Your urinary tract is the system that filters waste and removes excess fluids from your body through urination. Your urinary tract consists of:
These two bean-shaped organs sit on either side of your spine below your rib cage. They filter waste products from about 120-150 quarts of blood per day and help to balance fluids in your body.
Each of your kidneys is connected to a ureter, which is a thin muscular tube that transports to your bladder.
This balloon-like organ sits between your hip bones and expands as it fills with urine.
The urethra is a tube that carries urine from the bladder to the exterior of your body. When your urethra is damaged by disease or trauma, the tube may narrow so much that urine can’t pass through it easily, causing pain and backed-up urine. If you have strictures or if you wish to undergo gender-affirming surgery, your urologist may recommend urinary tract reconstruction.
At our office in Las Vegas, Nevada, our expert urologist, Alex Lesani, MD, offers urinary tract reconstruction for all genders. Whenever possible, he uses robotic surgery for greater precision, less bleeding, less trauma, and faster recovery time.
What happens when you undergo urinary tract reconstruction? Here’s the long and short of it.
When you come into our office to consult with Dr. Lesani, he conducts a thorough physical examination and takes a medical history. He may also order blood and urine tests. He uses various imaging techniques, such as an X-ray with contrast dye or an ultrasound with an endoscope (i.e., mini camera), to evaluate the number and severity of your strictures.
We help you prepare by recommending that you eliminate blood-thinning medications and substances — such as aspirin and Ginkgo biloba — and stop smoking. We encourage you to arrange for help with household chores and work. You must arrange for somebody to drive you home from the hospital.
We may place another tube, called a suprapubic catheter, into your bladder. The tube carries urine from your bladder into a bag. This allows your urethra to rest and be urine-free before the surgery.
On the day of your robotic surgery, you come to the hospital, change into a hospital gown, and remove any jewelry or contact lenses that you hadn’t removed at home. We then bring you into the operating suite, prep you for surgery, and give you anesthesia to put you to sleep.
Your surgeon cuts through your skin and muscles to reach your urethra using small, robotic scalpels that are more precise than hand-held tools. If you’re male, he accesses the urethra from under your penis or scrotum or in the perineal area. If you’re female, he may access the urethra through the vaginal wall.
He also inserts a miniature camera through an incision that sends a magnified, 3D, real-time image to his monitor. Dr. Lesani controls the instruments from a special panel and watches the procedure on the monitor. Surgical repairs usually take hours, even when using robotic surgery.
During your urethroplasty, we remove the scar tissue that’s formed the narrowing stricture. We then rebuild the urethra with healthy tissue from another area, such as:
We may also need to insert a catheter into the urethra to help hold it open and give the tube extra support. Once the strictures have been removed and the urethra repaired or shortened, we then remove the instruments and close the incisions. You’re moved to the recovery room, where you’re closely monitored as you regain consciousness.
You should be able to be taken home after you wake up, and we will give you the OK. We send you home with:
If you’re male, we may give you drugs that prevent erections. If we reconstruct the urethra from your oral tissue, you also get a special antiseptic, numbing mouthwash.
In addition to an appointment to remove the catheter, we also schedule several follow-up appointments. These are to check that your urethra remains open and to monitor you for side effects.
Urethroplasty has a long-term success rate of 90%-95%, which means you should be able to urinate freely and free from pain after your recovery period. Contact us immediately if you experience side effects, including extreme pain, difficulty with urination, or catheter leakage.
To ensure your urinary tract reconstruction is handled expertly and safely, schedule a consultation with Dr. Alex Lesani by calling us at 702-470-2579 today. You can also book your appointment online.
