Reconstructive and urethral surgery
Reconstructive Urology deals with the surgical restoration of the urogenital tract, which includes procedures such as urethral surgery (e.g., for urethral stricture), continence surgery, and penile surgery (e.g., for penile curvature or phimosis). If conservative treatments for conditions or diseases of the urogenital tract are unsuccessful, surgery should be considered to prevent complications and secondary conditions. Whenever feasible, minimally invasive procedures are favored over more extensive surgeries.
Urethral Stricture (Urethral Narrowing)Scarred narrowing of the urethra, also known as urethral stricture, is a common urological issue, particularly in men over the age of 55. Causes include congenital malformations of the urethra, bacterial infections, previous surgeries, or injuries. Urethral stricture often manifests as a weakened urine stream, difficulty urinating, and increased urinary urgency. There are several surgical procedures for treating urethral stricture. For short strictures, an initial treatment option is endoscopic incision using specialized instruments. If the stricture recurs, open urethral reconstruction is typically required. In reconstruction surgery, the narrowed part of the urethra is either dilated or excised, with short defects being repaired by suturing the ends together. For longer strictures, buccal mucosa grafting is used to reconstruct the urethra.
Penile Curvature (Peyronie’s Disease)The exact causes of Peyronie’s disease, which leads to penile curvature, are not fully understood. It can be congenital or acquired and can cause significant pain during sexual intercourse. Thanks to modern surgical techniques, penile curvature can be successfully treated in most cases. There are two primary methods: one involves shortening the healthy side of the penis, while the other involves surgically lengthening the affected side. The appropriate method depends on the specifics of the curvature and is thoroughly discussed in advance.
Phimosis (Foreskin Tightening)Phimosis can be congenital or acquired and often causes no symptoms. However, in some patients, the tightening of the foreskin can lead to uncomfortable inflammation, difficulty urinating, and painful erections. If conservative treatments are unsuccessful, surgical treatment of the foreskin is recommended.
