Genitourinary reconstruction may be performed to resolve a variety of urologic conditions.
Genitourinary reconstruction encompasses several procedures that doctors might discuss with patients suffering from certain conditions affecting the health of their urinary system. Having the basic facts may help men to determine when this type of surgery might be warranted.
Reasons for Genitourinary Reconstruction
Men might require this type of surgery for several reasons, including: .
- Urethral stricture
- Upper urinary tract reconstruction
- Hypospadias repair failure
- Penile prosthesis surgery
- Trauma or oncology-related reconstruction
- Recto-urethral fistula disease
- Concealed penis repair
- Erectile dysfunction
- Peyronie’s disease or penile curvature reconstruction
Bladder Control Procedures
There are a few procedures doctors might consider if a patient is having trouble controlling their bladder and if they are not being helped by medications or other more conservative treatments. These may include:
- Implanting a device that works to treat urinary retention, overactive bladder, and even fecal incontinence.
- Artificial urinary sphincters are primarily used to help with stress incontinence in cases where a patient has significant leakage of urine when they are exercising, sneezing, lifting heavy objects, coughing, laughing, and other body movements.
- Nerve rerouting helps with certain bladder issues by redirecting spinal cord nerves to help the patient in better controlling their urination. Once this procedure is done, when the patient needs to empty their bladder, they will either pinch or scratch their buttock or leg.
Sexual Dysfunction Procedures
There are medications and conservative treatments that can be tried initially, but when surgery is warranted for sexual dysfunction, there are various options. For erectile dysfunction, a penile prosthesis might be considered. This is a type of inflatable implant or a rod that is malleable and semi-rigid that is placed into the penis.
If the patient has Peyronie’s disease, there are three surgical procedures that may be considered:
- Penile prosthesis is an option to correct the penile curvature that might occur in men who have this condition.
- Penile plication procedures might be considered to reduce the length of the long side of the penis.
- Plaque excision/incision and grafting works to remove a plaque and then using a graft to fill in any space that might result. The removal of the plaque, or its associated incision, may be partial or complete.
Urethral Reconstructive Surgery
- Urethroplasty may be performed to reconstruct the urethra due to issues such as urethral strictures.
- Ileal conduit formation takes a piece of a person’s intestine and then uses it to create a channel to connect the patient’s ureters.
- Indiana pouch is done to create a urinary diversion to allow urine to flow from the body.
- Mitrofanoff procedure is done to create a conduit between the bladder and skin surface. The conduit is created from the appendix.
- Ileal neobladder uses the ileum to create urinary diversion.
- Ureteral reimplantation is a procedure that is used to fix the ureters.
If surgery is needed, it is imperative that the patient follow all pre-surgical instructions exactly. Following any of these procedures, doctors will provide patients with detailed recovery information.