Urology Reconstruction

Tulane Urology has a long history of being a leader in urologic reconstructive procedures. For comprehensive urological care, including both lower and upper urinary tract reconstruction, Tulane Urology offers the full range of expertise, equipment, and experience. Whether using the latest da Vinci robotic technology or advanced techniques, we are equipped to handle all aspects of urinary tract reconstruction—from the urethral meatus to the distant calyceal diverticulum.​​
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It is crucial for patients to receive care from experienced surgeons utilizing the latest technologies and innovations.​

Conditions Treated

Conditions treated at Tulane Urology include disorders of the upper and lower urinary tracts, Peyronie’s disease, hypospadias, and other conditions affecting the urethra and male external genitalia. We specialize exclusively in the treatment of these conditions. 

Urethral (Lower Tract)

The lower urinary tract extends from the bladder to the tip of the urethra, with more prevalent issues occurring in men. These conditions may include urethral strictures in the penile, bulbar, or bulbo-membranous regions, pelvic fracture urethral injuries, lichen sclerosus, complications from radiation and prostate surgeries, fistulas, bladder neck stenosis, and more.

Types of lower tract conditions include:

• • Urethral Strictures: Urethral Strictures Occur when the urethra narrows due to scarring or injury, blocking normal urine flow and causing discomfort or urinary problems.
  • Bulbar Strictures: Bulbar Strictures are one of the most common sites for urethral strictures is the bulbar urethra, located under the scrotum in the perineum. This area is poorly protected, making it more vulnerable to injury. Unlike the lungs (shielded by the ribs) or the brain (protected by the skull), the bulbar urethra lacks an external barrier to prevent damage.
  • Pelvic Fracture Urethral Injuries: A pelvic fracture is a serious injury that can tear the urethra beneath the prostate, ranging from a partial to complete rupture. It is most often caused by motor vehicle accidents but can also result from crush injuries, such as work-related falls or other trauma. This type of injury may also be referred to as a prostatomembranous urethral injury or a pelvic fracture urethral distraction defect. Regardless of the name, patients typically think of it as a torn urethra that needs repair.
  • Lichen Sclerosus: Lichen Sclerosus, also known as balanitis xerotica obliterans, is an acquired, non-cancerous disease of the penis and urethra. Though it is not contagious or sexually transmitted, its exact cause remains unknown, despite being chronic and often debilitating.

Ureteral (Upper Tract)

Ureteral (upper tract) reconstruction is typically required to address kidney obstructions that extend to the bladder. These conditions can include ureteral narrowing or blockage, ureteropelvic junction obstruction, ureterovesical stenosis, congenital kidney and ureter anomalies, trauma, prior surgical complications, and more.

Types of upper tract conditions include:

• • Ureteropelvic Junction Obstruction: Ureteropelvic junction obstruction (UPJO) is one of the most common causes of kidney drainage blockages. This condition refers to the obstruction of urine flow from the kidney pelvis to the ureter, which drains urine into the bladder. There are various causes for this blockage, including internal scar tissue, crossing renal vasculature, and kidney stones.
  • Ureteroureterostomy: Ureteral strictures can occur for several reasons, leading to blockages in the ureter (the tube that drains urine from the kidney into the bladder). Common causes include multiple episodes of kidney stones, medical procedures involving the urinary tract, radiation therapy for cancer, and trauma such as gunshot wounds and surgical injury.

Genital Reconstruction

These conditions may include penile reconstruction (due to trauma, cancer, or congenital defects), scrotal and testicular reconstruction, Peyronie’s disease, buried penis, impotence (penile implant surgery), and more.

• • Peyronie’s Disease: Peyronie’s disease is a condition where scar tissue or “plaque” forms inside the penis, causing it to bend or curve during erections. This curvature can lead to pain, difficulty with intercourse, and emotional distress. In advanced cases, reconstructive surgery may be necessary to correct the curvature and restore normal function. To learn more, visit the Peyronie’s Disease page.
  • Congenital Anomalies (Hypospadias and Epispadias Repair in Adults): Patients with a history of childhood surgeries for congenital anomalies, such as hypospadias or epispadias, may experience complications like fistulas, strictures, or curvature. When initial repairs fail or complications persist, additional reconstructive surgery is needed to restore function and alleviate symptoms.
  • Cancer-Related Male Genital Reconstruction: Men who undergo surgery for genital cancers, such as penile or urethral cancer, may face tissue loss and functional challenges. Genital reconstruction aims to restore form and function, addressing issues like urethral strictures, tissue loss, and cosmetic concerns.
  • Lymphangioma and Hidradenitis Suppurativa: Lymphangioma and hidradenitis suppurativa are chronic conditions that cause discomfort and disfigurement in the genital area. Surgical reconstruction often involves excising affected tissue and using skin grafts or flaps to restore appearance and function.

Male Urinary Incontinence

These conditions may include stress urinary incontinence due to prior prostate surgeries, pelvic trauma or surgeries, radiation therapy, and damage to the urethral sphincter. To learn more, visit the Male Urinary Incontinence page.