Reconstructive Urology

Reconstructive urology is different from mainstream urology because it is mainly open surgery and depends on a greater than usual familiarity with general surgical and plastic surgical techniques. There is a considerable overlap with female urology in the area of complex incontinence and fistula. There is some overlap with paediatric and adolescent urology in the reconstruction of congenital malformations, and in neuropathic bladder dysfunction, and there is some overlap with urological oncology in the area of bladder replacement. There is some overlap too with andrology in the are of penile reconstruction in congenital and traumatic conditions.

Problems treated with reconstructive Urology include

  • Urethral disruption injuries from pelvic fracture
  • Recto-urinary fistulas after prostatectomy or pelvic surgery
  • Refractory male urethral strictures
  • Radiation-induced urinary fistulas
  • Major bladder reconstruction – urinary diversion, continent catherizable stomas (Mitrofanoff, Monti), neobladder, augmentation cystoplasty, MACE (antegrade continent enema)
  • Major ureter reconstruction - Boari flap, Psoas hitch, ileal ureter, trans-ureteroureterostomy, complex pyleoplasty
  • Vesicovaginal or ureterovaginal fistulas after pelvic surgery
  • Male urinary incontinence – artificial urinary sphincter, male sling, bulking agents
  • Peyronie’s disease – plaque incision and grafting, penile placation.