Medical Oncologist
CION Cancer Clinics
Follow-up after penile cancer surgery | CION Cancer Clinics
Follow-up after penile cancer surgery means regular visits where the surgeon examines the operated area and both groins, asks how you are passing urine and coping, and orders a scan only when something needs checking. Visits are close together in the first two years, when the cancer is most likely to return, and spread out after that. This page explains what happens at each visit, what to check at home, and the signs that cannot wait. CION Cancer Clinics’ surgical oncologists in Hyderabad can talk this through with you.
MI
Medically reviewed by Dr. Mohammed ImaduddinConsultant Surgical Oncologist · MBBS, MS (General Surgery), MCh (Surgical Oncology) · last reviewed September 2026, next review due September 2027
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On this page
- What does follow-up after penectomy involve, and for how long?
- What actually happens at a follow-up visit?
- How often will I be seen, and for how many years?
- Four reasons men miss follow-up, and why each one is wrong
- What should I be doing between visits?
- Common questions about follow-up after penile surgery
The short answer
What does follow-up after penectomy involve, and for how long?
Follow-up after penile cancer surgery means regular visits where the surgeon examines the operated area and both groins, asks how you are passing urine and coping, and orders a scan only when something needs checking. Visits are close together in the first two years, when the cancer is most likely to return, and spread out after that.
Why the groin matters more than the scar
Penile cancer spreads first to the lymph nodes in the groin. Small glands there filter fluid from the penis, and a returning cancer often shows up as a lump in one of them before anything is visible on the penis itself. That is why every visit includes feeling both groins carefully, and why a new groin lump between visits is the sign that cannot wait.
What follow-up is not
It is not a scan every visit. Most checks are done by hand and by eye, because the areas that matter can be felt. A scan is ordered when the surgeon finds something or when nodes were involved at surgery.
What this page cannot tell you
Your own schedule. That depends on which operation you had, whether the groin nodes were removed and what the tissue report showed. Ask your surgeon to write it down at discharge.
Bring the discharge summary and the tissue report to every visit, even at the same hospital. It saves time and avoids repeated tests.
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Between visits, these cannot wait for the next appointment
A new lump or swelling in either groin, a sore or a hard patch on the scar or the remaining penis that does not settle within a couple of weeks, bleeding from the operated area, or new swelling of one leg. Call your surgeon's team the same week and ask to be seen early. Do not wait for the scheduled date, and do not take a course of antibiotics from a local chemist first in the hope that a groin lump is only an infection.
Not sure whether this applies to you?
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What actually happens at a follow-up visit?
Most visits are short. Four things happen at nearly every one.
The operated area is examined
The surgeon looks at the scar, the remaining penis or the new urine opening, and the graft if one was placed, for a sore that will not heal, a hard patch, or a change in colour.
Both groins are felt
This is the most important part of the visit. The surgeon feels for enlarged glands on both sides. If the groin nodes were removed, they also check the wounds and ask about leg swelling.
You will be asked about
- Any lump you have noticed yourself
- Swelling or heaviness in a leg
- Fluid leaking from a groin wound
Urine, sex and mood are asked about
A narrowed urine opening, spraying, a weak stream, difficulty with erections and low mood are all common and all treatable. They are only fixed if you mention them, so say so even if not asked.
A scan is ordered only if needed
An ultrasound of the groin, a CT of the abdomen and chest, or a needle test of a gland, when the examination raises a question or when nodes were involved at surgery. Routine visits often need no scan at all.
Typical timing
How often will I be seen, and for how many years?
A typical pattern, not your schedule. Men who had a penile-sparing operation are often seen more frequently than men who had a total penectomy, because there is more tissue to watch.
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The first weeks: wound visits
Dressing checks, removal of the catheter, and a look at the graft or the new urine opening. These are about healing, not about the cancer returning. The tissue report is usually discussed at one of these visits, and it decides whether groin node surgery is needed.
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The first two years: every few months
This is when the cancer is most likely to return, in the groin or at the scar, so visits are close together. Many teams see you every few months, examining the penis and both groins each time.
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The years after that: spaced out
If nothing has been found, visits move to roughly every six months and then to once a year. A scan is arranged only if the examination or your symptoms raise a question.
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Long term: checking yourself
After several clear years many surgeons hand over to yearly visits or to self-checking with an open door back to the clinic. The habit of feeling both groins once a month stays with you for life.
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Commonly believed
Four reasons men miss follow-up, and why each one is wrong
"The wound has healed, so the treatment is over."
The wound healing is the end of the operation, not the end of the care. A returning cancer in the groin gives no pain and no wound. It is found by a hand on the groin at a visit, or by you noticing a lump. That is what follow-up is for.
"I feel fine, so there is no need to travel to the city."
Feeling fine is exactly what early return feels like. A groin gland can enlarge for months without pain. A lump found early needs a smaller operation than one found late. Ask whether some visits can be done at a nearer centre.
"A groin lump is probably just an infection or a hernia."
Sometimes it is, and the surgeon will say so. But after penile cancer a groin lump is treated as the cancer until proved otherwise. A course of antibiotics from a local shop delays the answer by weeks. Go to the clinic, not the chemist.
"They should scan me every time to be sure."
A scan cannot feel what a trained hand can, and repeated CT scans carry their own cost and radiation. Scans are used when the examination raises a question or when nodes were involved.
At home
What should I be doing between visits?
Three things: check yourself once a month, keep the urine opening healthy, and stop tobacco if you use it. None of them takes long, and each one makes the next visit more useful.
Feel both groins once a month
Lie flat, relax the legs, and press gently with the flat of the fingers along the crease where the thigh meets the body, on both sides. You are feeling for a new lump or a firm area that was not there last month. If in doubt, ring the clinic.
Look at the operated area
Once a month, in good light, look at the scar, the remaining penis or the new opening. A sore that has not healed after a couple of weeks, a raised or hard patch, or a new discharge all need a visit.
Keep the urine opening open
After a partial penectomy or a new opening behind the scrotum, the channel can narrow over time. A stream that is getting weaker, straining, or dribbling afterwards should be mentioned early, because a small stretch done in clinic is far easier than a blocked opening treated as an emergency.
Stop tobacco and keep moving
Tobacco in any form, including gutka and beedis, raises the chance of a new cancer and slows healing. Ask the clinic for help to stop. Walking daily helps leg swelling if groin nodes were removed, and helps mood.
Questions we are asked
Common questions about follow-up after penile surgery
For how many years does follow-up go on?
Several years, with the visits closest together in the first two, when the cancer is most likely to return. After a run of clear checks many surgeons move to yearly visits or to self-checking with an open door back to the clinic. Ask your own surgeon for the plan in writing.
Can I do some of the visits nearer home?
Often, yes. The core of the visit is an examination that any experienced surgeon can do, and some centres arrange alternate visits at a district clinic. Ask. What should not change is who reviews a new finding: that goes back to the operating team.
Will I need a CT or PET-CT at every visit?
No. Most routine visits need no scan. A scan is ordered when the examination finds something, when the groin cannot be felt properly because of swelling, or as a planned check if the nodes were involved at surgery. If you are being scanned every visit with nothing found, it is fair to ask why.
I found a groin lump. Is it definitely the cancer back?
Not definitely. Infection, a hernia or a reaction to a wound can all cause a lump. But after penile cancer it is treated as the cancer until proved otherwise, usually with an ultrasound and a needle test. Ring the clinic the same week. Do not take antibiotics first and wait to see.
What if I missed a visit or stopped going?
Go back. Nobody at the clinic will scold you, and a late visit is far better than none. Ring, say you have missed follow-up, and ask for the next available slot. Bring the discharge summary and the tissue report if you still have them.
My leg has started to swell. Is that expected?
After groin node surgery, swelling of the leg on that side is a known effect, and it can start months later. It may be lymphoedema, which is swelling from blocked lymph channels and is managed with compression and exercise. It can also be a clot or a returning gland, so mention it at once.
Can I raise problems with erections or urine at these visits?
Yes, and you should. Surgeons expect these questions and answer them every week. A narrowed urine opening can be stretched in clinic. Erection problems after a partial penectomy often have options. Nothing is done about either unless you say something.
Does my wife need any follow-up?
Penile cancer is not passed to a partner, so she needs no follow-up for your cancer. The virus linked to some penile cancers is also linked to cervical cancer, so she should keep up the routine cervical screening every woman is advised to have. That is a general precaution, not a special risk.
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Dr. C. Raghavendra Reddy
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Sources
- Cancer Research UK — Penile cancer
- National Cancer Institute — Penile cancer treatment (PDQ), patient version
- Macmillan Cancer Support — Penile cancer
- American Cancer Society — Penile cancer
- NHS — Penile cancer
This page is general information, not a prescription. Do not change or stop any treatment based on what you read here. If anything is worrying you, contact your own treating team — or call our helpline and we will help you reach the right specialist.
Keep reading
Related pages
Groin Node Surgery in Penile CancerWhy the groin is the first place the cancer returns, and what node surgery involvesPassing Urine After PenectomyThe narrowing and spraying problems to raise at follow-upSexual Function After Partial PenectomyWhat to ask the surgeon once the wound has healedThe Pathology Report After SurgeryThe report that decides how closely you are followedComplications and Red FlagsWound and groin problems that need a call, not a wait
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