How Can Reconstructive Urology Improve Bladder Health?

If you’ve suffered bladder damage from radiation or have severe incontinence, male reconstructive urology may be a treatment option. Reconstructive surgery may also be possible if you had your bladder removed during cancer surgery.

Modern surgical techniques allow doctors to rebuild the bladder or help your existing bladder work better.

Here’s what you need to know about these cutting-edge treatments and how they can improve your quality of life.

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What Bladder Issues Can Be Treated With Reconstructive Urology?

Your bladder is a balloon-shaped organ that stores urine before it leaves your body. The pelvic muscles in your lower belly hold the bladder in place. Disease or injury can disrupt how the bladder works.

There are several bladder issues that doctors can treat with male reconstructive urology.

Bladder fistula

A fistula is an abnormal connection between organs. Crohn’s disease and diverticular disease are two common causes. People undergoing radiation for cancer are at risk of getting a fistula.

A bladder fistula happens when an abnormal opening forms between the bladder and another organ, often the bowel. You may have frequent urinary tract infections if you have a bladder fistula. Your urine may smell or look like stool.

Complications from bladder removal

Removing part or all of the bladder (cystectomy) is the most common treatment for invasive bladder cancer. Bladder cancer usually affects people over 55. Men are more likely to get it than women.

If your bladder has been surgically removed, you have options for reconstruction. You’re a good candidate for bladder reconstruction if you’re at low risk for cancer coming back. You’ll also likely do better if your bowels and kidneys still work well.

Neurogenic bladder

Neurogenic bladder is when you lose bladder control because of damage to the brain, spine, or nervous system. Messages from the brain and nerves usually tell the bladder when it’s time to empty. When the nerves get harmed by illness or injury, the messages get interrupted, and the bladder doesn’t work well.

People with multiple sclerosis, Parkinson’s disease, and spina bifida often have a neurogenic bladder. It’s also common in people with spinal cord injuries, stroke, or major pelvic surgery.

Urinary incontinence

Many men suffer from urinary incontinence, or UI — the involuntary passing of urine. UI can happen after surgery, because of an enlarged prostate, or due to a disease like diabetes.

Lifestyle changes and medicine may help with UI. In severe cases, your doctor may suggest reconstructive surgery.

Why Is Reconstructive Urology a Good Treatment Option for Certain Bladder Issues?

Reconstructive urology offers hope for those who have serious bladder problems. Minimally invasive surgical techniques allow doctors to fix or reconstruct the bladder in some cases.

Some of these treatments are:

Bladder fistula surgery

Doctors treat bladder fistulas with surgery. First, they remove the damaged part of the bladder. Then they move healthy tissue between the bladder and the other organ (such as the colon) to block the opening.

Artificial sphincter for neurogenic bladder or severe UI

The urethral sphincter muscle controls the flow of urine from the body. Those muscles don’t work well in cases of severe UI or neurogenic bladder. Doctors may suggest a surgically inserted artificial sphincter.

Doctors place the sphincter cuff around the urethra. They put a pump under the skin of the scrotum. You can use the pump to open the sphincter and pass urine as needed.

Neobladder

Sometimes doctors can form an entirely new bladder after cystectomy. The new bladder is in the same place in the body as the old bladder.

A surgeon usually uses part of your small intestine to form a new bladder. They sew on the ureters, the tubes that carry urine from the kidneys to the bladder. At the other end, they sew on the urethra, the tube that carries urine out of your body.

It takes some time for a new bladder to work well. You may experience UI for some months until the muscles that support the bladder get stronger.

Incontinent diversion

A new bladder isn’t an option for everyone after a cystectomy. Instead, your doctor may take a short piece of your small intestine and connect it to the ureters, called an incontinent diversion.

The urine flows out of the body through an opening in the belly called a stoma. A small bag sticks to the skin of your belly to collect the urine. The urine flows out as its created, so the bag must always stay attached.

Continent diversion

A continent diversion is similar to an incontinent diversion in that urine flows into a pouch. But the pouch is on the inside of your body.

When you want to empty the pouch, you attach a catheter through the stoma into the pouch. There’s no bag on the outside of your body.

Recovering From Bladder Reconstructive Surgery

Recovery time from bladder reconstructive surgery varies. It will depend on your type of surgery and the illness that led to it.

After bladder reconstructive surgery, you may have to stay in the hospital for a few days or weeks. A nurse will insert a catheter. The catheter is a thin tube that drains urine from the body.

You may go home with a catheter. After bladder surgery, you won’t feel the urge to pee, as the catheter will empty urine from your bladder. This allows your bladder time to heal.

You’ll return to the hospital in a few weeks so the doctor can check your healing. If the bladder is healing well, they’ll remove the catheter.

Your doctor will talk to you about how to empty your new bladder. The method will depend on what kind of surgery you had.

You may experience leaks for a while, especially at night. In time, your bladder should get stronger.

Your doctor will want to see you for regular follow-up visits. They will suggest a schedule based on your health concerns.

How Can I Find a Reconstructive Urologist Near Me?

To make an appointment for urology services at UPMC Mercy, call 412-232-5850.

We are at:

Mercy Professional Building

1350 Locust St.

Suite G100-A

Pittsburgh, PA 15219

Learn more about urology at UPMC.

Sources

American Cancer Society, Bladder Cancer Surgery, Link

American Cancer Society, What is Bladder Cancer? Link

National Library of Medicine, Bladder reconstruction: The past, present and future, Link

Urology Care Foundation, What is a Bladder Fistula? Link

National Association for Continence, What is a Fistula? Link

National Library of Medicine, Artificial urinary sphincter, Link

NHS, Surgery and procedures: Urinary incontinence, Link

Cancer Research UK, Bladder reconstruction, Link

Urology Care Foundation, Neurogenic Bladder, Link

National Library of Medicine, Fundamentals of prosthetic urology, Link

About Urology

The UPMC Department of Urology offers a wide variety of specialized care for diseases of the male and female urinary tract and the male reproductive organs, including erectile dysfunction, kidney stones, urinary incontinence, prostate cancer, and more. We have a multifaceted team of physicians and researchers working together to provide the best care to both children and adults. Our team is nationally renowned for expertise in highly specialized technologies and minimally invasive surgical techniques. To find a provider near you, visit our website.