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Reconstructive and Prosthetic Urology
Difficulties in relation to your bladder or sexual health can negatively impact a man’s day-to-day quality of life. Many men suffer from treatable symptoms of genitourinary disorders for years before seeking treatment, causing unnecessary grief and possible long-term problems.
Our team of specialists, led by a fellowship-trained surgeon, offers precise treatments for male genital and urethral disorders that can help put an end to this suffering and facilitate a return to a healthy, normal life.
Male reconstructive urology
As a sub-specialty of urology also called Male Genitourinary Reconstruction, it focuses on restoring normal function by repairing, rerouting or recreating areas of the upper and lower urinary tract.
Patients are referred to a reconstructive urologist when urethral stricture disease is present. This is scar tissue in the urethra that can cause a blockage or obstruct urine flow. These issues can be caused by birth defects, injury, medical conditions or complications from surgery or other treatment, including complications from treatment of prostate cancer.
Patients are referred to a reconstructive urologist when urethral stricture disease is present. This is scar tissue in the urethra that can cause a blockage or obstruct urine flow. These issues can be caused by birth defects, injury, medical conditions or complications from surgery or other treatment, including complications from treatment of prostate cancer.
Our most common procedures performed include:
- Urethral reconstruction, repair of urethral strictures (narrowing of the urethra)
- Penile implants for treatment of erectile dysfunction
- Procedures for penile curvature (Peyronie’s disease)
- Bladder neck reconstruction
- Urinary diversion
- Penile and scrotal reconstructive surgery
- Surgical treatment of Male Stress Urinary Incontinence
Urethral stricture
Though often unrecognized by patients, symptoms of urethral stricture are commonly difficulties or irregularities while urinating. This may include a slow prolonged urinary stream, straining to urinate or a feeling of your bladder completely emptying. It is important to diagnose a stricture to determine the best treatment option.
Typically, a cystoscopy procedure in the office will diagnose a stricture, and an imaging study called a retrograde urethrogram will help characterize any strictures or other abnormalities in the urethra. Once the diagnosis and evaluation are complete, your physician will discuss treatment options.
Penile implants for treatment of Erectile Dysfunction
Medical therapy for Erectile Dysfunction (ED) has improved tremendously, but some men find medication and/or all non-surgical options ineffective in achieving satisfactory erections. In these cases, penile implant surgery is a treatment option. This procedure involves the placement of an internal device, called a “penile prosthesis,” that restores your ability to have erections and sexual intercourse.
Your specialist physician will have a detailed discussion with you regarding your individual goals for what you want to achieve with therapy for ED, and review all options to optimize and restore your sexual quality of life.
Peyronie’s disease
Peyronie’s disease is a condition in which scar tissue, called plaque, develops beneath the skin of the penis, causing it to bend or curve during an erection. While some curvature is normal, a new or significant bend, narrowing, or indentation of the penile shaft may indicate Peyronie’s disease. The condition is often associated with the body’s healing response to minor penile injuries, which may go unnoticed. As scar tissue builds up, it can cause changes in the shape of the penis, discomfort, and difficulty with sexual activity. Early evaluation by a urologist can help determine the severity of the condition and identify appropriate treatment options.
Bladder neck reconstruction
Complications from surgery or radiation to the prostate can occur after treatment of malignant diseases like prostate cancer, or after procedures for benign prostatic hyperplasia (BPH). If scar tissue develops at the outlet of the bladder, also called the “bladder neck,” it can make urinating difficult and result in problems with urinary retention or even urinary tract infections. This is called a bladder neck contracture, and various surgical options can help alleviate the problems.
Most often, your surgeon can perform a minimally invasive, endoscopic procedure to open this area. But sometimes the scar can return. If this happens, Bladder Neck Reconstruction is a procedure that involves making a connection (anastomosis) of the bladder neck to the membranous urethra after the prostate is removed. Your surgeon will discuss all options, and help you decide on the best choice for you.
Urinary incontinence
Following treatment of prostate cancer – surgery, radiation, or brachytherapy (“seeds”) – patients can experience leakage of urine due to side effects of the therapy. Some patients will improve with non-invasive treatment such as pelvic floor physical therapy, but others may have leakage that means they must wear pads or other absorbent products. This can significantly impact a patient’s quality of life, leading to avoiding social interactions, decreasing the amount of fluid one drinks, impacting sexual activity, etc. Depending on unique patient characteristics, treatment options could include a minimally invasive sling procedure, or even an Artificial Urinary Sphincter device that can give you back control of your bladder. Your urologist can help you decide on the best option to achieve your individual goals.