Penile Biopsy

Why is it done?

• To confirm/ exclude the presence of malignancy
• To find the best effective treatment option for this lesion

Pre-requirements

• An informed consent is required from the patient.
• This can be done under a local or general anaesthetic.
• If done under a GA, patients may not eat or drink from midnight the previous evening.
• Patients are to refrain from smoking before the procedure.
• Patients allergic to IODINE / CHLORHEXIDINE should clearly state this at the Pre-admission clinic as well as to theatre staff and Dr Schoeman.
• Any anti-coagulants such as Warfarin or Aspirin must be stopped 7 days prior to surgery. Clexane injections may be substituted.

How is it done?

• This procedure is done under local or general anaesthetic.
• Supine position.
• The Foreskin may be the only affected area and therefore a circumcision is done.
• Otherwise the affected area is exposed and cleaned.
• If it is a large area, a wedge resection of an area close to normal skin is done.
• Otherwise a complete excision biopsy is done.
• Hemostatic sutures are placed.
• Hemostatic dressings are placed
• Specimen is sent to a histo-pathologist.
• A in catheter may be inserted if the biopsy area involves the meatus of your urethra.
• A dressing is then applied, which should be removed after 72 hours.
• A local anaesthetic is injected at the base of the penis as a penile block thus giving post-operative pain relief for the next 4-6 hours.

What to expect after the procedure?

• Any anaesthetic has its risks and the anaesthetist will explain such risks.
• Bleeding is a common complication.
• A haematoma (blood collection under the skin). Bruising is normal.
• Sutures may tear loose with vigorous use of erect penis, and the procedure may then require revision.
• An infection of the wound may occur and requires immediate attention.
• DANGER SIGNS: A wound that swells immediately, fever, and puss. Contact Dr Schoeman or the hospital immediately as this occurs in up to 15–20% of all cases.

What next?

• Dressings should be kept dry for the initial 72 hours after surgery and soaked off in a bath thereafter.
• The dressing may sometimes adhere to the wound causing slight bleeding on removal. Don’t panic, the bleeding will stop.
• The catheter will be removed as soon as you are awake, or if there are concerns, the following morning.
• On discharge, a prescription may be issued for patients to collect.
• Patients should schedule a follow-up appointment with Dr Schoeman 2 weeks after the procedure.
• There will be signs of bruising for at least 10 days.
• Refrain from using your erect penis for 3-4 weeks.
• The suture-line will be hard and indurated for at least 8-10 weeks.
• Sick leave will be granted for 10 days.
• Please direct all further queries to Dr Schoeman’s rooms.
• PLEASE CONTACT THE HOSPITAL DIRECT WITH ANY POST-OPERATIVE CONCERNS AND RETURN TO THE HOSPITAL IMMEDIATELY SHOULD THERE BE ANY SIGNS OF SEPSIS.

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Penile Biopsy