OHSU's fellowship-trained physicians are very successful in treating urethral stricture disease. For many men, urethral stricture disease has been managed as a chronic disease, with periodicincision (internal urethrotomy) and regular self-dilation. However, more than one internal urethrotomy is neither efficacious nor cost-effective in treating bulbar urethral strictures, and this treatment is not effective at all in strictures of the penile urethra. Furthermore, the trauma and inflammatory response to repeated urethrotomies and self-dilation can convert a short, simple stricture into a longer, densely fibrotic stricture which is more difficult to repair. Long-term studies of anastomotic urethroplasty series show success rates of well over 90%. If a man with a short bulbar urethral stricture fails treatment with a single internal urethrotomy, a urethroplasty may cure him of his disease. Reconstructive experts use plastic surgery techniques such as buccal mucosal grafting and fasciocutanous skin flaps to reconstruct long-segment urethral strictures. Technological innovation holds further promise for the field of reconstructive urology, including the possibility of tissue substitutes or laboratory-grown tissues from a patient’s own cells.
Typically occurring after acute injury, Peyronie's disease is characterized by a plaque, or lump, that forms on the tissue of the penis. Often beginning as inflammation, the plaque can develop into a fibrous tissue, and while benign, it manifests as a bend or shortening of the penis. Resulting pain and emotional distress can cause difficulty with sexual intercourse. Fortunately, several treatment options that may or may not require surgical repair offer those suffering with Peyronie’s a return to full sexual function.
In some men with erectile dysfunction, after other medical treatments have been pursued, advanced treatment may be considered for cases in which the cause is unlikely to resolve naturally or with other therapies. Penile prostheses offer men an opportunity for regaining sexual function. There are several types of penile implants, depending on preference and anatomy. Due to the very high success rate and extremely low complication rate of the inflatable penile prosthesis in our practice, the inflatable penile prosthesis can be offered as a very desirable solution to the problem of male impotence.
Phalloplasty (penile reconstruction)
A variety of genetic conditions or acute injuries may cause penile damage necessitating reconstruction, or phalloplasty. Here at OHSU, our providers are highly experienced with the causes behind penile damage, and are equipped with the most advanced surgical equipment and techniques to address each situation with a tailored plan designed to bring you the best possible outcome.