Demographic analysis of penectomies in France from 2019 to 2022

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INTRODUCTION: Penectomy, whether partial (PP) or radical (RP), are mainly performed for oncological reason. It is a rare but impactful surgery, with significant bio-psycho-social consequences. As some countries moves towards centralization to improve patient outcomes, a demographic analysis of current management in France is needed. This study provides a demographic analysis of partial and total penectomies performed in France from 2019 to 2022. METHODS: All 2150 total and partial penectomies performed in French healthcare facilities from 2019 to 2022 were included. Data were extracted from Visuchir, an Assurance Maladie data-visualization tool. RESULTS: Incidence and ratio are stable, around 100 RP and 400 PP per year. The median age of patients was 78. Half of all penectomies were performed in private facilities (n=1115, 51.9%), with a higher rate of PP in these centers (55%, P<0.05). The rate of RP was significantly higher in comorbid patients than the fitter ones. In total, 423 centers reported at least one penectomy over the period, with significant variations in volume. In total, 251 facilities performed less than one procedure per year (59%), while larger centers performed up to 85 over the 4-year period. Length of stay was significantly shorter in high-volume centers. CONCLUSION: This study shows the heterogeneous distribution and management of penectomies in France. Although there is no official centralization, the data reveal a "reference center" trend. Further data could help determine whether management in high-volume centers improves survival and quality of care for patients requiring penectomy.

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