(008) Organ Sparing Surgery for Penile Cancer: The Radical Circumcision

Introduction Avoiding emasculating procedures in penile cancer surgery reduces the risk of perceived feminization, loss of sexual function, voiding dysfunction, anxiety, post-traumatic stress, and avoidant behavior. Organ-sparing surgery (OSS) represents a valid option when technically feasible, provided that strict follow-up compliance and thorough counseling regarding recurrence risk are ensured. These aspects are particularly important in elderly patients, in whom the psychological impact of radical surgery is often underestimated, and the balance between oncologic safety and quality of life remains crucial. Objective In this video abstract, we present the case of an elderly patient successfully treated with a radical dorsal-slit circumcision. Methods An 84-year-old man presented with a 3 cm verrucous lesion of the prepuce that had progressively enlarged over one year. Strongly motivated to avoid mutilating surgery, he underwent clinical and radiological assessment, which excluded deep or nodal invasion. A radical dorsal-slit circumcision was therefore performed, allowing complete excision while preserving penile anatomy. Follow-up was conducted according to EAU–ASCO 2025 guidelines (penile and nodal examinations every 3 months for 2 years, then every 6 months up to year 5). To assess patient satisfaction, the visual analog scale (VAS) for functional and aesthetic outcomes was used. Results Histology confirmed T1a verrucous squamous cell carcinoma, HPV-negative, with clear 5 mm margins. The patient reported maximum satisfaction on the VAS scale for functional and aesthetic outcomes at one month and remains disease-free at one year, under EAU–ASCO 2025 guideline–based follow-up. Conclusions This video abstract shows that properly indicated organ-sparing surgery, as part of individualized management, can preserve both oncologic safety and psychological well-being. Disclosure No