For smaller primary penile tumors, organ-preserving treatment is recommended, but with a concomitant increased risk of local recurrence (27%) and is not recommended for tumors larger than 4 cm, or pathologically graded grade III, or invading the urethra of the penile head, or invading the corpus cavernosum of the penis. For patients with invasion of the corpus cavernosum (T2), most guidelines recommend mandatory penectomy (partial or total), regardless of tumor size. For patients with invasion of the urethra (T3), total penile excision with perineal urethrostomy is mandatory. Total penile excision should also be performed in patients who are unable to achieve standing urination at the penile stump after securing an exact surgical margin. When performing total penile dissection: 1. When separating the ventral part of the penile root, pay attention to pulling the scrotum and testicles to avoid damage to the testicles and spermatic cord. If the tumor is large, it often invades the scrotal skin and needs to be removed together. 2.The subcutaneous area separated by total penile excision is large, and the subcutaneous tissue of perineum is loose and rich in blood supply and lymphatic tissue, so subcutaneous bleeding, edema and lymphatic fistula are likely to occur after surgery. However, the blood vessels supplying the scrotum are mainly distributed longitudinally from above to below, so when making an incision around the root of the penis, avoid making a transverse shuttle incision, and instead make a longitudinal shuttle incision, which can reduce the destruction of the blood supply to the scrotal incision and avoid postoperative ischemic necrosis of the incision. 3.The subpubic incision should be closed with layered sutures to leave no dead space, the drainage tube should be low to fully drain the scrotum, the tissue at the scrotum is loose, and a small amount of effusion after surgery may lead to infection. 4.It is recommended that in addition to placing two drainage tubes for adequate drainage. 5.The scrotum is held up with an ice saline bag and applied externally within 48 hours after surgery, which can reduce local edema and oozing of blood from the scrotum and effectively prevent infection of the incision. 6, total penile incision will cause serious psychological burden to patients, especially young patients, so the doctor should fully communicate and communicate with them before and after surgery, and when conditions permit, ask the psychologist to participate in the treatment. With the development of plastic surgery technology, cases of simultaneous or late penile reconstruction and prosthesis implantation have been reported.