The purpose of reconstructive surgery is to restore the function and appearance of urinary system organs and structures.
Reconstructive surgery may involve a skin graft, synthetic materials, or the use of prosthetic devices and implants. The results seen with reconstructive surgery will depend on:
- Why it’s being done
- Overall health
- Whether or not underlying health issues are involved
- The specific procedure performed
Peyronie’s Disease and Penile Curvature
Peyronie’s disease is an abnormal curvature of the penis caused by the accumulation of scar tissue. The condition usually develops later in life. The curvature sometimes progressively increases as more scar tissue forms.
Penile curvature usually becomes noticeable when teen males become sexually mature. The difference is that penile curvature isn’t caused by scar tissue in the penis. It’s usually a congenital condition. If penile curvature is mild, there’s usually no need for treatment.
Any type of surgery for either Peyronie’s disease and penile curvature is usually a last resort if non-surgical treatment options aren’t effective. Reconstruction surgery can involve adjusting the length of tissue on the opposite side of the curvature so the length and shape are equal. Depending on the nature of the curvature, surgery may involve adding tissues on one side or removing tissues on the other side.
Hidradenitis is a chronic and often painful skin disease that results in skin bumps that sometimes develop in the groin area. It’s believed to be linked to blockages in hair roots. If the resulting outbreaks can’t be managed with medication, surgery may be necessary to cut away affected patches of skin.
Reconstructive surgery involves a skin graft if a significant amount of skin tissue has to be removed. In men, the condition usually occurs around the anus and scrotum. If this is the case, surgery usually includes removal of the scrotum. The scrotum can also be reconstructed with a skin graft to restore its cosmetic appearance.
With hypospadias, the opening of the tube that carries urine is on the underside of the penis by the tip. It’s a rare condition that may be corrected with reconstructive surgery to restore the normal appearance of the affected part of the penis. Some men with this deformity may have a urethral opening in the middle of the penis or in the scrotum. If the base of the penis is affected, corrective surgery typically involves tissue grafts. Penis function is usually unaffected following reconstruction.
Penile Implants and Prosthesis
A common reason why men consider a penile implant and prosthesis is erectile dysfunction (ED) that’s not correctable with other treatment efforts. If an implant is non-inflatable, it’s bent upwards when an erection is desired. With two-piece or three-piece inflatable implants, a pump is used to achieve an erection. Most men who receive an implant report being completely or moderately satisfied with their penile prosthesis following surgery.
Scrotal lymphedema is a disease that causes the skin on the scrotum to become thick and abnormal in appearance. The scrotum eventually becomes excessively large and swollen due to an accumulation of lymph fluid and tissue. Eventually, the excessive tissue may encompass the penis. Surgery involves removing extra tissue. In most instances, the testicles and urethra can be preserved.
If the urethra isn’t able to function properly to allow urine to exit the body, a urethroplasty may be performed. It’s sometimes necessary for patients with urethral strictures (scarring) that had to be surgically removed. During the procedure, an incision is made in the area where the stricture is located. After the urethra is reconstructed, a catheter is temporarily inserted until tissues heal.
There are many possible reasons for reconstructive surgery. Some patients are born with deformities that become increasingly problematic later in life. Others may need this type of surgery as a follow-up to cancer treatment or surgery for a urinary or reproductive problem, due to a disease or condition that alters skin appearance, or because of an abnormality like a penile curvature that’s affecting quality of life. A urologist can explain available options and help patients decide what’s best for their needs and preferences.