Initial procedure

The various anatomical components of the penis should be examined as any of these may be the site of involvement.

• measurements:

- dimensions (cm) of specimen and individual components (foreskin, shaft and glans).

- tumour: length x width x depth (cm) or maximum dimension (cm).

distances (cm) to the urethral and surgical resection margins.

• identify the shaft and glans.

• remove the foreskin, leaving a 2-3 mm redundant edge of skin around the sulcus. This permits better evaluation of the coronal sulcus. Proceed with foreskin as above.

• ideal sectioning is longitudinal, centred along the urethra, with additional parallel sections on both sides. With a probe as a guide the urethra is opened along the ventral aspect where it is closest to the surface and the cut is then continued to bisect the penis.

• involvement of the foreskin, frenulum, glans, meatus, corpora cavernosa, urethra and corpus spongiosum are recorded.

• a transverse section of the urethral margin should include the mucosal surface, surrounding lamina propria and corpus spongiosum. This is usually long in partial penectomy specimens because the surgical technique uses a long urethra stump for reconstruction.

• shaft margin: usually a large specimen. Divide it in two, from dorsal to ventral along the central septum and submit the cut surface entirely. Each half should be labelled left or right. If the specimen has a long shaft, cut two or three additional sections distal to the margin.

• examination of the cut surface of the glans represents the best approach for surgical pathology evaluation.

• glans (glansectomy): several longitudinal sections should be taken. Cut the specimen into two halves labelling them left and right, going from meatus to proximal urethra. Cut three to six serial sections, 2-3 mm in width from each half.

• photograph suitable individual slices.

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