Can penile reconstruction be performed if the individual has a history of urinary incontinence?

Yes, penile reconstruction can be performed if the individual has a history of urinary incontinence. However, the type of surgery that is best for the individual will depend on the cause of their urinary incontinence and the severity of the condition.

For example, if the individual has stress urinary incontinence, which is caused by a weak urethral sphincter, they may be eligible for a male sling procedure. This surgery involves placing a mesh sling under the urethra to support it and prevent leakage.

If the individual has overflow incontinence, which is caused by an overactive bladder, they may be eligible for a bladder neck reconstruction surgery. This surgery involves widening the opening between the bladder and the urethra to improve drainage.

If the individual has urinary incontinence due to a complex condition, such as a spinal cord injury or a birth defect, they may need a more complex surgery.

In all cases, it is important to discuss the risks and benefits of penile reconstruction surgery with a qualified urologist. The urologist can assess the individual’s individual needs and recommend the best course of treatment.

Here are some of the things that a urologist will consider when deciding whether or not a person with urinary incontinence is eligible for penile reconstruction surgery:

• The type of urinary incontinence
• The severity of the urinary incontinence
• The cause of the urinary incontinence
• The patient’s overall health
• The patient’s expectations for surgery

Penile reconstruction surgeries, such as phalloplasty and metoidioplasty, can be performed for individuals with a history of urinary incontinence, but the specific approach and considerations will depend on the individual’s unique medical history, the cause of urinary incontinence, and their overall health.

Here are some important points to consider:

1. Assessment of Urinary Incontinence: Before undergoing penile reconstruction, individuals with a history of urinary incontinence should undergo a comprehensive evaluation to determine the cause and severity of their incontinence. There are various causes of urinary incontinence, including neurological conditions, anatomical abnormalities, and functional issues, and the treatment approach can vary accordingly.
2. Treatment of Underlying Causes: If the urinary incontinence is related to an underlying medical condition or anatomical issue, it may be necessary to address and manage these issues before or during penile reconstruction surgery. In some cases, treating the underlying cause may help improve urinary continence.
3. Surgical Techniques: The choice of surgical technique for penile reconstruction may be influenced by the individual’s history of urinary incontinence. Surgeons may consider techniques that minimize the risk of exacerbating incontinence or that provide additional support to the urinary system.
4. Urethral Lengthening: In cases where individuals with urinary incontinence are undergoing metoidioplasty or phalloplasty, surgeons may perform urethral lengthening as part of the procedure. This involves extending the urethra to allow for standing urination, which can enhance urinary control.
5. Postoperative Continence Management: After penile reconstruction surgery, individuals with a history of urinary incontinence may need ongoing management of their urinary symptoms. This can include pelvic floor exercises, biofeedback, and other interventions to improve urinary control.
6. Consultation with Healthcare Providers: It is essential for individuals to have open and thorough discussions with experienced healthcare providers, including gender-affirming surgeons and urologists, about their history of urinary incontinence and the potential impact of penile reconstruction on urinary function.