We focus on reconstructive surgery of the lower urinary tract. Examples of surgical procedures that we commonly perform are:
Urethral Stricture Repair-Urethroplasty- Repair of urethral, or urinary tube, strictures, can be a complex and demanding procedure. Patients in the past often underwent repeated dilation or incision of the scar tissure that forms urethral strictures. Studies published over the past few years indicate that long term results are actually far better if one undergoes an open surgical procedure to reconstruct the area of the urethra that is narrowed by scar tissue. We have extensive experience with these procedures and are able to tailor the best procedure to an individual's clinical situation. Click here for further information.
Surgery to Improve Continence in Men- Incontinence, or loss of urinary control, is more common in men than most people realize. Loss of urine can occur from natural processes such as growth of the prostate, or as a consequence of medical treatments for prostate cancer such as surgery or radiation therapy. We perform a large volume of artificial urinary sphincter implants, urethral sling procedures, Interstim implants, and Botox injections. Click here for further information.
Penile Implant Surgery or Revision- We have been performing penile implants in volume for over 24 years. Complex cases including revision surgery and post-priapism implantation are of particular interest. About 50% of our implant patients have had prostate cancer treatment including surgery or radiation therapy, and almost 30% have Peyronie's disease. Click here for further information.
Surgical Treatment of Peyronie's Disease- Severe Peyronie's disease produces sexual disability that is permanent unless one undergoes successful intervention. We perform four different procedures for treatment of Peyronie's disease. Individuals with severe curvature (generally greater than 60 degrees and less than 110 degrees) who retain good erectile rigidity can be treated by incision of the scar tissue and placement of a graft. Those with less severe curvature are often offered either injection of an enzyme to digest the scar (collagenase or Xiaflex) or an outpatient surgical corporoplasty repair. Finally, if the patient has experienced both curvature and decreased erectile rigidity, then a penile implant is usually the best choice. Our goal is to tailor therapy to the individual need in order to restore sexual function. Click here for further information.
Bladder Augmentation and Urinary Diversion- These procedures utilize a segment of small intestine to add capacity to the urinary bladder or in the case of diversion to bypass the bladder. Bladder augmentation is usually performed in individuals who have experienced spinal cord injury. Bladder augmentation usually restores urinary continence and protects the kidneys from high bladder pressure. Urinary diversion is performed in individuals who have experienced an unreconstructable impairment to their bladder. We see this problem most commonly after complications of radiation therapy or severe tissue breakdown.
