Penile Ca

Question 1

Penile lesion assess pt

Answer 1

See in 2 ww clinic with partner if feasible
Hx : duration , painful/less, associated discharge or itching , urinary symptoms, sexual hx, hpv hx , smoking hx , immunobcompoimised, circumcision as a child , phimosis

O/E offer chaperone , general health, abdomen , groins , genitalia , lesion exophytic or diffuse.
Circumcised or not , relation to meatus , palpate for lesion extension into corpus spongiosum or corpora cavernosa , groins for palpable LNs

Question 2

PeIN

Answer 2

Premalignant condition
HPV related or Lichen sclerosis related

Treatment
Circumcision is usually curative

5 FU topical for 4 weeks or
Imiqumoid ( immunotherapy) for 6 weeks or
Laser Nd:yag
Or photo dynamic therapy

Can offer punch bx