Reconstructive
Surgeries
Reconstructive Surgeries
Reconstructive urology surgery helps patients with conditions like birth defects (hypospadias – urinary opening at the undersurface of penis), cancer, neurological disorders, male and female incontinence, stricture of urethra (narrowing of urethra) and pelvic floor prolapse.
Reconstructive urology also helps repair traumatic injuries to organs like kidney, ureter, bladder, and genitals. Trauma is often associated with pelvic fractures that can happen as a result of road traffic accidents or falls. Common reconstructive surgeries performed include:
Benefit Reconstructive Surgeries:
- Hypospadias repair
- Urinary fistulas
- Bladder trauma
- Erectile dysfunction surgery
- Kidney trauma
- Urethral stricture
- Urinary diversion
- Penile trauma
- Peyronie's disease
- Surgeries for male and female urinary incontinence
- Testicular trauma
- Urethral stricture
- Urethral trauma
Hypospadias Repair
Hypospadias repair is surgery to correct a defect in the opening of the penis that is present since birth. The urethra (the tube that carries urine from the bladder to outside the body) does not end at the tip of the penis. Instead, it ends on the underside of the penis. Corrective surgery will create a new tube which ends at the tip of the penis.
Peyronie's Disease
In this disease there will be abnormal thickening of tissue of the penis which usually disturbs the erection by causing a bend associated with pain. Corrective surgery will remove the thickened tissue and fill the gap with another type of tissue to straighten the penis during erection and thus relieving pain.
Erectile Dysfunction Surgery
These are the surgeries done for problems with penile erection. An artificial cylinder is inserted into the penile body which can be inflated when desired to attain good erection for successful intercourse.
Urethral Stricture
This is a condition in which there is narrowing of the urinary passage due to previous trauma, accident or surgery. The corrective procedure includes exploring the urethra and excising the narrow part of the urethra followed by attaching the cut ends or broadening the passage by using tissue like mucosa of oral cavity or skin.
Urinary Fistulae
In this condition an abnormal communication develops between urinary bladder / ureter and the vagina, which usually happens following gynecological surgery like hysterectomy (removal of uterus) or caesarean section. This leads to continuous urinary leak from the vagina. Reconstructive surgery for this includes exploration and removal of the abnormal connection (fistula) followed by repair of bladder and vagina separately. This procedure can be done by formal open surgical approach or by laparoscopic surgery.
Pelvi-ureteric junction obstruction
This is an abnormality usually present since birth, where in the junction between the kidney and the upper part of the ureter (tube which connects kidney to the bladder) is narrow leading to ballooning of the kidney due to stasis of urine. Surgery includes removal of the narrow part and connecting the ends together. Traditionally this was done through open surgery, but in recent years with the evolution of key hole surgery it is routinely done with the minimally invasive technique.
Neo-bladder Formation
Neo bladder means “new bladder”. In patients with cancer of the bladder, after surgical removal of the bladder to cure the disease, a new bladder is created using patient’s intestine. With this technique patient can continue to pass urine through normal urinary passage.
Reconstruction in Genito-urinary tuberculosis
Genito-urinary tuberculosis leads to narrowing of ureters (tube which connects kidney to the bladder) leading to obstruction for urinary drainage and also causes shrinkage of the bladder storage capacity. Reconstruction includes replacement of the narrowed ureter with segment of patient’s intestine and increasing the storage capacity of bladder by using intestinal patch which is called as “augmentation”.