Urethral Strictures & Pelvic Trauma

Uretheral strictures, pelvic trauma, and certain congential abnormalities can often lead to structural damage, inflammation and infection. As a result, these conditions can severly affect the urinary tract, and sometimes impede sexual and reproductive functions.


Urethral strictures

A urethral stricture is scar tissue that has formed in the urethra, the tube that passes urine from the body. This scar tissue can reduce or completely block the flow of urine. If the scar tissue is not removed or loosened, urine builds up in the bladder and can lead to inflammation or an infection of the urinary tract.

Temple's urologists offer a range of treatments for urethral strictures, including both reconstructive and minimally invasive endoscopic surgery. Learn more about treatment options for urethral strictures.

To schedule an appointment with a Temple urologist, click here or call
1-800-TEMPLE-MED (1-800-836-7536).


Pelvic trauma

The pelvis is a ring of bone that sits at the bottom of the torso. It provides support when standing and sitting, and protects a number of reproductive and digestive organs that are situated within the pelvic ring. When the pelvis sustains a traumatic injury, it may become sore, bruised and/or swollen.

Teen or adult athletes typically sustain avulsion fractures to the pelvis. These injuries occur when a tiny piece of the pelvis bone is torn away by contracting muscles. Often times, avulsion fractures are mistaken for pulled muscles.

Older adults with osteoporosis are likely to sustain a pelvic fracture during a fall. These injuries tend to damage a single bone rather than the structural integrity of the entire pelvis.

The most common cause of pelvic fractures, accounting for roughly 60%, is a high-energy impact, resulting from a car crash, fall or crushing accident.

When a pelvic injury occurs, Temple urologists must ensure that the surrounding organs have not sustained any damage. In addition to a full suite of diagnostic equipment, Temple offers both surgical and nonsurgical treatment of pelvic trauma.

To schedule an appointment with a Temple urologist, click here or call
1-800-TEMPLE-MED (1-800-836-7536).

Peyronie's disease

Peyronie's disease is a condition in which scar tissue develops inside the penis and causes painful, curved erections. While some penises are naturally curved, Peyronie's disease is characterized by a sharp bend, and significant pain that can impede sexual intercourse or result in erectile dysfunction.

Symptoms of Peyronie's disease may include:

  • A significant bend in the penis, either upwards, downwards or to either side
  • An hourglass appearance to the penis, with a narrow portion in the middle of the shaft
  • Scar tissue that can be felt under the skin of the penis
  • Problems with developing or maintaining an erection
  • Shortening of the penis
  • Pain, either upon any contact with the penis, or only during an erection or orgasm

It is believed that Peyronie's disease results from the rupturing of small blood vessels inside the penis. When these blood vessels heal, blood cells build up at the site of the rupture, leading to the development of scar tissue. Genetics may determine if scar tissue forms, as not all men who experience penile injuries will develop Peyronie's disease.

Risk factors for Peyronie's disease may include:

  • Having a father or brother with Peyronie's disease
  • Having a connective tissue disorder
  • Growing older

Temple's urologists offer a variety of medical treatments for Peyronie's disease, as well as surgical treatments (plication surgery and penile graft) for cases severe enough to make sexual intercourse impossible.

To schedule an appointment with a Temple urologist, click here or call
1-800-TEMPLE-MED (1-800-836-7536).

Hypospadias

In hypospadias, the opening of the penis is located on the underside of the penis, rather than the tip of the head. Hypospadias is a relatively common condition that is usually treatable. In most cases, it does not interfere with sexual function in adults.

In most cases of hypospadias, the opening (also called the urethra) is located underneath the head of the penis. In more severe cases, it can be located at the mid-shaft or even the base of the penis. In rare cases, the urethra can be located on or below the scrotum.

The symptoms of hypospadias include:

  • Downward-curving penis
  • Spraying during urination
  • Hooded appearance to penis (due to the foreskin not covering the bottom half)

Hypospadias is a congenital condition, meaning it is present at birth. It can be inherited, but is not always so. While its exact cause is still unknown, physicians know that it results from a malfunction in the developmental hormones that control the formation of the urethra and foreskin.

Hypospadias is more common in infants with a family history of the condition. Some research has suggested that the condition is more common in children born to older mothers, or those who used in vitro fertilization. Another study found that pesticide exposure was linked to a higher rate of hypospadias.

Regardless of the cause, Temple's urologic surgeons offer a variety of surgical techniques to reposition the urethral opening and, if necessary, straighten the shaft of the penis.

To schedule an appointment with a Temple urologist, click here or call
1-800-TEMPLE-MED (1-800-836-7536).

Penile skin deficiency

Penile skin deficiency is a condition in which the penis lacks enough skin to cover certain parts of its anatomy. A penile skin deficiency can be caused by a range of diseases, traumatic injuries and prior surgical treatments. For example, when certain penile tumors are removed, the surgery may leave uncovered areas on the penis. Fournier's Gangrene, another condition affecting the penile skin, is treated by removing all of the diseased tissue, meaning there may not be enough healthy skin left over after surgery.

Fortunately, most penile skin deficiencies are accompanied by an excess of skin in other areas of the penis. For example, a skin deficiency around the mid-shaft of the penis is often coupled with extra foreskin. Temple's urologic surgeons use this excess skin to cover penile skin deficiencies.

Surgery for a penile skin deficiency differs from a skin graft. Temple's urological surgeons generally avoid grafting bodily skin to the penis since grafts cannot achieve the same softness and elastic qualities as natural penile skin. Skin grafts are only performed when there is not enough excess penile skin to cover the deficiency. In these cases, skin grafts from the thigh are often used.

To schedule an appointment with a Temple urologist, click here or call
1-800-TEMPLE-MED (1-800-836-7536).

Penile skin bridges

Penile skin bridges, also called penile skin adhesions, are a rare complication of circumcision. A skin bridge forms when a leftover piece of foreskin attaches to the head of the penis. The appearance is a seamless skin bridge extending from the side of the penis to the head.

In some cases, skin bridges have no undesirable effects other than their appearance. In other cases, they may produce intense pain during erections or sexual intercourse. Temple's urologic surgeons offer surgical treatments for penile skin bridges under both local and general anesthesia.

To schedule an appointment with a Temple urologist, click here or call
1-800-TEMPLE-MED (1-800-836-7536).

Major penile injuries

The penis can sustain a variety of major injuries resulting in the partial or total loss of the organ. These injuries include:

  • Penile tissue loss from traumatic injury
  • Partial or total penectomy (surgical removal of the penis)
  • Surgical removal of penis cancer (typically squamous cell carcinoma)
  • Penile ischemia as a result of surgery
  • Penile infection as a result of surgery

Temple's urologic surgeons can often reattach the penis if it has been severed off by a sharp instrument, such as a knife or a sword. When the penile loss is due to other causes, our surgeons' main priority becomes the recreation of an opening through which the patient can urinate. If there is only a partial penile loss, then the opening is created on the tip of the remaining penis. If the loss is total, the opening is made under the scrotum.

Temple's urologic surgeons offer a wide variety of treatments for major penile injuries, including free flap phalloplasty, the major reconstructive surgery of the penis.

To schedule an appointment with a Temple urologist, click here or call
1-800-TEMPLE-MED (1-800-836-7536).

Prostate cancer complications

Because prostate cancer and its treatments present many difficult side effects, Temple stands ready to help our patients cope with any complications and ensure a smooth road to recovery. These complications may include:

  • Erectile dysfunction (ED) - ED is a common side effect of surgery, radiation and/or hormonal therapies that are necessary to treat prostate cancer. Fortunately ED is treatable with medications or penile implants.
  • Incontinence - the loss of control of one's bladder or bowel function can be an especially overwhelming complication. Incontinence can result from prostate cancer treatments, or the disease itself. It can be permanent or temporary. Some men can control their incontinence by making behavioral changes — for example, scheduling certain times to go to the bathroom each day. Certain exercises can also build the strength of the pelvic muscles, thereby increasing control over bladder function. Medications can also be helpful.
  • Additional cancer - while treatment aims to prevent a cancer from returning, in some cases the disease can still spread to the bones or other organs of the body through the bloodstream or lymph nodes.
  • Bladder neck contracture/urethral stricture - urethral stricture disease is the narrowing of the urethra. Bladder neck contracture occurs when the narrowing appears where the prostate meets the bladder. This is likely to occur after radiation therapy for prostate cancer. If the prostate is removed altogether, bladder neck contracture can also occur where the urethra meets the bladder.
  • Rectal-urethral fistula - a rectal-urethral fistula is the formation of an abnormal hole connecting the rectum to the prostate. It is a rare and very seriously complication of radiation therapy for prostate cancer. The hole allows feces to enter the urinary tract, and urine to enter the rectum.

To schedule an appointment with a Temple urologist, click here or call
1-800-TEMPLE-MED (1-800-836-7536).

Scrotal lymphedema

Scrotal lymphedema is a very serious condition in which lymphatic fluid and tissue build up between the testicles and the scrotal skin, causing massive swelling. The scrotum eventually becomes so large that the penis is completely buried beneath it. Ultimately the patient has difficulty walking due to the size and weight of the testicular swelling.

Scrotal lymphedema is most likely to occur in obese men. Often times these men are told to lose weight in order to decrease the scrotal swelling, but the sheer size of the swollen scrotum makes exercise nearly impossible. Temple's urologist offer surgical treatments to remove the mass of tissue and fluid without affecting the penis or urethra. Temple's surgeons also strive to preserve the testicles.

To schedule an appointment with a Temple urologist, click here or call
1-800-TEMPLE-MED (1-800-836-7536).

Hidradenitis suppurativa

Hidradenitis suppurativa is a non-contagious skin disease affecting the underarms, inner thighs, scrotum, buttocks, groin and perineum, the medical term for the skin between the scrotum and the anus. The skin in these areas develops lesions, boils and pus-filled pockets that rupture and drain. Permanent scarring can result.

Hidradenitis suppurativa is a chronic condition that comes and goes in "flare-ups" of varying intensity. It is technically considered a severe form of acne, beginning to appear after puberty and gradually becoming more severe over time. It often starts as a single painful bump that fails to heal and then spreads over a wider area of skin.

Hidradenitis suppurativa occurs when the oil glands and hair follicles within the skin become blocked by dead skin cells, fluid or matter released by the sweat glands. When the blockages mix with oil from the oil glands, they can result in infection and inflammation.

The main symptoms of hidradenitis suppurativa include:

  • Leaking bumps or sores
  • Painful, pea-sized lumps
  • Tender, red bumps
  • Blackheads

The main risk factors include:

  • Family history of hidradenitis suppurativa
  • Being female
  • Being between puberty and age 40

Temple's urologists offer a variety of treatment options for hidradenitis suppurativa, including antibiotics, anti-inflammatory drugs and surgical procedures for more advanced cases.

To schedule an appointment with a Temple urologist, click here or call
1-800-TEMPLE-MED (1-800-836-7536).