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| Name | 69) Tumours of the Penis |
| Video Uploader | Video From Dr. Mahesh Chaudhari's Niramayee Vasudha |
| Upload Date | This Video Uploaded At 26-10-2021 05:51:33 |
| Video Discription | TUMOURS OF THE PENIS - CONDYLOMA Three types of condyloma occur in the penis. (i) condyloma acumination of viral (ii)Grant condyloma (iii)syphilitic condyloma CONDYLOMA ACUMINATUM - Such lesion may grow in moist mucocutaneous surface including vaginal, anal or urethral mucosa in the penis these lesions are mostly seen near the coronal sulcus and inner surface of the prepuce these are usually sessile or pedunculated red papillary excrescences that vary from minute lesions of 1to several millimeters in diameter large Raspberry-like masses several centimeters in diameter. Such lesions caused human papilloma virus (HPV) and are sexually transmitted Treatment - Either of the two methods may be employed - (i) Chemical or (ii) surgery locally applied wart with stick Chemical Podophyllin 25%in spirit may be locally applied to the wart with a stick and the surrounding area is powdered for protection.it is washed after 6 hours. (ii) surgery - Cryosurgery is successful in the treatment of these warts. MALIGNANT TUMOURS - Malignant tumour in the penis means squamous cell carcinoma. Only in extremely rare cases one may find malignant melanoma hemangiosarcoma or fibrosarcoma. CARCINOMA OF THE PENIS - Squamous cell carcinoma of penis represents about 1%cancer in the male. Aetiology - 1. Phimosis- Circumcision protects and tumorigenesis by preventing accumulation of smegma and minimising the tendency to irritation and infection. 2.Balanoposthitis 3. Condyloma acuminata or penile warts are 4.Leukoplakia of the glans penis. 5. Paget's disease- This is an area of chronic, red eczema of the glans penis or inside of the prepuce. 6. Erythroplasia of Queyrat- It causes a dark red, flat but slightly indurated patch on the glans penis or innner side of prepuce . 7. Bowen disease Pathology -. Macroscopically two varieties are usually seen - Ulcerative variety, which is commoner and papilliferous variety. TREATMENT- The treatment of this condition is wide surgical excision ie. partial amputation of penis when glans or distal shaft is involved When the lesion occurs on the proximal shaft, total amputation of penis is required Very recently Laser treatment with neodymium: YAG Laser is gradually replacing surgery There are two methods of treatment for primary pro TREATMENT OF THE PRIMARY - There are two methods of treatment for primary growth. 1. Radiotherapy and 2. Surgery. 1. RADIOTHERAPY -This is indicated for small and well differentiated growths limited to the glans penis. Its advantage are - (i)that the result is same or even better than surgery and (ii) it avoids mutilatting operation . Its disadvantages are - (i) it may cause bad scarring which result in painful erection and (ii) it may cause postoperative sterility It is contraindicated in (i) big growth, (ii) growth involving the shaft and (ii) anaplastic tumuour. Methods of radiotherapy are - (a) Implantation of flexible radioactive tantalum wires which offer a total dose of 6000 rads in 5 days (b) Medium or high voltage X- rays known as tele radiation which offfers 5000 to 6000 rads in divided doses in 5 weeks, (C) Surface radiation may be given by radium mould applicator worn intermittently or continuously, so that it can offer 5000 to 6000 rads in 7 to 10 days 2) SURGERY - This is indicated in (i) anaplastic growth, (ii) In case of a big growth, (iii) When there is infiltration to the shaft penis. (iv) When radiotherapy has failed. Methods of surgery are:- (a) Partial amputation used for distal growth limited to glans penis (b) Total amputation of penis performed in (i) advanced case involving the shaft of the penis and (ii) in case of anaplastic lesion. Partial amputation of the penis.---This operation is indicated when the growth is confined to the glans and prepuce only and has not spread to the body of the penis Total amputation of the penis-This operation is indicated when the malignant tumour has involved the body of the penis. B. TREATMENT OF THE SECONDARY - (i) No enlarged lymph nodes- After the treatment of the primary growth the patient. is carefully followed up a sentinel lymph node biopsy after the primary tumour has been excised (ii) There are enlarged lymph nodes which are not fixed (a) It is advisable to wait for at least 3 weeks after the primary growth has been treated. One can perform lymph node sampling or sentinel lymph node biopsy to detect quickly whether the enlargement it due to metastasis or not (iii) When the enlarged inguinal lymph nodes are massive fixed and inoperable surgery is difficult in these cases and deep X-ray therapy should be tried . SYSTEMIC DISEASE WITH MULTIPLE METASTASIS - Chemotherapy is probably the best treatment in these cases 4 chemotherapeutic agents have shown activity against penile carcinoma are Methotrexate, Cis - platin, Bleomycin and 5- fluorouracil. |
| Category | Howto & Style |
| Tags | Tumours of the Penis | Condyloma Acuminatum | Malignant Tumours of the Penis & it's treatment | Total Amputation of Penis | Partial amputation of Penis |
