RECONSTRUCTIVE UROLOGY • BRISBANE
Penile, Genital & Urinary Reconstruction
Urological assessment and reconstructive care for urethral stricture, buried penis, genital scarring, complex foreskin problems, testicular prosthesis surgery and selected penile and genital reconstruction.
Reconstructive problems are often more complex than a single diagnosis. Previous surgery, scarring, skin disease, urethral narrowing and changes in urinary or sexual function can overlap. Assessment focuses on defining the underlying problem before deciding whether observation, further investigation or reconstructive treatment should be discussed.
CONDITIONS & RECONSTRUCTIVE PATHWAYS
What can we help with?
Select the problem that most closely matches what you have been told or what is affecting you. The individual condition pages explain the assessment and treatment considerations in more detail.
Urethral Stricture & Urethroplasty
Assessment of urethral narrowing, recurrent stricture and reconstructive options when repeated dilation or endoscopic treatment is not enough.
Explore urethral reconstruction → 02Buried Penis Reconstruction
Assessment of adult acquired buried penis, including concealment, urinary difficulty, scarred penile skin, lymphoedema and surrounding tissue.
Explore buried penis reconstruction → 03Lichen Sclerosus & Genital Scarring
Evaluation of penile and foreskin scarring, meatal narrowing and associated urethral disease when inflammatory skin disease is suspected.
Explore lichen sclerosus → 04Complex Circumcision & Foreskin Problems
Assessment when circumcision is complicated by significant scarring, previous surgery, skin deficiency, buried penis or urethral involvement.
Explore complex circumcision → 05Penile Cancer & Reconstruction
Information about penile-preserving and reconstructive considerations when cancer treatment affects penile tissue, skin or function.
Explore penile cancer care →Testicular Prosthesis & Revision
Information and assessment regarding testicular prosthesis surgery after orchidectomy or an absent testis, together with review of symptoms or concerns involving a previous testicular implant.
URETHRAL RECONSTRUCTION
Repeated treatment is not always the same as definitive reconstruction
Urethral stricture can recur after dilation or internal urethrotomy. When narrowing is recurrent, long, dense or associated with previous surgery, trauma or lichen sclerosus, the anatomy may need to be mapped before deciding what further treatment is reasonable.
Urethroplasty is a reconstructive operation rather than a single standard technique. The approach depends on the location and length of the stricture, tissue quality, prior procedures and individual urinary and sexual function.
Read about urethral stricture and urethroplasty →ASSESSMENT MAY CONSIDER
- Where the narrowing is located
- How long and dense the stricture is
- Previous dilation, urethrotomy or urethroplasty
- History of trauma or pelvic surgery
- Lichen sclerosus or poor tissue quality
- Baseline urinary and sexual function
PENILE IMPLANT REVISION
Problems after a penile implant may require a different surgical assessment
Penile implant revision may be considered when there is suspected mechanical failure, difficulty inflating or deflating, component malposition, erosion, infection, persistent pain or another problem following previous implant surgery. The appropriate approach depends on the device, the reason for revision, previous operations, tissue quality and the individual clinical situation.
Revision surgery is not simply a repeat of first-time implantation. Previous surgery can alter tissue planes and produce scarring, and the existing device may need to be assessed in the context of the current symptoms and any prior complications.
REVISION ASSESSMENT MAY REVIEW
- The original implant type and date of surgery
- Whether the problem involves inflation, deflation, rigidity, pain or positioning
- Any history of infection, erosion or previous revision surgery
- Previous operative reports and device information when available
- Penile scarring, fibrosis, curvature or altered anatomy
- The potential need for revision, replacement, removal or another strategy
TESTICULAR PROSTHESIS & REVISION
Testicular prosthesis surgery can be considered at the time of testicular loss or later
When a testicle is absent or has been removed, reconstructive options can include discussion of testicular prosthesis surgery. This may be considered at the time of orchidectomy in suitable circumstances or as a delayed reconstructive procedure after previous testicular surgery.
Consultation focuses on the reason for reconstruction, previous surgery, available scrotal space, the opposite testicle where present, and realistic expectations about appearance and feel. A prosthesis does not replace the hormonal or fertility function of a biological testicle. Patients with a previous testicular implant can also be assessed for persistent pain, position concerns, suspected infection, skin problems or other implant-related symptoms.
Information on this page is general and does not recommend a particular implant, manufacturer or device. Suitability for any procedure requires individual clinical assessment.
ASSESSMENT MAY CONSIDER
- Why the testicle is absent and the timing of previous surgery
- The opposite testicle, scrotal anatomy and available space
- Previous inguinal or scrotal operations and scar tissue
- Expected implant size, position, firmness and movement
- Whether primary implantation or delayed implantation is being considered
- Pain, malposition, migration, infection, erosion or other concerns with an existing implant
YOUR RECONSTRUCTIVE UROLOGY PATHWAY
From defining the problem to planning treatment
Understand the history
Previous operations, infections, trauma, catheterisation, skin disease, urinary symptoms and sexual function can all change the reconstructive plan.
Define the anatomy
Examination and selected investigations can help establish whether the problem involves the urethra, penile skin, foreskin, scrotum or surrounding tissues.
Discuss reasonable options
Not every reconstructive problem requires surgery. Where treatment is considered, the potential benefits, limitations, risks and alternatives should be discussed for the individual situation.
Plan reconstruction and follow-up
Complex surgery may require staged treatment, grafts, prolonged catheterisation or additional wound care. Follow-up is tailored to the operation performed.
RECONSTRUCTIVE UROLOGY
Why see Dr Jack Crozier?
Dr Jack Crozier is a Brisbane urologist with fellowship training in andrology and reconstructive urology. His practice includes urethral reconstruction, complex penile and genital surgery, buried penis, lichen sclerosus, penile cancer reconstruction, testicular prosthesis surgery and revision surgery.
Complex cases are assessed with the aim of understanding the underlying anatomy and preserving urinary, sexual and genital function where reasonably possible.
About Dr Jack CrozierINTERSTATE & INTERNATIONAL PATIENTS
Travelling to Brisbane for reconstructive urology care?
Where appropriate, existing imaging, operative reports, photographs and investigation results can be reviewed as part of planning. Complex reconstruction may require more than one assessment or a longer period in Brisbane depending on the surgery and postoperative care required.
FREQUENTLY ASKED QUESTIONS
Questions about reconstructive urology
What is reconstructive urology?
Reconstructive urology deals with structural problems affecting the urinary or genital tract. This can include urethral stricture, scarred or deficient genital skin, buried penis, complications of previous surgery and selected penile or genital reconstruction.
Do all urethral strictures need urethroplasty?
No. Management depends on the location, length and severity of the narrowing, previous treatment and the individual's circumstances. Some strictures may be managed without open reconstruction, while others may be more appropriately assessed for urethroplasty.
Can a urethral stricture come back after treatment?
Yes. Recurrence can occur after endoscopic treatment and after reconstruction. Recurrent symptoms should be reassessed rather than assuming the same treatment should simply be repeated.
Is buried penis only caused by obesity?
No. Surrounding tissue can contribute, but scarred penile skin, lichen sclerosus, previous circumcision or surgery, lymphoedema and penoscrotal anatomy can also play a role.
Can circumcision make a buried penis worse?
In some men with a genuinely buried penis, apparently redundant foreskin may be important for shaft coverage. Removing additional skin without first defining the anatomy can worsen skin deficiency, which is why complex cases benefit from reconstructive assessment before surgery.
What if I already have a penile implant and something is not working?
Problems such as difficulty inflating or deflating, loss of rigidity, pain, abnormal positioning or concern about a previous implant should be assessed in the context of the device and prior surgery. See the dedicated penile implant revision page for more information about assessment and revision considerations.
Can a testicular prosthesis be inserted after orchidectomy?
Potentially. A testicular prosthesis may be considered at the time of orchidectomy in suitable circumstances or as a delayed procedure after the original surgery. Previous surgery, scarring, the available scrotal space and individual preferences are considered during planning. See the testicular prosthesis page for more information.
What if a testicular implant sits too high or is painful?
Persistent pain, a high-riding or poorly positioned implant, migration, significant size concerns or other implant-related problems can be assessed. Not every concern requires another operation, but selected patients may be considered for removal, repositioning or replacement depending on the cause. See the testicular implant revision page for more information.
Can reconstructive surgery affect erections or sensation?
Depending on the condition and operation, sexual function, sensation, ejaculation or penile appearance may be relevant to the risk discussion. Baseline function and the anticipated effects of treatment should be considered before surgery.
What should I bring to a reconstructive urology appointment?
Previous operative reports, urethral imaging, cystoscopy reports, pathology, relevant scans and a list of previous procedures can be particularly useful. The exact records needed depend on the problem being assessed.
INDIVIDUAL RECONSTRUCTIVE ASSESSMENT
Have you been told your urinary or genital problem is complex or recurrent?
A reconstructive assessment can help define the anatomy, review previous treatment and clarify the reasonable next options.