When is this exam indicated?
Biopsy can be performed on any part of the penis: foreskin, glans, penile shaft. For lesions involving the external urethral meatus, urethroscopy may be required to evaluate urethral involvement. The scope of the biopsy depends on the characteristics of the penile lesion and is determined by the urologist, in order to ensure the most accurate anatomo-pathological analysis possible.
There are two types of biopsy, incisional or excisional. The incisional biopsy consists in taking a fragment of the lesion with a scalpel. Excisional biopsy, on the other hand, involves the removal of the entire lesion in question. In any case, it is important that the sampling enables to evaluate the depth of the lesion. Following the biopsy, some sutures will be applied, normally resorbable, to reduce bleeding.
How is it performed?
As a rule, if a benign or a small lesion is suspected, an excisional biopsy is performed, with both diagnostic and therapeutic intent. In case of suspicion of a cancerous lesion or a large lesion, an incisional biopsy with extemporaneous histological examination can be performed, so that definitive treatment can be carried out immediately during the same surgical session. In addition, if the lesion is located on the foreskin, a circumcision is often required.
The biopsy can be performed under local anesthesia (penile block) or general anesthesia, depending on the extent of the collection. Complications related to this procedure are minimal; the most frequent are infection and dehiscence of the wound and bleeding.
There are no absolute contraindications to penile biopsy. Particular attention should be paid to coagulated and uncoagulated patients for the consequent risks of bleeding and to immunocompromised individuals for the consequent risks of infection.