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
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
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
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
A curved erection caused by Peyronie’s disease may happen because of a problem in the way the body heals after an injury (a connective tissue disorder). Often the injury is not even noticed by patients, and the curve simply develops over time. When this happens, the body doesn’t properly control how much scar tissue develops and too much builds up gradually. A bump of scar tissue forms under the skin of the penis. This bump is called a Peyronie’s plaque.
Treating Peyronie’s disease
If the curvature of the penis does not correct itself over time, it’s important to discuss treatment options with a urologist. Surgery is considered the gold standard therapy, but other treatment options may help.
Surgery remains the gold standard treatment for Peyronie’s disease. There are several surgical options including:
Excision – This procedure involves removing or cutting of the plaque and attaching a graft. This method will straighten the penis and restore some lost length. Risks of the procedure include numbness of the tip of the penis and decreased rigidity of erections in a small number of patients.
Plication – This procedure involves removing or pinching a piece of the tunica albuginea from the side of the penis opposite the plaque, to straighten out the penis. This method is less likely to cause numbness or erectile dysfunction, but it is associated with a decrease in penile length.
Penile Prosthesis – For patients with Peyronie’s disease and erectile dysfunction, placement of an inflatable penile prosthesis (penile implant) is used to increase the rigidity and straighten the penis adequately. Penile prosthesis remains the gold-standard treatment for patients with ED and Peyronie’s disease.
Medical therapy/injection therapy
Bladder neck reconstruction
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.