Tumors of the penis

To benign tumors of the penis are warts that occur most often on the inner leaf of the foreskin and the glans penis. They have pointed shape in contrast to the wide warts, which are formed in syphilis.
Genital warts often occur when phimosis and long tight foreskin from unscrupulous people. When pointed condylomas happens hypertrophy and hyperplasia maleyeva layer and the increase of dermal papilla. The top layer consists of a flat, dead skin flakes.
Condylomas are usually small, multiple; sometimes they form clusters of large sizes in the shape of cauliflower. Their surface is easily materials, ulcerated, acquires weeping character with purulent discharge and foul-smelling odor (Fig. 122).
Unlike cancer of the penis warts do not infiltrate underlying tissues.
To destroy warts used cautery - trichloroacetic acid, podophylin and others, electrocoagulation, scraping or destruction of acute way, and excision of the prepuce. Prevention is the systematic washing of external genitals.
Penile cancer is about 1 to 2% of all cancers in men. It occurs usually in patients suffering from congenital phimosis. Stagnating in prepucialna bag smegma decompose and cause chronic irritation of the head and foreskin that predispose to cancer.
Most often, penile cancer is seen in people aged 40 to 60 years. Favourite localization - the head of the penis, the inner leaf of the foreskin, or - more often - the coronal sulcus (Fig. 123).


Fig. 123. Cancer of the penis.

The most common squamous cell cancer with varying degrees of keratinization. Metastasis occurs through the lymph system in surface and deep inguinal, and then in the iliac nodes. Deep pelvic lymph nodes are affected during germination swelling of the mucous membrane in the urethra. Some of enlarged lymph nodes are found only inflammatory changes.
In the early period of the disease subjective feelings are absent. Tumors, developing under narrowed foreskin inherent concealed and masked over. In the process of disintegration of the tumor susceptible to infections, pain and stinking bloody discharge from prepucialna cavity; the opening of the head becomes impossible. Along with that determined the increase and compaction inguinal lymph glands. Cachexia comes late. If the tumor spreading the urethra can join acute urine retention.
Differential diagnosis. Penile cancer should be differentiated from erythroplasia, syphilitic defeat of the penis, condylomatosis and plastic hardening penis.
Erythroplasia the penis is characterized by the appearance on the head of his compacted area is red, do not have the propensity to pitting and infiltration. Microscopic study shows a significant development of vascular plexuses and thickening of the epithelial layer of cells which have a uniform volume without germination underlying tissues.
The Wasserman, history, research separated at the spirochaete allow us to provide snow cancer from syphilis.
When condylomatosis penis papillary education crayons and multiple, not infiltrate underlying tissues. In all cases of doubt, shown biopsy.
Treatment. When tumors located on the foreskin can be limited excision of the latter. In cancer, not germinate the corpus cavernosum, excised all the skin (scalping penis).
If the cancer affects the cavernous bodies of the penis shown preoperative radiation tetany, then amputation of the penis (within the healthy tissues) and the continuation of radiation after surgery. With the involvement of the lymph nodes (metastases) removes all of the penis with excision of all inguinal lymph nodes, with the removal of the urethra in the crotch and subsequent radiotherapy.