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Reconstructive Urology

"Reconstructive" means restoring the original form and function through repair rerouting, or replacement. The diseases that require the services of expert reconstructive urology surgeons include bladder cancer, genitourinary fistula, genital injuries, testicular cancer, cancer or congenital abnormalities of the ureters, and stress incontinence. In addition, reconstructive urology requires advanced urology care, multispecialty teamwork, experienced reconstructive urology surgeons, and state-of-the-art surgical techniques.

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Diseases and conditions

  • Urethral Stricture: Urethra is a tube-like structure that carries urine from the bladder and drains it outside the body. Urethral stricture is characterized by the narrowing of the urethra due to scarring. Patients with urethral strictures are at increased risk for developing infection or inflammation. The symptoms of urethral strictures include incomplete bladder emptying, reduced urine stream, difficulty in urination, urinary tract infections, and increased urination frequency.
  • Hypospadias: In normal healthy males, the urethra opens at the tip of the penis. However, in patients with hypospadias, the abnormal urethral opening can open anywhere in the penis except at the tip. Abnormal openings occur between 8 to 14 weeks of fetal development. Complications of hypospadias include abnormal penile appearance, abnormal penile curvature during erection, impaired ejaculation, and difficulty in learning about using a toilet.
  • Bladder, Urethral, and Renal Injuries: Injuries of bladder, urethra and kidney are termed as urotrauma. It may be due to a vehicle accident, a fall, deep wounds, or blunt trauma. The symptoms depend upon which part of the urinary system is affected. Common symptoms of urotrauma include blood in urine, pain in the back, pelvic pain, difficulty urination, and bloating.

Procedures and treatment

  • Urethroplasty: It is a surgical intervention performed to repair a defect or injury in the urethra. It also involves replacing or repairing the urethra when scar tissue develops inside the urethra, thereby narrowing it. Patients with hypospadias, epispadias, and urethral strictures are advised to undergo this procedure. Urethroplasty has a high success rate in treating urethral strictures.
  • Hypospadias Repair: Hypospadias repair involves surgical repair of the urethra that does not open on the tip of the penis. The risks associated with the surgery include blood clots, urine leakage, and narrowing or scarring of the repaired urethra. In most cases, children require only a single surgery that lasts a lifetime with a fully functional penis and normal appearance. However, multiple surgeries are required in complicated hypospadias to obtain the desired outcome.
  • Reconstructive Surgeries: Reconstructive surgeries in urology aim to restore the normal function of the genitourinary tract. The surgeons may also improve the appearance of the abnormal urological and productive organs. Some of the reconstructive surgeries in urology include neurogenic bladder treatment, bladder reconstruction, repairing ureteropelvic junction obstruction, penile prosthetics, urogynecology reconstruction, ureteral reconstruction.