Copyright © 2015 Wolters Kluwer Health, Inc. All rights reserved. C URRENT O PINION Penile cancer: organ-sparing surgery Antonio Carlos Lima Pompeo a , Steˆnio de Ca´ssio Zequi b , and Alexandre Saad Feres Lima Pompeo c Purpose of review Penile cancer is a devastating disease, usually diagnosed late, that requires wide excisions, which causes alterations in self-esteem and body image, affecting sexual and urinary functions, which compromise quality of life. Recently, an increasing interest in penile-sparing surgeries (PSSs) has emerged, aiming to spare patients from these complications. Recent findings Several options of PSS have been popularized for selected cases (Ta-1, Tis and some T2), such as wide local excision, circumcision, partial penectomy, total or partial glansectomies with or without glans- resurfacing procedures, as well as new glans reconstructions using spatulated urethral advances or free skin grafts. These options, in general, achieve good local control, with adequate functional results and satisfactory cosmetic appearance. The local recurrences, however, are slightly higher than amputations. Contemporary techniques such as laser or cryotherapy can be performed in selected cases. Summary PSS must be indicated only for superficial penile cancer cases, such as Tis and Ta-1, and for selected invasive lesions (small distal pT2 tumors). Candidates for PSS should be adherent to follow-up requirements, allowing early detection of local recurrences. Prompt and effective salvage procedures are mandatory in these situations. Keywords glansectomy, organ sparing, penile cancer INTRODUCTION Penile cancer is a rare disease in the USA/Europe (0.2/100,000 men), but is common in underdevel- oped countries. The highest incidence is found in South America, Africa and Asia (2.3–8.3 cases/ 1,000,000) [1–3]. Recent survey in Brazil revealed that 40% of patients with penile cancer were young: under 26 years (3.5%), 27–35 (3.9%), 36–45 (12%) and 46–55 (18.7%), respectively [4]. For advanced stages, total or partial amputa- tions are the current therapeutic options [3,5]. In spite of the oncological effectiveness, penile ampu- tations promote mutilations that affect corporal image, self-esteem and genital sensibility, fre- quently impairing sexual function or micturition. Several conservative procedures have been pro- posed to enhance functional/cosmetic outcomes for partial penectomy [6 & ,7 & ,8,9 & ,10] aiming to maintain the high amputation cure rates. The authors’ objective in this article is to update the contemporary knowledge related to penile-sparing surgeries (PSSs). MATERIAL AND METHODS Literature review was done searching (http:// www.ncbi.nlm.nih.gov/pubmed/) the following mesh terms: ‘penile sparing surgeries, partial penec- tomy, penile preservation, glansectomy, glans resurfacing/reconstruction, neoglans, organ sparing surgery and penile cancer’. As literature is scarce, we searched publications from the last two decades (1990–2014) and some classic articles in English, Spanish, Portuguese, German, French and Italian languages. a Department of Urology ABC Medical School, Santo Andre ´, b Division of Urology, Department of Pelvic Surgery, AC Camargo Cancer Center and c Division of Urology, ABC Medical School, Santo Andre ´, Sa ˜ o Paulo, Brasil Correspondence to Antonio Carlos Lima Pompeo, Disciplina de Urolo- gia, Faculdade de Medicina do ABC, Av. Prı´ncipe de Gales, 821-Vila Prı´ncipe de Gales, SantoAndre ´ -SP 09060-650, Brazil. Tel/fax: + 5511 4993 5462; e-mail: pompeuro@uol.com.br Curr Opin Urol 2015, 25:121–128 DOI:10.1097/MOU.0000000000000149 0963-0643 Copyright ß 2015 Wolters Kluwer Health, Inc. All rights reserved. www.co-urology.com REVIEW