Penile carcinoma is a tumoral condition of inconsistent incidence. Its biological and etiological features are under permanent scientific review. Such circumstance is increased by the growing awareness of a greater demand of anything related with the patients' quality of life. This paper reviews the latest controversies guiding current therapeutic approaches in penile cancer. An analysis is made through a revision of the lymphadenectomy indication and its therapeutic value, criteria related to technical aspects and indications. At the same time, the criteria that should preside over the choice between conservative or radical options are established and emphasis is placed on the growing role of prevention in tumoral conditions and the contribution of innovative gene therapy regimes.