RECONSTRUCTIVE UROLOGY

Reconstructive Urology

Restores the functionality of the genito-urinary tract. Male and female incontinence, ureter all kind of strictures, bladder reconstruction (size modification, uraco disease ) due to the cancer treatment of prior pelvic surgery, erectile dysfunction (penile prosthesis), recto – urinary, vesicovaginal or ureterovaginal fistulas. There are examples of the conditions that could be treated by minimally invasive urology reconstructive surgery

Bladder Reconstruction

Due to the cancer surgery, injury or previous surgery complications bladder might need reconstruction, augmentation, reduction or creation of the neo – bladder from the own tissue of the small bowl. This can be performed at the same time as the initial cancer surgery. For the neo-bladder construction about 60 cm of the small bowl is obtained and a pouch is formed. After urethra and ureters are sewn to a new bladder. During the healing process of the neo-bladder, the urine drainage is necessary. Bladder catheters are assisting this process until the new bladder can function on itself. Patient will need a detailed instructions and training of how to empty the neo – bladder, since it is not an original muscular structure. In this case pelvic muscles can take over the function

In case of the fracture or partial damage of the bladder – reconstruction may be performed with the flap and muscular function restored

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Reconstruction of the Ureters

Ureter can be injured or narrowed during previous pelvic or urologic surgery. The injured ureter might obstacle the urine pathway from the kidney to the bladder

Vesicovaginal or Ureterovaginal Fistulas

The most common reason for vesico – vaginal fistula is a previous pelvic surgery as for example hysterectomy. Fistula is a pathway between the bladder and the vagina, which is resulting with involuntary urine leakage into vagina. Ureterovaginal fistula is a pathway between the ureter and the vagina. Could be result of trauma, previous surgery, infection. All the fistulas significantly lower the quality of life and are very challenging for a self-esteem of the affected person. That is why, as well as for medical reasons - need to be treated as soon as possible

Pyeloplasty

Is a procedure to remove obstacles in the area of the connection between kidney and ureter. It is called ueteropelvic junction (UPJ). Obstruction may appear as a result of kidney stones, scare tissue or anatomy defects. The danger of this obstacle is that coming back to kidney urine, may damage the functionality of the kidney

Dr Corona performs reconstructive urology surgery using the minimally invasive approach (Laparoscopic or Robotic-Assisted) due to the great visualisation, high success rate and minimal patient fatigue. if presence of stones they can be remove at the same operative time, been a huge advantage of treatment.

Can the minimally – invasive approach (Laparoscopic or Robotic – Assisted) be used after previous open surgery or multiple surgeries?

Yes ! Many patients think, that after open surgery minimally-invasive approach is not indicated. It is not so. Dr Corona successfully performs minimally-invasive surgeries after even multiple open interventions. He usually attempts to use already existing scars, to minimalize additional scaring. His record was to perform laparoscopic fistula repair for the patient, who had 17 previous open surgeries