The lymphatic drainage of the penis is entrusted to superficial and deep inguinal nodes and is characterized by a well known anatomy crossover between those two groups, both omolaterally and bilaterally. The sentinel node for the prepuce is located on the supero-medial zone and drains from this to the superficial inguinal nodes (8 to 25 nodes) while glans and corpora cavernosa could drain to superficial inguinal node or directly to the deep inguinal nodes and to the external iliac nodes. For this reason, in patients undergoing lymphadenectomy both the superficial and deep inguinal nodes are removed according to the ilioinguinal Lymph node dissection (IILND), in fact in more than 50% of patients treated with a bilateral inguinal lymphadenectomy controlateral metastases were found despite the absence of palpable lymph nodes.
