Genitourinary Reconstruction

Diseases such as cancer, genetic defects, sudden injury, and persistent infections or urinary problems are among the reasons why surgery may be performed on various parts of the urinary or reproductive system.

While every effort is made to preserve various structures in the pelvic area, there are times when surgery results in the need for secondary procedures to restore function and appearance.

Restorative procedures in both men and women may involve the urinary bladder, the tube that takes urine out of the body (urethra), the tubes that carry urine from the kidneys to the bladder (ureters), and the kidneys themselves. Women sometimes need vaginal reconstruction to correct damage from pelvic organ prolapse (POP). Women with fertility problems could benefit from fallopian tube reconstruction. Genitourinary reconstruction specific to women may also involve:

• Vaginal repair or reconstruction for reasons other than POP
• Ovarian reconstruction
• Correction of abnormalities with the uterus or fallopian tubes
• Perineal reconstructive between the anus and vulva due to poorly healed tears

In addition to abnormalities with the kidneys, bladder, urethra, or ureters, men may need reconstruction surgery following removal of all or part of the prostate gland. Testicular or scrotal cancer could result in a need for follow-up procedures to restore the normal appearance of these structures. Genitourinary reconstruction surgery unique to the male anatomy may also include:

• Testicle reconstruction
• Partial or full restoration of the penis
• Restorative procedures to correct damage from a iatrogenic injury to the epididymis or vas deferens
• Perineal reconstructive between the anus and scrotum

A common reason for genitourinary reconstruction is because of the removal of a benign or cancerous tumor, which sometime requires the need for the removal of nearby tissues for preventative purposes. Such procedures might be necessary after urethral strictures are removed to restore the flow of urine through the urethra. Some patients have preexisting deformities that become increasingly problematic later in life. An example of such a situation is if Peyronie’s disease results in painful erections that affect a man’s sex life or contribute to issues with erectile dysfunction (ED) that can’t be corrected with medication and other non-surgical treatments.

The exact procedure performed will depend on what needs to be restored. For instance, open or laparoscopic surgery may be done to repair a congenital or acquired problem in ureters and kidneys. Prior to surgery, a urologic surgeon typically performs a series of image and other diagnostic tests to determine what needs to be corrected and what procedures should be used to achieve the desired results. Some reconstruction procedures involve skin grafts from other areas of the body or synthetic sources, while others require implants, prosthetic devices, or the need to create an alternate pathway to restore function.

Recovery time from genitourinary reconstruction surgery will depend on what was done and the complexity of procedures performed. In order to minimize stress on the body, a urologist may suggest performing some types of surgical reconstruction in stages. Some patients may need to make special modifications with certain processes, as may be the case with bladder reconstruction requiring the use of an external bag. Advances in technology have made some reconstructive procedures less invasive.