Reconstructive Urology Service

Overview

Our approach to treating patients is truly multidisciplinary. At other hospitals, a single doctor often guides the treatment decision. At Mass General, multiple specialists examine each patient and reach a team recommendation on the most beneficial treatment.

Patient care begins with a comprehensive evaluation by one of our surgical specialists in our offices at the Department of Urology. For the initial appointment, please bring your medical records and test results. Additional testing, if necessary, is completed onsite. Most tests are noninvasive or minimally invasive and conducted on an outpatient basis.

During the evaluation, you can expect:

• A complete physical examination
• A review of your medical history, test results and notes from your referring urologist or oncologist
• An in-depth conversation about your urinary-tract symptoms and normal function along with a profile of your everyday activities
• A discussion of your treatment expectations

Our support staff and nurses coordinate your postoperative care and are available to answer questions about your treatment and recovery.

Personalized, Multidisciplinary Care

Although your specialist performs your recommended procedures, he or she typically manages your care in collaboration with other board-certified surgeons on the Reconstructive Urology team. As a result, you receive highly personalized treatment from experienced practitioners with multiple perspectives.

For patients with genitourinary cancers, our physicians work side by side with other specialists at Mass General, including those at the Cancer Center. Depending on your condition, your team of accomplished genitourinary cancer specialists may include urologic surgeons, radiation oncologists, medical oncologists, diagnostic radiologists and pathologists.

We also work closely with physicians in our hospital's Division of Trauma, Emergency Surgery and Surgical Critical Care and Burns Service. If you have experienced acute genitourinary injuries or burns, these collaborations ensure you receive exceptional, comprehensive care from some of the finest reconstructive and emergency-medicine surgeons in New England.

Improving Care Through Research

To increase the quality, safety and effectiveness of patient care, our team actively participates in basic science and clinical research. Several of our surgeons are scientists who have been recognized by prestigious surgical associations for their contributions to the field of reconstructive urology.

Ranked Among the Best Urology Departments in the Nation

U.S. News & World Report consistently ranks the Mass General Department of Urology among the best in the nation. Every year, our urologists manage care for thousands of patients in every specialty of male and female urology.

Many patients are referred to the Reconstructive Urology service because they have developed incontinence or other urinary-tract disorders from cancer, cancer therapies, accidents or deformities. Our surgeons administer treatments including:

• Replacement of bladders removed due to cancer or other diseases
• Surgical repair of disfigurements caused by burns and genital traumas
• Urinary-tract reconstruction during the removal of malignant tumors
• Surgery to correct abnormalities, such as uretero-pelvic junction (UPJ), a blockage that interferes with normal urination

Every year, we complete hundreds of urinary-tract reconstructions for patients during radical prostatectomies as well as patients who have received radiation therapy for prostate cancer. Additionally, our specialists treat patients with relatively rare cancers (e.g. of the adrenal glands, testes or penis).

Our surgical techniques for treating penile cancer seek to preserve as much natural tissue and normal function as possible.

Innovative Reconstructive Techniques

Our surgeons are often at the forefront of developing today's surgical breakthroughs. For example, an advanced bladder-sparing protocol we introduced helps more patients with bladder cancer retain their naturally functioning tissue.

We are experienced in innovative reconstructive procedures such as:

• Orthotopic neobladder: A section of the bowel is used to create a replacement bladder, which connects to the urethra, directing the flow of urine from the body. This treatment doesn't require the patient to wear a catheter or collection bag
• Split-thickness skin grafting: This innovative technique involves the structural and cosmetic repair of the groin following extensive tumor resections
• Pyeloplasty: In UPJ patients, the urinary blockage is removed and normal function is restored—without the need for artificial implants

Increasingly, our surgeons perform more of these procedures with minimally invasive techniques, which typically reduce recovery times. The therapy recommended by the patient's specialist, however, depends on factors such as overall health and the patient's commitment and ability to participate in his or her rehabilitation.

Learn more about minimally invasive surgery at the Department of Urology.

An Accomplished Surgical Team

Through years of clinical practice and leading-edge research, our surgeons have accumulated the specialized knowledge and skills necessary to complete total and partial reconstructions of the urinary tract:

• Reconstructing injured genitalia
• Treating patients with genitourinary burns and penile cancer
• Constructing neo bladders