Curr Urol 2011;5:62–71 DOI: 10.1159/000327453 Key Words Abstract Copyright © 2011 S. Karger AG, Basel Fax +41 61 306 12 34 E-Mail karger@karger.ch www.karger.com © 2011 S. Karger AG, Basel 1015–9770/11/0052–0062$26.00/0 Accessible online at: www.karger.com/cur Penile cancer • Sexual function • Urologic reconstruction • Quality of life Introduction: Traditional treatment for penile cancer in- volved wide excision resulting in both poor cosmesis, as well as poor sexual and urinary function. Contemporary ap- proaches emphasize tissue preservation and reconstruction while maintaining comparable oncological outcomes. In this review, we summarize modern trends in the manage- ment of penile cancer, emphasizing contemporary mini- mally invasive techniques, reconstructive methodologies, and their efect on quality of life (QoL) and sexual function. Methods: PubMed search for publications on the manage- ment options and functional outcomes of penile cancer. Results: Contemporary treatment modalities for local pe- nile cancer include microscopically guided surgery, laser therapy, radiotherapy, penile-sparing surgery, reconstruc- tion after glansectomy, partial and total penectomy. Sexual ability can be preserved or restored in many patients treated for penile cancer, although overall QoL for most does not necessarily relate to erectile function. Conclusion: Increas- ing evidence suggests that sexual function can be restored and QoL maintained despite treatment for penile cancer. Brock O’Neil Division of Urology, University of Utah 30 North 1900 East Salt Lake City, UT 84132 (USA) Tel. +1 801 213 2700, Fax +1 810 585 2891, E-Mail brock.oneil@hsc.utah.edu Penile Cancer: Contemporary Considerations in Management of Local Disease Brock O’Neil a William O. Brant a Sean D. Slack a Jonathan Tward b Jeremy B. Myers a a Department of Surgery, Division of Urology; b Department of Radiation Oncology, University of Utah, Salt Lake City, Utah, USA Review Received: January 7, 2011 Accepted: February 22, 2011 Published online: July 22, 2011 Introduction Despite the relative rarity of penile cancer in the United States, squamous cell carcinoma of the penis represents a signiicant cause of mortality and morbidity in other parts of the world, and may be one of the most common malignancies in males in certain regions. Although refer- ences to penile cancer and penectomy are found as early as the irst century of the Common Era, Thiersch pro- vided the irst detailed description of penectomy in 1875. Since the description of Barringer in 1924, the standard surgical approach to penile cancer has traditionally been wide excision with surgical margins of at least 2 cm [1– 4]. Over the last 3 decades, signiicant challenges to this approach have led to an emphasis on sexual function and quality of life (QoL) while preserving oncologic goals and principles. Due to the infrequency that penile cancer is encoun- tered in the developed world, much of the advancement in the treatment of penile malignancy has been based upon retrospective case studies with a noticeable paucity of high-level evidence. Yet, shifts towards organ-pre- servative techniques do not appear to have signiicantly worsened survival outcomes compared to historical data, and morbidity is often reduced. In this review, we sum- marize modern trends in the management of penile can- cer, emphasizing contemporary minimally invasive tech- niques, reconstructive methodologies, and their effect on QoL and sexual function.