(015) Glansectomy and Neoglands Reconstruction Using a Free Skin Graft

Introduction Glansectomy is a conservative surgical technique indicated in early-stage penile cancer when the tumour is confined to the glans. This approach allows for partial penile preservation, maintaining urinary and sexual function while achieving satisfactory oncological and aesthetic results. Objective This academic video demonstrates a step-by-step glansectomy for penile cancer followed by immediate reconstruction using a free skin graft. The procedure emphasizes oncologic safety, anatomical precision, and functional restoration. The technique ensures optimal aesthetic and functional outcomes while preserving patient quality of life. This educational resource aims to standardize surgical practice and enhance training in penile cancer management. Methods The procedure is suitable for T1B–T2 lesions without invasion of the corpora cavernosa. A circumferential subcoronal incision is made around the glans; the penis is degloved, and a tourniquet is applied at the base. The urethra is mobilised and preserved. The glans is excised at the distal level of the corpora cavernosa. The urethra is transected with a safe margin and fixed to the distal corpora. The dartos fascia and skin are sutured to Buck’s fascia to reconstruct a new balanopreputial sulcus using 5-0 Vicryl. A free split-thickness skin graft, harvested with an electric dermatome (0.4 inches), is adapted and sutured to the neoglans with 5-0 stitches. A compressive dressing is maintained for five to six days, followed by weekly follow-up for two months to avoid complications. Subsequent reviews are performed every two to three weeks to assess graft integration. Results The final aesthetic and functional outcomes are highly satisfactory, preserving penile length and function Conclusions Glansectomy represents a reliable organ-sparing alternative in the management of localised squamous cell carcinoma of the glans, combining oncological safety with excellent cosmetic results. Disclosure No