Balanectomy: Understanding the Procedure and Purpose

Balanectomy = surgical excision of the glans penis (the distal, sensitive portion containing the urethral meatus).

Indications

• Malignancy: Penile cancer involving glans (partial/total penectomy may follow).
• Severe BXO (balanitis xerotica obliterans) unresponsive to topical therapy.
• Trauma: Irreparable crush/avulsion injury.
• Gender-affirming surgery: Part of vaginoplasty (penile inversion technique uses glans for neoclitoris).

Procedure

• Under general/regional anesthesia.
• Glans amputated; urethra shortened and repositioned (perineal urethrostomy) or reconstructed.
• Shaft skin closed; drains placed.

Consequences

• Loss of major erogenous zone.
• Urinary stream changes (sitting often needed).
• Psychological impact – counseling essential.
• If for cancer: lymph node dissection, adjuvant therapy per stage.

Radical procedure; multidisciplinary team (urology, oncology, plastics, psych) required.