Urinary system, pelvic, and reproductive organs can be affected by diseases like cancer, congenital defects present at birth, injuries, or issues related to weak pelvic muscles. Depending on the nature of the problem, reconstructive surgery could involve skin grafts or synthetic materials, the use of prosthetic devices and implants, or tissue removal.
A urologic surgeon can determine what approach to reconstructive surgery is appropriate.
Many of the procedures performed today to restore function and appearance involve less invasive techniques that minimize risks and shortened recovery times.
Penile curvature refers to any type of abnormal curvature of the penis. Deformities of this nature usually become noticeable when males reach sexual maturity. Often congenital, penile curvature usually only requires reconstructive surgery if it’s contributing to recurring discomfort or issues with sexual functioning.
Also involving an abnormal curvature of the penis, Peyronie’s disease is caused by accumulated scar tissue that prevents the penis from fully straightening, especially when erect. More common among older men, Peyronie’s disease is positively diagnosed with image tests. A urologist may also perform a Doppler flow study to evaluate blood flow patterns. Before reconstructive surgery becomes an option, men are sometimes treated with injections that may break-up scar tissue. If such efforts fail, surgery typically involves removing or adding tissue on either side of the curvature to create a more even appearance.
Also referred to as acne inversa, hidradenitis is a rare skin condition that can produce painful, tender lumps in the groin area and around the buttocks. If the lumps open, tunnels may be created in the affected area. The condition isn’t curable, although topical medications and immune system suppression drugs may be helpful. If reconstruction surgery is needed, the affected skin is removed. Doing so sometimes requires a skin graft. In cases where the condition affects skin on the scrotum in males, reconstruction of this sac of skin may be necessary if it has to be removed.
Some boys are born with the tube that transports urine and semen (urethra) on the underside of the penis. It’s a condition known as hypospadias that’s often detected early and treated with surgery that may involve tissue grafts. In rare instances, the abnormal opening develops in the scrotum. Most boys experience normal development following surgery.
Penile Implants and Prosthesis
Erectile dysfunction (ED) is the most common reason why a penile implant and prosthesis may be surgically inserted if other treatments aren’t effective. There are three basic types of implants. Non-inflatable ones are bent up when an erection is desired. Two-piece inflatable implants include a pump implanted in the scrotum that’s used to achieve an erection. A multi-component penile implant provides a normal look when the penis is erect and non-erect.
Excessive enlargement of the scrotum is sometimes caused by a disease called scrotal lymphedema. The condition is caused by a buildup of fluid in soft tissues that progressively causes skin to thicken and engulf the penis. Reconstruction surgery involves the removal of the extra skin. Urologic surgeons are often able to preserve the testicles and urethra.
Referred to as a urethral stricture, scar tissue sometimes forms within the urethra and causes problems with urination. If outpatient procedures that dilate or widen the urethra fail to improve urine flow, a urethroplasty might be done to surgically remove the scar tissue and reconstruct the urethra. This option is usually reserved for severe strictures.
When possible, attempts are made to manage issues related to structural abnormalities or certain conditions that affect urinary or reproductive system function and appearance with medication and non-surgical treatments. It’s usually when quality of life or urinary health is affected that reconstructive surgery becomes an option. Results will depend on why surgery was recommended, which specific structures were corrected, and whether or not underlying health issues or other abnormalities are involved.