Genitourinary Reconstruction
Genitourinary reconstruction is done to treat conditions or abnormalities affecting the urinary or reproductive system and to improve quality of life.
The goal of surgery is to preserve function when possible. However, removing an organ or related tissues and structures may be necessary, impacting genital appearance and function. Because reproductive organs are linked to the urinary system, removing an organ or tissue may also alter the patient’s ability to process and remove urine from the body.
In these situations, genitourinary reconstruction surgery may be recommended as a follow-up to treatment for the initial condition affecting the urinary or reproductive system.
Why Genitourinary Reconstruction is Performed
If the surgeon had to remove a large amount of tissue in the genital and pelvic area caused by disease, infection, sudden trauma, or an abnormality, a few different types of reconstructive procedures may be recommended. Patients with pelvic organ prolapse (POP) experience increased pressure from misplaced organs, causing dislocation or tears in the tissue that need to be reconstructed.
Men with genital and lower urinary tract conditions such as urethral strictures or urinary fistulas may need genitourinary reconstruction. Patients with cancer that originates in or affects the penis and testicles may also need to undergo reconstructive procedures.
Both men and women may develop problems with sexual functioning or urinary incontinence over time due to congenital and urological conditions. Genitourinary reconstruction can address the kidneys, urinary bladder, ureters, and urethra.
Types of Reconstructive Surgery
Most reconstructive procedures done in the pelvic area involve a combination of oral mucosal grafts, skin grafts, and muscle flaps. Some procedures may require tissue grafts from parts of the intestine to create new urinary structures.
Other types of genitourinary reconstruction surgeries involve reconnecting structures in various ways. For example, during urethral reconstruction part of the urethra is removed and the remaining part of the tube is reattached at the normal ends. Other times, the surgeon will use an alternative method to allow urine to exit the body as part of reconstructive surgery.
How Surgery is Performed
The appropriate approach to surgery will depend on where the affected organs or tissues are located. Some genitourinary surgeries are performed through an incision in the lower abdomen or pelvic area. In some situations, the surgeon may access the affected area through the scrotum and anus. Robotic genitourinary reconstruction is a newer approach to surgery that involves assistance from a robotic device guided by the surgeon’s hand movements.
