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Conditions and Treatments

Conditions We Treat

Click Expand All at right or the condition name below to learn more about the conditions our urologic reconstructive surgeons treat. Click the Treatment tab above for more information on how these conditions are treated.

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Urethral Stricture or Obstruction

A urethral stricture, also known as a urethral obstruction, is scar tissue that builds within the urethra, making it difficult to urinate.

Urethral strictures are more common in men because their urethras are longer than those in women. Causes of urethral strictures include:

  • Idiopathic, where the cause is unknown
  • Previous hypospadias surgery
  • A traumatic incident, like a car accident or bicycle injury
  • Lichen sclerosus or Balanitis Xerotica Obliterans (BXO), which causes white, thick patches on the genitals and makes urination difficult
  • Cancer radiation therapy and prostate surgery
  • Urethral cancer
  • Sexually transmitted diseases like gonorrhea and chlamydia
  • Urologic procedures, like repeated insertion of catheters or other instruments

Complications Following Prostate Cancer Treatment

Prostate cancer is the most common cancer in men.

In fact, more than 180,000 men in the U.S. will be diagnosed with prostate cancer this year. There are many effective prostate cancer treatment options available today (i.e. surgery or radiation), but these treatments can sometimes cause complications to the genitourinary area, including:

  • Rectourethral and urethral fistulas, which are abnormal holes between two organs that normally don’t connect. Fistulas are a rare but devastating complication of pelvic surgery, radiation and genitourinary cancers. A rectourethral fistula, also known as a urinary rectal fistula, is a small hole that forms between the urethra and the rectum. A urethral fistula is an abnormal opening within the urinary tract.
  • An obstructed or blocked urethra, which can make it difficult to urinate. This can be caused by:
    • Urethral stricture
    • Bladder neck contracture: A radical prostatectomy removes the prostate and then connects the bladder neck directly to the urethra. If this connection narrows due to scarring, this is called a bladder neck contracture. Robotic prostatectomy, offered at leading cancer hospitals like UC San Diego Moores Cancer Center significantly reduces the incidence of bladder neck contractures.
  • Urinary incontinence is bladder leakage due to a weakened urethral sphincter, the muscles that help you control when you urinate.

Adult Hypospadias Requiring Repair

Hypospadias is a rare birth defect where the opening of the urethra in males is on the underside of the penis instead of at the tip.

Treatment of hypospadias in infants typically involves surgery to reposition the urethral opening. Sometimes when the patient becomes an adult, this treatment leads to complications, including urethral strictures or fistulas. We provide revisional surgery for adults seeking treatment of these complications.

Trauma

The genitourinary system is involved in roughly 10 percent of trauma cases.

When pelvic bones near the prostate and urethra are fractured, the forces can also tear the urethra, rupture testicles or cause trauma to the scrotum. Activities that can lead to genitourinary trauma include:

  • Sports or recreational activities
  • Automobile and motorcycle accidents
  • Work-related activities

Treatments for Conditions

Our specialists at UC San Diego Health System have developed novel treatments for even the most difficult conditions, like recurrent bladder neck contractures and urethral strictures. We perform delicate reconstructive surgeries to help improve outcomes and provide sustained relief, including:

  • Urethroplasty, also called genitourinary reconstruction, removes or widens the narrowed section of the urethra through minimally invasive surgery. The recurrence of strictures after urethroplasty is very low.
  • Urinary fistula, or rectourethral fistula, repair aims to close a hole that has formed within, or has connected to, the urethra
  • Hypospadias revision surgery

Why should I consider surgical treatment of my urological disorder?

When there is a problem, like a stricture, the bladder has to squeeze harder to eliminate urine. Patients may experience severe pain, excessive straining or prolonged time to empty while urinating. Eventually, the bladder may begin to show signs of damage, including thickening or enlargement of the bladder itself. In some cases, the backup of urine can cause irreversible damage to the bladder and kidneys.



Talk to the experts.

Chancellor Park
4520 Executive Drive, Suite 111
San Diego, CA 92121

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Call 858-657-8860