Reconstructive Urology Surgery
What is Reconstructive Urology Surgery?
Reconstructive urology surgery aims to restore normal anatomy and function of the genitourinary tract, involving organs such as the genitalia, kidneys, bladder, ureter and more.
Who undergoes Reconstructive Urology Surgery?
Patients might need reconstructive urology due to:
- Injuries such as perineal, pelvic or urethral trauma
- Congenital abnormalities in the urinary tract
- Bladder fistulas (abnormal connections between the bladder and nearby organs, such as the vagina or rectum)
- Complications from surgery (e.g. colorectal or gynaecological) or other treatment
What are the types of Reconstructive Urology Procedures?
Some types of reconstructive urology procedures are listed below:
Bladder reconstruction
Patients with locally aggressive bladder cancer may need to undergo surgical removal of the bladder, and a new bladder (neobladder) is made from a part of the intestine.
Genital reconstruction
A combination of muscle flaps and skin grafts are placed under the skin to restore the anatomy and minimise scarring of genital tissue. This could range from anything from clitoridectomy to foreskin restoration.
Neurogenic bladder treatment
The size of the bladder is increased through bladder augmentation (using bowels) for patients with bladder dysfunction caused by nerve damage. This is done to prevent kidney damage by increasing the size of the bladder and decreasing bladder pressure.
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Ureter reconstruction
Obstructions in the ureter caused by injury or ureteric stricture (narrowing of the ureter) are repaired through open or minimally invasive approaches. The bladder may have to be reconstructed as well.
Ureteropelvic junction (UPJ) obstruction repair
Pyeloplasty, a surgical procedure to resect scarred tissue and reconnect the healthy parts of the ureter may be required to clear the blockage in the area where the ureter and kidney meet.
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Urethral reconstruction
Skin grafts, oral mucosal grafts (mucous membrane lining the inside of the mouth), and skin and muscle flaps are used to replace the urethra and increase the diameter so that voiding can be restored to normal. Scarred tissue may be resected away before this.
Summary
Reconstructive urology involves re-routing, recreating or repairing parts of the urinary tract, and is necessary for patients with related physical abnormalities, incontinence and strictures, or trauma related to another surgery.