The reproductive and urinary tract systems are inextricably linked, so medical procedures performed on these two areas can alter the way that urine is processed and removed from the body. A genitourinary reconstruction can help correct problems while maintaining function as much as possible.
Sometimes genitourinary reconstruction is needed because a significant portion of the genital tissue has been damaged by trauma, infection, disease, or a congenital abnormality that is particularly upsetting to the patient. One example is “pelvic organ prolapse" that causes the patient’s other organs to place undue pressure on her vagina. If this pressure causes the tissues to tear or become dislocated, genitourinary reconstruction will be required.
Urinary incontinence due to congenital or urological conditions are other reasons that a woman might consider genitourinary reconstruction. The organs that can be affected by genitourinary reconstruction include the Fallopian tubes, the perineum, the uterus, the ovaries, and the vagina. The urethra, urinary bladder, ureters, and the kidneys may also be affected.
Most genitourinary reconstructive surgeries take place in the pelvic area. These procedures include a consolidation of the muscle flap and mucosal graft and skin graft procedures. Some of these procedures are performed by excision of a portion of the intestines. This tissue is then used to create organs in the urinary tract system. There are also procedures that allow the surgeons to reconnect structures that require reconnection. One example is urethral reconstruction. This is when the damaged area is removed and the remaining area is reattached. In some cases, the surgeon is forced to create another way for urine to be released from the body.
The type of surgery you will have will depend on the location of the structures that need to be repaired. In some cases, the surgeon will perform the operation by making an incision in your lower pelvic area or abdomen. If the surgery cannot be performed in this way, the surgeon may be able to access the area by passing through the vagina. A new and innovative approach uses a robotic device that the surgeon manipulates with his or her hands.
Whether you have a major surgery or one that is minimally invasive, you will have a recovery period before you can return to your normal activities. You may be given medications after the surgery to ease any discomfort you may experience. If your pelvic muscles require it, you may be referred for physical therapy to strengthen them. If your bladder will be affected during your surgery, you may need to learn to urinate differently or use a catheter.