men. The number of new cases recorder a year is about 150. This carcinoma accounts for 0.4% neoplastic causes of death.
- Aim of the study. The aim of the study was to evaluate retrospectively patients treated because of the penis carcinoma Patients and methods. In the years 1988-1998 in the Clinic of Urology in Cracow and in the Ward of Urology (Department of the Hospital in Czerwona Góra) 77 operations were performed in patients with suspicion of penis carcinoma. Histopa-thological examinations showed planoepithelial cancer in 67 patients, papillous carcinoma in 1 case. The patients operated for penis carcinoma were between 42 and 80 years of age. The neoplasm was localized on the glans penis 59, on prepuce of the penis 5, on the body of the penis 4. It had ulcerating form in 41 patients, infiltrating form in 8 patients and exophitic in the 19 patients. The size of the neoplasm ranged from 0.5 cm to 6-7 cm. Staging of the tumours was the following: Ta 1 case, Tl 12 cases, T2 42 cases, T, 11 case, T4 2 cases patients.
- Results. The operations performed in the patients were as follows: Total resection of penis in 16 cases. These operations were supplemented by bilateral superficial and deep lymphadenectomy. Subtotal resection of the penis in 49 patients. These operations were supplemented by superficial lymphadenectomy in 4 cases. Local resection of the tumour was performed in 3 patients. The most frequent complications after the operations were: suppuration (of the wound) in 4, wound dehiscence in 3, oedema of lower extremities limbs in 2 and urethrostenosis in 11 patients. In ambulatory follow-up recurrence of the neoplastic process was found in 2 patients. During the first month after the operation 3 patients died, 2 of them were in bad condition before the operation and had pulmonary metastases. In 1 patient the cause of death was circulatory insufficiency.
- Conclusions. Necessity for improvement of the flow of information to other specialists because in about 60% of the patients the moment of undertaking treatment operative treatment was elongated because of conservative therapy. In patients with examinable increased inguinal lymph nodes optional lymphadenectomy should be preceded by antibiotic therapy. In the case of regression lymphadenectomy should not be performed. Computer tomography of abdominal cavity and pelvis should be performed in patients with higher staging and lymph nodes not being increased in order to assess evaluate remote metastases. There exists necessity for improving hygienic sanitary education among men.
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Klinika Urologii CM UJ
ul. Grzegórzecka 18, 31-581 Kraków