Penile lesion biopsy at Cheltenham Hospital

Why might I need one?

Your doctor might recommend a biopsy if they've examined a lump, spot, ulcer or patch of skin on your penis and cannot be certain what it is from looking alone. It's also used when there's a chance the change could be cancerous, so this needs to be ruled out.

Many lumps and marks on the penis are completely normal and harmless. A biopsy is used when there's genuine doubt about the diagnosis, not for every lump you notice.

What are the benefits of having it?

A biopsy gives you a definite answer about what a lesion is, rather than relying on how it looks. This means you can be reassured quickly if it's harmless, or start the right treatment quickly if it's not.

It's worth knowing that a biopsy isn't always the first step. In some cases, a second opinion from a specialist, or being reviewed again in a few weeks, can be just as useful, since normal, harmless lumps don't tend to change over time.

Are there different types of biopsy?

Yes. Depending on the lesion, your consultant may use:

• an excisional biopsy, removing the whole lesion if it's small enough, with the sample sent to the laboratory for testing
• an incisional biopsy, removing part of a larger lesion
• a punch or shave biopsy, used for some smaller or surface lesions.

An excisional biopsy also acts as treatment, since the lesion is removed completely at the same time as it's sampled.

How do I prepare for it?

Before recommending a biopsy, your doctor will usually examine the area and ask about your health first, including:

• your sexual history and any previous sexually transmitted infections
• whether you smoke or use recreational drugs
• whether you're circumcised
• any urinary symptoms you've had.

They'll also check the lymph nodes in your groin as part of this assessment.

What happens during the biopsy?

The procedure is usually done under local anaesthetic, so you'll be awake but the area will be numbed. It's normally carried out as an outpatient, so you won't need to stay in hospital overnight.

Your consultant removes either the whole lesion (excisional biopsy) or a smaller sample of it (incisional, punch or shave biopsy), depending on its size. The sample is then sent to a laboratory to be tested.

What happens after the biopsy?

You'll usually be able to go home shortly after the procedure, as it's normally done on an outpatient basis.

To allow the delicate skin edges to bond cleanly and prevent the fine stitches from opening, you must observe strict pelvic rest for a minimum of 2 weeks post-surgery. This means completely avoiding all forms of sexual intercourse, penetrative activity, masturbation, and heavy physical groin straining.

What happens next depends on the biopsy result. If the lesion is benign, it may simply be monitored or treated with a cream. If it turns out to be cancerous, you'll usually need surgery.