Problems after surgery for penile cancer

There is a risk of problems or complications after any operation. Not everyone who has surgery has a problem or complication. Many problems are minor but some can be life threatening.

Treating them as soon as possible is important.

Possible problems depend on the type of surgery you have. After circumcision you are unlikely to have any problems, apart from possibly infection. After more extensive surgery you might have a risk of erection problems or problems passing urine. 

Blood clots

Blood clots (deep vein thrombosis, DVT) are a possible complication of having surgery because you might not move about as much as usual. Clots can block the normal flow of blood through the veins. Let your doctor or nurse know if you have an area in your leg that is swollen, hot, red or sore.

There is a risk that a blood clot can become loose and travel through the bloodstream to the lungs, causing a blockage there (a pulmonary embolism). Symptoms include:

• shortness of breath

• chest pain

• coughing up blood

• feeling dizzy or lightheaded

To prevent clots it's important to do the leg exercises that your nurse or physiotherapist taught you. Your nurse might also give you an injection just under the skin to help lower the risk whilst you are in hospital. You might need to carry on having these injections for 4 weeks, even after you go home. This depends on the type of operation you had.

Your nurse might teach you to do these injections yourself before you go home. Or a district nurse might come to your home to do them.

It's important to continue wearing compression stockings if you have been told to by your doctor.

Infections

You are at risk of getting an infection after an operation. This includes a wound, chest or urine infection. You will have antibiotics to reduce the risk of developing an infection after surgery. Tell your doctor or nurse if you have any symptoms of infection.

They include:

• a high temperature
• shivering
• feeling hot and cold
• feeling generally unwell
• cough
• feeling sick
• swelling or redness around your wound and your wound might feel hot
• a strong smell or liquid oozing from your wound
• loss of appetite

Rarely for an infection in your wound, you may need another operation.

Chest and breathing problems

Chest infections, including pneumonia, can be serious. 

You can lower your risk by:

• stopping smoking before your operation
• getting up and moving as soon as possible after your operation
• doing any breathing exercises your physiotherapist teaches you

If you get an infection you have antibiotics to treat it. 

Feeling tired and weak

Most people feel weak and lack strength for some time afterwards. How long this lasts varies between people.

Tell your doctor or nurse if the weakness continues for more than a few weeks. They can suggest things to help, such as physiotherapy.

Erection problems and sex life changes

Some men can not have an erection after their surgery. Doctors might call this impotence. This can be very distressing for some people. The chance of this happening depends on the type of surgery you have.

There are medicines and devices that can help with erection problems after surgery. Your doctor or specialist nurse can also refer you to a clinic for people who have sexual problems after treatment. You can store sperm before your operation if you would like to have children in future. 

Problems passing urine

Problems with controlling the flow of urine can happen after surgery to the penis. The chance of problems depends on the type of surgery you have. Let your doctor or specialist nurse know straight away if you have any problems.  

Leakage of urine

Leakage of urine is not a common problem after surgery unless you leaked urine before. If you have any urine leakage let your doctor know. There might be ways of helping with this, such as medicines or muscle exercises to help with bladder control. You might also need to wear a small pad.

Your doctor can refer you to a special clinic if leakage becomes an ongoing problem. Staff there can help you with further muscle exercises and bladder training.

Bladder training

Bladder training encourages your bladder to hold larger amounts of urine for longer periods of time. You keep a diary of when you go to the toilet and gradually increase the time between each visit.

Spraying urine

You might find you are spraying urine, rather than having a steady stream when you go. This might happen after a glansectomy or partial penectomy, due to pressure on the urethra .

Talk to your specialist nurse or doctor about this. Sitting down to pass urine can help. They might recommend a male funnel. This equipment can help with spraying by helping direct the urine stream.

Not being able to pass urine

Sometimes surgery to the penis can narrow the urethra. Let your doctor know if you find it more difficult to pass urine. They can advise you on what can help. This problem might happen some time after surgery.

You might need a small operation to make the urethra wider. The operation is called urethral dilatation.

Swelling in the legs and genitals

Some people get swelling in one or both legs after radiotherapy or surgery to the lymph nodes in the groin and pelvis. This is called lymphoedema. Lymphoedema is a build up of lymph fluid that causes swelling in a part of the body.

It is common to have some swelling around the genital area for a couple of weeks after surgery. If this continues or you notice some swelling in your legs or feet, you may be developing lymphoedema.

Tips to help reduce the risk of lymphoedema:

• Protect your legs and feet from sharp objects – always wear shoes, and wear long trousers for gardening.
• Wear insect repellent so that you don't get bitten.
• Take care of all cuts, scratches or bites straight away by cleaning them with antiseptic and covering with a dressing.
• Avoid sunburn.
• Take extra care when cutting your toenails – you should not cut or tear the cuticles.

If you notice any swelling, tell your doctor or specialist nurse straight away. Lymphoedema is easier to control if it is caught early. They can refer you to a lymphoedema specialist for assessment. The specialist is usually a nurse or physiotherapist.

Fluid build up after groin lymph node surgery

A lymphocele is a collection of lymph fluid in the groin. This is often small or goes away on its own. In rare cases it can be large enough to give you problems moving around.

Doctors can treat this by putting in a small needle and draining the fluid.

Wound and skin problems after groin lymph node surgery

Your small wounds might take time to heal or the wound might open. In rare cases the skin overlying the wound site may have problems with blood supply. Your team will tell you how to care for your wound and who to contact if you have any problems.

Coping

This cancer affects a deeply personal and private part of your body. It can be difficult to cope after surgery.

We have information about living with penile cancer, including changes to your body after surgery and who can help you cope.