The Center for Genitourinary Reconstruction offers individualized and advanced surgical treatment options for patients with common and uncommon lower urinary tract and genital conditions, disorders and anomalies. Patients primarily consist of male adolescents and adults, but also include some female patients who are born with genitourinary system abnormalities and have problems continuing into adolescence and adulthood.
The genitourinary tract is the system most often affected by congenital defects (problems present at the time of birth). However, as children with congenital anomalies of the genitourinary system are entering adolescence and adulthood with excellent health, issues of sexuality, genital appearance and function, urinary and bowel incontinence, and fertility become important health and quality of life issues. In addition, patients who are born with these problems later experience typical age-related urological problems such as prostate enlargement and prostate cancer that are then more difficult to treat as a result of their previous condition or prior surgeries.
Our program works with patients with childhood anomalies to balance challenging and sometimes competing urological and personal needs. We combine our medical plan with the patient's own personal health objectives to develop an individualized treatment plan. The initial visit to our center typically involves a detailed review of the patient's medical and surgical history. Sometimes additional testing is necessary to thoroughly assess the patient.
After all of this information is obtained and evaluated, we map out a plan with each patient to address the genitourinary problems they are currently experiencing and as well as plan for future needs.
Our surgeons have treated patients from across the world and are recognized internationally for providing successful care to patients with genitourinary health issues. In an effort to provide all-around coordination of care, we will share notes and records with the patient’s referring physician with the patient’s consent.
What We Treat
- Adult Spina Bifida
- Complications following prostate cancer treatment
- Complications related to prior hypospadias repair in adolescents and adults
- Congenital anomalies of the bladder and genitalia
- Congenital Penile Curvature
- Erectile Dysfunction
- General Urinary Incontinence
- Genital Lymphedema
- Male Urinary Incontinence
- Neurogenic bladder due to spinal cord injury or myelomeningocele
- Penile and urethral cancer
- Peyronie’s Disease
- Rectourethral Fistula
- Urethral strictures
- Urethrocutaneous Fistula
Treatments and Procedures
- Artificial urinary sphincter
- Augmentation cystoplasty with catheterizable channel
- Cystectomy with urinary diversion
- Male genital reconstruction
- Male urethral sling
- Penile plication
- Penile prosthesis
- Peyronie's Disease
- Plaque incision with graft placement
- Posterior Urethral Reconstruction
- Prosthesis implantation
- Rectourethral fistula repair
- Surgery for buried penis
- Testicular prosthesis
- Urethrocutaneous fistula repair
- Xiaflex injection
|Kenneth Angermeier, MD - Director, Center for Genitourinary Reconstruction|
|Drogo Montague, MD|
|Hadley Wood, MD|
Adult Spina Bifida Clinic
Spina bifida, or myelomeningocele, is the most common permanent congenital anomaly in the United States. Over the past 30 years, the multidisciplinary clinics for children with spina bifida has become the standard of care. These clinics integrate neurological, urological, orthopedic care and social services for patients and families living with spina bifida. The improvement in care for children affected by spina bifida has resulted in prolonged lifespan and quality of life for these patients, with over 85% of these children surviving into adulthood.
Increasing awareness of the gap in care from adolescence to adulthood offers a unique opportunity for innovative care for this patient population. It is not uncommon for adults with spina bifida to experience a decline of function into adulthood, as well as problems that are unique from those they encountered during childhood.
The goals of the adult spina bifida clinic are to:
- Provide ongoing support for patients who have outgrown the pediatric spina bifida clinic.
- Recapture and provide ongoing preventative medical care to adult patients who have been lost to routine medical care.
- Better understand the unique medical needs and quality of life concerns of these patients as they age.
The clinic is staffed by health care provider representatives from urology, physical medicine, and internal medicine. When feasible, patient’s records are reviewed prior to the appointment so that appropriate screening testing can be ordered on the same day as the clinic for the patients’ convenience. Referrals to providers in colon-rectal, gastroenterology, gynecology, and other specials are also facilitated as needed. Clinics are offered approximately every 3-4 months depending on patient demand. For more information, please call 216.444.2146.
For additional information on adult spina bifida, visit the Spina Bifida Association website.