ABSTRACT
Objective
To examine the routes to penile cancer diagnosis and the role of penile biopsy.
Materials and Methods
This retrospective observational study from a tertiary referral center included 625 patients referred as urgent suspected penile cancer within the Danish Cancer Patient Pathway (CPP) and 216 patients undergoing penile biopsy outside the CPP between January 1, 2021 and March 31, 2025. The main outcomes were the number of patients diagnosed within and outside the CPP and secondary outcomes included biopsy findings, the ratio between urgent suspected penile cancer referrals and the number of patients subsequently diagnosed with penile cancer.
Results
Among 529 patients referred under the CPP for suspected penile cancer, only 10% were diagnosed with cancer. Biopsy confirmed cancer was more frequent within the CPP, though overall cancer detection rates were similar (~10%). Patients biopsied outside the CPP were younger and more often had prior biopsies. Complication rates after penile biopsy were low and comparable between groups. Diagnostic concordance between clinical suspicion and histology was slight (κ = 0.20, SE 0.04) for cancer and fair (κ = 0.33, SE 0.05) for PeIN. Biopsies demonstrated both diagnostic and therapeutic value, occasionally altering clinical management.
Conclusion
The CPP identifies a higher proportion of malignancies but with a low overall conversion ratio, and some cancers are still diagnosed outside the pathway. Penile biopsy is safe and essential for accurate diagnosis due to low clinical–histological concordance, with added therapeutic value. Continued focused penile biopsy use, including re‐biopsy in uncertain cases, is warranted to ensure optimal management and oncological safety.
Keywords: biopsy, early detection of cancer, pathology, penile neoplasms, squamous cell carcinoma
1. Introduction
Based on recent data from the UK National Health Service (NHS), the ratio between urgent suspected cancer referrals and the actual number of patients subsequently diagnosed with cancer is approximately 14:1 to 16:1. For every 100 patients urgently referred for suspected cancer, only about 6 to 7 are diagnosed with cancer [1]. For suspected penile cancer, this number has yet to be established. Clinical experience with penile cancer is sparse and treatment with a curative intent has been centralized to two Danish centers [2]. The appearance of penile tumors is diverse and owing to the rarity of the disease and lack of awareness, patient and doctor may misinterpret penile cancer symptoms as condyloma, benign phimosis or benign skin conditions [3, 4, 5, 6, 7]. Several studies have examined time intervals and factors delaying penile cancer diagnosis [4, 5, 8, 9, 10, 11, 12, 13, 14]. In 2008–2009, in Denmark, national cancer plans introduced the Cancer Patient Pathway (CPP) a common framework to reduce the diagnostic delay and unjustified waiting times by fast‐track referral and set timeframes for units participating in cancer diagnosis and treatment. We previously studied the CPP as an intervention to reduce penile cancer treatment delay caused by unnecessary reluctance of the healthcare system, but did not consider the referral to diagnosis conversion ratio and the penile biopsy outcomes of patients referred [14].
Here we aimed to assess the diagnostic pathways of penile cancer at a tertiary referral university hospital and investigate penile biopsy practice and outcomes. Furthermore, we examined the ratio between suspected penile cancer referrals and the number of patients subsequently diagnosed with penile cancer and estimated the biopsy to cancer ratio of patients diagnosed from trajectories outside the CPP.
2. Materials and Methods
2.1. Study Design and Setting
The study was conducted as a single center retrospective observational study in one of the two tertiary referral centers for penile cancer in Denmark. The center handles all referrals for penile cancer from the area of western Denmark (~3.0 million inhabitants).
2.2. The Cancer Patient Pathway for Penile Cancer
The penile CPP defines milestones and time limits in calendar days of the patients' clinical pathway. The CPP sets a time limit of 6 days between referral to a tertiary center and the patient's first visit to the center, 21 days from the first visit until referral to treatment. The penile biopsy is typically taken at the first visit. From referral to start of definitive treatment, the framework allows 10 days. The CPP defines penile cancer warning signs—so‐called ‘alarm symptoms’, which should lead to immediate referral, see Table S1. For patients referred to a regional hospital with penile cancer suspicion, the Danish penile cancer guidelines advise local dermatologists and urologists to either perform a penile biopsy at the local hospital or refer to the tertiary center for biopsy.
2.3. Study Population
Patients urgently referred with suspected penile cancer to Aarhus University Hospital in the period January 1, 2021 to March 31, 2025 were identified in the departments' business intelligence portal. To elucidate the trajectories of men diagnosed with penile cancer outside the CPP, data on penile histology and complications on 398 patients referred for penile biopsy were extracted from medical records and administrative systems based on code for penile biopsy from the same period. We validated all patients and established the clinical flow toward diagnosis of penile cancer and other clinical and histopathological outcomes as depicted in Figure 1.
FIGURE 1.
Patient and biopsy flow chart. Patients biopsied at the local hospital arriving at the tertiary center with the histological diagnosis of penile cancer were not the focus of this study. We have included these patients in a separate box in the figure for completeness, but they were not a part of the biopsy outcome investigations.
In cases where multiple biopsies were taken from different anatomical sites on the same day, we defined the histological outcome and the biopsy site as the site with the most severe histological outcome (squamous cell carcinoma (SCC) > Penile intraepithelial neoplasia (PeIN) > inflammation/benign). For patients referred with a biopsy‐confirmed diagnosis of PeIN, the indication was recorded as “suspected PeIN,” and the newly obtained biopsy from our institution, often performed because of suspicion of more invasive disease, served as the study baseline.
For patients with further penile surgical treatment, specimens were analyzed if obtained within 3 months following biopsy. These procedures included a secondary penile biopsy, removal of foreskin, glans resection, glansectomy, partial, and total penectomy.
Tru‐cut coarse needle biopsy was categorized with punch biopsies. Prior biopsies performed by private providers outside the public pathology database were assumed benign if not otherwise documented.
2.4. Pathology Data
All procedures were compliant with relevant laws, institutional guidelines and in line with WHO Guiding Principles with approval from our institutional committee, number 662027270325. We used pathology registry data on formalin‐fixed paraffin embedded biopsy and surgical specimen. No pathology re‐revision was performed in this study.
2.5. Analysis
Study data were collected and managed using REDCap electronic data capture tools. Data are presented as percentages, means, medians, and 1st to 3rd interquartile ranges. Medians were compared between two groups by the Wilcoxon rank sum test, and we used the Kruskal‐Wallis test for comparison of more than two outcomes between groups. We calculated Cohens kappa for cancer suspicion by the clinician and final cancer histology and for PeIN suspicion by the clinician and final PeIN histology. We used the recommendations from Landis and Koch to report the magnitude of agreement [15]. All estimates were performed with Stata Now 19.5 MP—Parallel Edition, StataCorp LLC Licensed to the Central Danish Region.
3. Results
During the study period January 1, 2021, to March 31, 2025 a total of 625 patients were referred to our hospital within the framework of the urgent Cancer Patient Pathway (CPP). Out of the 625 patients in the CPP, 529 were clinically evaluated at our department, of these, 347 (55.5%) patients were managed without penile biopsy as the evaluating urologist at the tertiary center deemed biopsy unnecessary and followed conservative treatment, observation or ended the hospital trajectory after reassuring the patient (Figure 1). 182 patients went on to have a penile biopsy taken of which 54 biopsies harbored cancer, rendering a cancer detection rate among referrals of 54/529 (10.2%).
3.1. Patients Undergoing Penile Biopsy Outside the Cancer Patient Pathway
In the same period, 216 patients outside the CPP had a penile biopsy taken, of which 38 patients were internally referred from a follow up programme typically for PeIN or Lichen, whereas 178 patients were referred from general practitioners, private practice dermatologists, hospital dermatologists, or other stakeholders with different penile pathology for urologist evaluation. Of the 216 patients outside the CPP who had penile biopsies taken, 21 biopsies harbored cancer, rendering a cancer detection rate among referrals of 21/216 = 9.7% (Figure 1). Patients biopsied outside the CPP were younger than patients referred in the CPP median (Q1–Q3) 66 (56–74) years vs. 70.5 years (60–78), p = 0.005.
3.2. Biopsy Practice
Excisional knife biopsies dominated in both groups, and more patients outside the CPP compared to patients referred in the CPP had previous biopsies (at least one) from the penis in the history 110/216 (46%) vs. 48/182 (26%), p < 0.001. There was a trend that a history of numerous penile biopsies in the same patient was more frequent in patients referred within the CPP with a mean (range) number of biopsies was 2.29 (1–11) vs. 1.68 (1–8), p = 0.07, in patients biopsied outside the CPP. A trend toward difference in anatomical sites of biopsy was observed with more biopsies close to meatus and at the ventral phrenulum‐near aspects of glans within the CPP as opposed to more biopsies from dorsal glans in patients biopsied outside the CPP, however the difference did not reach statistical significance at this cohort size p = 0.1 (Table 1).
TABLE 1.
Patient characteristics of the penile biopsy cohort.
| Total biopsy cohort | Cancer patient pathway | Standard trajectory | p | |
|---|---|---|---|---|
| Patients, n (%) | 398 (100) | 182 (46) | 216 (54) | |
| Age, years, mean (range) | 65.8 (19–94) | 68.2 (25–94) | 63.8 (19–92) | 0.005 |
| Age, years, median (Q1–Q3) | 68 (58–76) | 70.5 (60–78) | 66 (56–74) | |
| Biopsy type, n (%) | ||||
| Excision biopsy, knife | 391 (98) | 178 (98) | 213 (99) | 0.81 |
| Punch or coarse needle biopsy | 7 (2) | 4 (2) | 3 (1) | |
| Biopsy position, n (%) | Multiple positions possible, percentages do not add to 100 | |||
| Glans dorsal | 168 (42) | 68 (37) | 100 (46) | 0.1 |
| Preputial inner lining | 139 (35) | 59 (32) | 80 (37) | |
| Corona glandis | 48 (12) | 25 (14) | 23 (11) | |
| Close to meatus | 47 (12) | 27 (15) | 20 (9) | |
| Preputial outer lining | 45 (11) | 16 (9) | 29 (13) | |
| Glans ventral/phrenulum | 36 (9) | 22 (12) | 14 (6) | |
| Shaft skin | 24 (6) | 9 (5) | 15 (7) | |
| Tumor stage of final cancer specimen, n (%) | ||||
| T0 | 324 (81) | 129 (71) | 195 (90) | < 0.001 |
| T1a | 28 (7) | 18 (10) | 10 (5) | |
| T1b | 15 (4) | 9 (5) | 6 (3) | |
| T2 | 21 (5) | 17 (9) | 4 (2) | |
| T3 | 8 (2) | 8 (4) | 0 (0) | |
| T4 | 2 (0.5) | 1 (0.6) | 1 (0.5) | |
| Previous penile biopsies (≥ 1), yes n (%) | 158 (40) | 48 (26) | 110 (46) | < 0.001 |
| Number of previous penile biopsies, mean (range) | 1.86 (1–11) | 2.29 (1–11) | 1.68 (1–8) | 0.07 |
| Number of previous penile biopsies, meadian (Q1–Q3) | 1 (1–7) | 1 (1–3) | 1 (1–2) | |
| Procedure time penile biopsy a , minutes, mean (range) | 44 (3–244) | 41 (10–84) | 45 (3–244) | 0.89 |
| Number of patients within guarantee time limits, n (%) | — | 64 (35) | — | — |
| Cancers diagnosed, n (%) | 75 (18) | 54 (30) | 21 (10) | 0.005 |
Penile biopsy was in some cases a part of a larger surgical procedure and the recorded times are for procedure totals. Wilcoxon rank‐sum test used for binary grouping variables and Kruskal–Wallis test for more groups.
3.3. Penile Biopsy Outcomes
The biopsy outcomes within and outside the CPP differed significantly with a larger fraction of cancer harboring biopsies within the CPP 54/182 (29.7%) than outside 21/216 (9.7%), and the other way around for PeIN 40/182 (22%) inside the CPP vs. 75/216 (35%) outside, p = 0.005.
3.4. Penile Biopsy Related Complications
A low rate of reported penile biopsy‐related complications was observed (Table 2). A total of 17/398 (4.3%) patients reported pain, 14/398 (3.5%) bleeding and/or hematoma and 13 (3.3%) swelling. Most notably, only 11 (2.8%) patients had a wound infection after penile biopsy. There was no difference in biopsy‐related complications between patients referred within the CPP and patients biopsied in a standard trajectory. Four patients in the CPP group died within 3 months, two of penile cancer, and no patients outside the CPP died within 3 months after biopsy, p < 0.001.
TABLE 2.
Outcome of penile biopsy and biopsy complications.
| Total biopsy cohort | Cancer patient pathway | Standard trajectory | p | |
|---|---|---|---|---|
| Patients, n (%) | 398 (100) | 182 (46) | 216 (54) | |
| Penile biopsy outcome, n (%) | ||||
| Benign, inflammation | 205 (52) | 86 (47) | 119 (55) | 0.005 |
| Penile intraepithelial neoplasia (PeIN) | 115 (29) | 40 (22) | 75 (35) | |
| Squamous cell carcinoma | 73 (18) | 53 (29) | 20 (9) | |
| Other malignancy | 2 (0.5) | 1 (1) | 1 (0.5) | |
| Insufficient biopsy | 3 (0.5) | 2 (1) | 1 (0.5) | |
| Penile biopsy related complications, n (%) | ||||
| None observed | 342 (86) | 160 (88) | 182 (84) | 0.43 |
| Bleeding/hematoma | 20 (5) | 6 (3) | 14 (6) | |
| Pain/discomfort | 17 (4) | 6 (3) | 11 (5) | |
| Biopsy site wound infection | 10 (3) | 5 (3) | 5 (2) | |
| Lower urinary tract infection | 0 | 0 | 0 | |
| Other complications | 14 | 7 (4) | 7 (3) | |
| Treated with antibiotics after biopsy, n (%) | ||||
| No antibiotics | 374 (94) | 170 (93) | 204 (94) | 0.84 |
| Yes, oral antibiotics | 24 (6) | 12 (7) | 12 (6) | |
| Yes, intravenous antibiotics | 0 | 0 | 0 | |
| Dead within 3 months, n (%) | ||||
| All causes | 4 (1) | 4 (2) | 0 | < 0.001 |
| Penile cancer | 2 (0.5) | 2 (1) | 0 | |
Note: Wilcoxon rank‐sum test used for binary grouping variables and Kruskal–Wallis test for more groups.
3.5. Comparison of Penile Biopsy Outcomes With Eventual Operative Specimens
In 297/398 patients (75%) no operative specimen was available within 3 months after the penile biopsy (Table 3 and Table S2). In 101 (25%) patients, an operative specimen was identified within this period. The procedures identified were a secondary penile biopsy, removal of foreskin, glans resection, partial penectomy, and total penectomy. Penile biopsies are often used both as a diagnostic and therapeutic measure. In our clinical setting, biopsies often aim to radically excise pathology covering small areas. This scenario was observed in 89/115 (77.4%) patients with PeIN in the penile biopsy. The diagnostic function of the penile biopsy is reassuring in the context for patients with PeIN, who can be offered topical treatment or laser treatment for any further visible pathology on the penis. The clinical value of repeat biopsy is illustrated by the 26 patients in whom the clinical decision was to perform a further biopsy after a primary PeIN finding, because the clinician was not completely reassured that the macroscopic appearance of the penis was compatible with an only PeIN biopsy. One (3.8%) of these 26 patients had no further visible pathology in the following biopsy, 7 (26.9%) patients had inflammatory findings not compatible with PeIN features, 11 (42.3%) had PeIN also in the second biopsy and went on to laser‐ablation or topical treatment and in 7 (26.9%) patients cancer was detected in the second biopsy and significantly changed the clinical trajectory. Therapeutic action was observed in 18/73 (24.7%) patients with SCC with free biopsy margins requiring no further penile surgery (Table 3). In 73 patients with SCC in the penile biopsy, 40 (54.8%) of the operative specimens harbored further SCC.
TABLE 3.
Penile biopsy outcome, n (%).
| Outcome of operative specimen within 3 months after the penile biopsy; foreskin, glans resection, partial penectomy, total penectomy, n (%) | |||||||
|---|---|---|---|---|---|---|---|
| No disease left | Benign/inflammation | PeIN | SCC | Other malignancy | No operative specimen | Total | |
| Penile biopsy outcome of primary penile biopsy, n (%) | |||||||
| Benign/inflammation | 1 (0.5) | 11 (5.4) | 3 (1.5) | 1 (0.5) | 0 | 189 (92.2) | 205 (100) |
| PeIN | 1 (0.9) | 7 (6.1) | 11 (9.6) | 7 (6.1) | 0 | 89 (77.4) | 115 (100) |
| SCC | 0 | 6 (8.2) | 9 (12.3) | 40 (54.8) | 0 | 18 (24.7) | 73 (100) |
| Other malignancy | 0 | 0 | 0 | 0 | 2 (100) | 0 | 2 (100) |
| Insufficient biopsy | 0 | 1 (33.3) | 0 | 1 (33.3) | 0 | 1 (33.3) | 3 (100) |
| Total | 2 (0.5) | 25 (6.3) | 23 (5.8) | 49 (12.3) | 2 (0.5) | 297 (74.6) | 398 (100) |
Note: In 297 patients (75%) no operative specimen within 3 months after the penile biopsy was available. Lesions were either completely excised by the penile biopsy (free margins) or in cases of Penile intraepithelial neoplasia (PeIN) went on to laser‐ablation or topical treatment with no further biopsies during the 3 months following the primary biopsy. 101 (25%) patients had an operative specimen within 3 months after the penile biopsy: foreskin, glans resection, partial penectomy, total penectomy.
Abbreviation: SCC, squamous cell carcinoma.
3.6. Comparison of the Clinical Diagnosis by the Referring Doctor and the Biopsy
In 182 patients referred with the suspicion of cancer 86 patients (47.3%) had benign inflammatory penile conditions, most often Lichen Sclerosus, whereas 54 (29.7%) had cancer (Table 4). Cohen's kappa for the concordance between the diagnostic guess of the clinician “cancer” and the cancer histology was 0.20, SD 0.04, which is equal to an interpretation of slight agreement. The agreement between the referring doctors' clinical suspicion and the primary biopsy for PeIN was fair with a Cohen's kappa of 0.33, SD 0.05.
TABLE 4.
Comparison of the clinical diagnosis by the referring doctor and the biopsy outcome in 398 penile biopsy patients.
| Penile biopsy outcome in 398 patients, n (%) | |||||
|---|---|---|---|---|---|
| Insufficient biopsy | Benign/inflammation | PeIN | Cancer | Total | |
| Clinical diagnosis by the doctor referring to penile biopsy | |||||
| SCC | 2 (1.1) | 86 (47.5) | 40 (22.1) | 54 (29.7) | 182 (100) |
| PeIN | 0 | 30 (32.6) | 52 (56.5) | 9 (9.89) | 91 (100) |
| Phimosis/biopsy during surgery | 0 | 22 (71.0) | 3 (9.7) | 6 (19.4) | 31 (100) |
| Ulcer non‐healing | 1 (3.7) | 20 (74.1) | 5 (18.5) | 1 (3.7) | 27 (100) |
| Condyloma | 0 | 2 (40.0) | 3 (60.0) | 0 | 5 (100) |
| Other indication | 0 | 45 (72.6) | 12 (19.4) | 5 (8.1) | 62 (100) |
| Total | 3 (0.8) | 205 (51.5) | 115 (28.9) | 75 (18.8) | 398 (100) |
Note: Cancer includes SCC and 2 other malignancies (1 Malignant extramammary Pagets disease, and 1 malignant melanoma).
4. Discussion
We found that the ratio between urgently suspected penile cancer referrals and the actual number of patients histologically verified with penile cancer was 10.2% within the CPP and 9.7% in the cohort undergoing penile biopsies outside the CPP. In most cancer types, a ratio between urgent suspected cancer referrals and the actual number of patients histologically verified with cancer is around 6%–7% [1]. This may be due to the external and visible presentation of penile cancer and the sometimes recognizable differential diagnoses, allowing biopsies to be targeted at the most suspicious cases. In the case of lung cancer, for example, hemoptysis is a more non‐specific symptom that can mask various benign conditions [16]. As expected, given their differing risk profiles, more cancers were detected in the CPP cohort, n = 54/182 (29.7%) vs. n = 21/216 (9.7%) and two penile cancer related deaths occurred within 3 months in the CPP group versus none outside. However, there is still a notable proportion of patients diagnosed with invasive penile cancer outside the CPP, reflecting that the morphology of penile cancer is not always straightforward. This underlines the importance of frequent biopsies in cases of doubt and mismatch between clinical appearance and previous biopsy results.
The size of a penile biopsy is an important factor in case of suspicion of malignant or premalignant disease, because in very small biopsies below 1 mm, it is challenging for the pathologist to assess tumor infiltration. Velazquez and coworkers reported that assessment of tumor infiltration was technically impossible in 91% of very small biopsies [17]. The majority (98%) of penile biopsies were knife biopsies performed by a urologist, aiming for excision of smaller lesions and incision of larger lesions.
The penile biopsy procedure was, overall, well tolerated, and our complication rate at 56/398 (14.1%) is slightly lower than the 17% reported by David et al. [18]. The rate of biopsy‐related infections in our study at 2.8% is in concordance with other penile biopsy infection rates reported in earlier studies in the field [19, 20]. Histological findings were consistent with the clinical diagnosis in 52/92 (56.5%) of patients referred with suspected PeIN, and 54/182 (29.7%) of patients referred with suspected penile cancer. This correlates with other studies [19, 20, 21]. However, most other studies of penile biopsies in genitourinary medicine settings have primarily focused on lichen, non‐specific balanitis, genital warts, and other benign pathology.
This study has several weaknesses. The retrospective design introduces reporting bias and our lack of photo‐documentation of biopsied lesions limits the educational potential and the generalizability of the diagnostic guess of the referring doctor. Biopsy decisions were clinician dependent, introducing potential verification bias but also reflecting real‐word practice. A major strength is the use of a well‐defined patient sample. To our knowledge, this is the first study of this kind to include a penile biopsy patient sample of this magnitude. Histopathological and clinical data were collected using predefined criteria, we used pathological data recorded in clinical practice. No central pathology re‐review was performed, and interobserver variability in penile lesions is well known [22, 23, 24, 25, 26]. These data stem from a tertiary referral center, and our high fractions of PeIN and penile SCC may not represent the clinical everyday numbers at less specialized hospitals. Patients referred to the department, based on a biopsy performed elsewhere that verified PeIN were included. This likely overestimates the clinical‐histological agreement on that specific entity and contributes to the higher proportion of PeIN diagnoses in the non‐CPP cohort, which should be considered when comparing biopsy outcomes between groups. Further, the inclusion of this subgroup may not reflect the background population of the non‐CPP cohort. In general, the findings of the study justify the practice of performing diagnostic penile biopsy before deciding if further surgical strategies are warranted and performing re‐biopsy if the outcome of the primary biopsy does not seem to represent the macroscopically evaluated lesion.
In this retrospective cohort, the Cancer Patient Pathway (CPP) identified a higher proportion of patients with malignant penile biopsies compared to patients managed outside the CPP. The overall CPP cancer detection rate among referrals was 10% and slightly higher than CPP conversion ratios in other cancers. A substantial number of patients were managed without penile biopsy, reflecting appropriate clinical triage, yet a notable proportion of cancers were still diagnosed outside the CPP, underscoring the diagnostic challenges of penile lesions. Penile biopsy proved to be a safe procedure with low complication rates and demonstrated both diagnostic and therapeutic value, including cases where management was altered following re‐biopsy. The slight clinical–histological concordance for cancer (κ = 0.20) and fair concordance for PeIN (κ = 0.33) reflect several well‐recognized challenges including that the rarity of penile cancer limits clinician case experience even at specialist centers, early squamous cell carcinoma overlaps morphologically with high‐grade PeIN and severe lichen sclerosus and interobserver variability in histological grading cannot be excluded as a contributing factor in the absence of central pathology re‐review. Collectively, these findings reinforce histological confirmation as a clinical necessity before any definitive management decision.
Author Contributions
Christian Raun Boné: conceptualization, writing – original draft, writing – review and editing, data curation, formal analysis, visualization, methodology. Jakob Kristian Jakobsen: conceptualization, writing – original draft, writing – review and editing, formal analysis, methodology, supervision, visualization.
Funding
The authors have nothing to report.
Ethics Statement
The protocol for this research project has been approved by a suitably constituted Ethics Committee of the institution, and it conforms to the provisions of the Declaration of Helsinki. Committee of Aarhus University Hospital, Approval No. 6620271030325.
Consent
Penile biopsies were performed after individually obtained informed consent from the patient.
Conflicts of Interest
C.R.B. declares no conflicts of interest (COI). J.K.J. declares the following COI: Unrelated grant from Novo Nordisk Foundation, support for meeting attendance from Medac, advisory role for Cystotech.
Supporting information
Table S1: Warning signs for immediate referral.
Table S2: Comparison of 101 penile biopsy outcomes with operative specimen within 3 months after the penile biopsy. Operative specimen within 3 months after the penile biopsy; foreskin, glans resection, partial penectomy, total penectomy.
Data Availability Statement
The data that support the findings of this study are available on request from the corresponding author. The data are not publicly available due to privacy or ethical restrictions.
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Associated Data
This section collects any data citations, data availability statements, or supplementary materials included in this article.
Supplementary Materials
Table S1: Warning signs for immediate referral.
Table S2: Comparison of 101 penile biopsy outcomes with operative specimen within 3 months after the penile biopsy. Operative specimen within 3 months after the penile biopsy; foreskin, glans resection, partial penectomy, total penectomy.
Data Availability Statement
The data that support the findings of this study are available on request from the corresponding author. The data are not publicly available due to privacy or ethical restrictions.