Penile cancer (PC) is a rare malignancy, with an average of just 50 new cases diagnosed each year in the Republic of Ireland [[1], [2]]. The majority of PC is squamous cell carcinoma (SCC) [3]. Risk factors for PC include human papilloma virus (HPV) infections, most commonly strains 16 and 18, phimosis, chronic inflammation, smoking and poor hygiene. The development of the quadrivalent HPV vaccine, initially commencing in Ireland in 2010 for females and in 2019 for males, has been shown to significantly reduce HPV-associated genital disease in men, including genital warts with an efficacy of 89.4% [4].

There is growing evidence internationally that centralisation of services to treat rare malignancies such as PC improves outcomes for patients and leads to both improved survival as well as improved quality of life [[5], [6], [7]]. Given the rarity of the disease, the National Institute of Clinical Excellence (NICE) have recommended the establishment of specialised PC multidisciplinary teams, and that a team should serve a population base of ≥4 million patients, expecting to manage a minimum of 25 new patients each year [8]. Prior to centralisation, the management of PC in secondary and tertiary centres was based on unclear protocols and in order to eliminate inconsistencies a supra-regional network that is standardised and easily accessible to all patients was recommended [7]. In the Republic of Ireland this has led to the formation of a single centre supra-regional approach [7,9].

The primary aim of this study was to determine the outcomes after 5-years of national centralisation of PC care in the Republic of Ireland relating to the rates of phallus preservation.