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Passing urine after a penectomy | CION Cancer Clinics
After a partial penectomy, most men pass urine standing through a new opening at the tip. After a total penectomy, you sit down, because the new opening is behind the scrotum. Either way, control is normal, because the muscle that holds urine in is near the bladder and is not touched. This page explains the catheter, the first weeks, practical tips and the problems to report. 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
- How will you pass urine after a penectomy?
- Partial and total penectomy: how does passing urine differ?
- What happens from the catheter to a normal routine?
- What makes passing urine easier in practice?
- Four worries we hear, and what is actually true
- When should you call the team?
- Common questions about urinating after penectomy
The short answer
How will you pass urine after a penectomy?
After a partial penectomy, most men pass urine standing, through a new opening at the tip of the shorter penis. After a total penectomy, you pass urine sitting down, through a new opening behind the scrotum. In both cases control is normal, because the valve that holds urine in sits near the bladder and is not touched.
Why control is not affected
Many men fear they will leak. The penis carries urine out, but it does not hold it in. That job belongs to a ring of muscle deep in the pelvis, below the bladder. A penectomy does not reach it. You will feel the need to go and be able to wait, as before.
What does change
The direction and shape of the stream change. Without the head of the penis to guide it, urine can spray or go to one side. After a total penectomy it comes from lower down, so sitting is needed. These are practical changes, and most men settle into a new routine within weeks. This page explains what to expect. It cannot tell you exactly how your own stream will behave, because that depends on how your wound heals.
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One thing that cannot wait
If you cannot pass urine at all, and your lower belly is swollen and painful, go to the nearest emergency department the same day and say you have had a penectomy. Do not wait to see whether it passes. Do not try to push anything into the opening yourself. A blocked catheter that is not draining needs the same urgent attention.
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Ask an oncologistSide by side
Partial and total penectomy: how does passing urine differ?
After partial penectomy
After total penectomy
Opening at the tip of the remaining penis
Opening in the skin behind the scrotum
Most men stand; some prefer to sit
You sit on the toilet
Stream may spray, especially at first
Leaning forward keeps the stream in the pan
Control is normal
Control is normal
The first weeks
What happens from the catheter to a normal routine?
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The catheter
You wake with a soft tube, called a catheter, draining urine into a bag. It lets the new opening heal without urine passing over the stitches. Keep the bag below your waist and the tube free of kinks.
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The catheter comes out
When the team is happy with the healing, the catheter is removed, either on the ward or at a clinic visit. It feels odd but takes only a moment.
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The first few times
Passing urine may sting and the stream may be thin, uneven or spray. Sit down for these first times, whichever operation you had. A nurse will check that you have emptied your bladder.
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The first weeks at home
The stinging fades and the stream becomes steadier as swelling goes down. Drink plenty of water, because dilute urine stings less and lowers the chance of infection.
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Settling into a routine
Most men find what works for them within a few weeks, standing or sitting. The clinic checks the stream at follow-up visits and looks for any narrowing of the opening.
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Day to day
What makes passing urine easier in practice?
Small adjustments that men and their carers tell nurses help most.
Controlling spray
Sitting removes the problem entirely. If you prefer to stand after a partial penectomy, gently holding the skin back from the opening and standing close helps direct the stream.
Away from home
Use a cubicle rather than a urinal. Nobody notices. Carry a small pack of tissues or wipes, because many public toilets in India do not have them.
Worth carrying
- Tissues or wet wipes
- A spare pair of underwear at first
Indian-style toilets
Squatting works well after a total penectomy, since urine comes from low down. Lean slightly forward. After a partial penectomy, squatting is also fine once the wound has healed.
Keeping the skin healthy
Pat the area dry after passing urine. Urine left on the skin can make it sore. Wear loose cotton underwear and change it if it becomes damp.
Commonly believed
Four worries we hear, and what is actually true
"I will be wetting myself for the rest of my life."
The muscle that holds urine in is near the bladder and is not touched by a penectomy. Leaking is not an expected result. If you do leak once healed, tell the team, because something else may be going on and it can be looked into.
"I will have a urine bag permanently."
The bag attached to the catheter is temporary. Once the catheter comes out, urine passes through the new opening with no bag. A permanent bag is not part of either partial or total penectomy.
"Sitting to pass urine means something has gone wrong."
After a total penectomy, sitting is simply how the new opening works. After a partial penectomy, many men choose to sit because it is tidier. Neither is a sign of a problem.
"If I drink less water, I will not have to go as often."
Drinking less makes urine concentrated. That stings more, irritates the healing opening and raises the chance of infection. Keep drinking normally unless a doctor has told you to limit fluids for another reason.
Problems to report
When should you call the team?
Call the team when passing urine gets harder rather than easier, or when something new appears. Most problems are easier to fix when they are caught early.
A stream that gets weaker
The commonest problem is narrowing of the new opening as it heals, called meatal stenosis on a report. The stream becomes thinner, slower or splits, and you may need to strain. It often develops over weeks or months. It can be treated, sometimes by gently stretching the opening and sometimes with a small operation. Report it rather than getting used to it.
Signs of infection
Burning that returns after it had settled, cloudy or smelly urine, needing to go very often, pain low in the belly, or a fever. These need a call to the team or your doctor the same week, and sooner if you feel unwell.
Blood in the urine
A little blood in the first days after the catheter comes out is common. Blood that appears later, or clots, should be reported.
This page is general advice. Your own team knows how your operation went and may give you different instructions. Follow theirs.Questions we are asked
Common questions about urinating after penectomy
Do I have to sit down to urinate after a penectomy?
After a total penectomy, yes, because the new opening is behind the scrotum. After a partial penectomy, most men can stand once healed, though many sit because the stream sprays less. For the first few days after the catheter comes out, sitting is sensible whichever operation you had.
How long does the catheter stay in?
It stays until the team is happy the new opening has healed enough for urine to pass over it. That varies with the operation and how you heal. Ask your surgeon for the typical timing in your case, and whether it will be removed on the ward or at a clinic visit.
Why does my stream spray everywhere?
The head of the penis used to shape the stream into a single jet. Without it, urine can fan out. Swelling in the first weeks makes this worse. It often improves as healing settles. Sitting down solves it entirely, and many men decide that is simply easier.
Will I be able to urinate while squatting?
Yes. After a total penectomy, squatting on an Indian-style toilet works well because urine comes from low down. After a partial penectomy, squatting is also fine once the wound has healed. Lean forward slightly and take your time until you know how your stream behaves.
It burns when I pass urine. Is that normal?
In the first days after the catheter comes out, mild stinging is common and fades. Burning that lasts, returns later or comes with cloudy urine or a fever may be an infection. Call the team or your doctor rather than buying tablets from a pharmacy on your own.
Can the new opening close up?
It can narrow as scar tissue forms, which is the most common longer-term problem. You notice a thinner, slower stream or need to strain. It can be treated. The clinic checks for it at follow-up, but report it between visits if you notice it.
Can I travel or go back to work?
Yes, once the wound has healed and you are comfortable. Plan toilet stops on long journeys and use cubicles in public places. Carry tissues. Your surgeon will tell you when heavy work and long travel are safe for you.
Who can help my father with this at home?
The ward nurses will teach the patient and one family member how to care for the catheter and the wound before discharge. Ask for that session and write down what you are told. If something is unclear once you are home, call the helpline and a nurse will talk you through it.
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Sources
- Cancer Research UK — Penile cancer: treatment
- Macmillan Cancer Support — 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
Total penectomy and perineal urethrostomyHow the new opening behind the scrotum is madePartial penectomy: what is removedWhat remains and why most men still standDrains, tubes, lines and cathetersLooking after the catheter in the first daysComplications and red flagsWhat needs a same-day call after surgeryCaretaker and family guide to surgeryHelping at home after discharge
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