Q & A | Tulane Urology Recon

Questions & Answers

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“I’ve had urethral dilations and direct vision internal urethrotomies in the past, but my stricture keeps coming back. I’m tired of the cycle of recurrence and procedures. Is there a better, long-term solution?”

Urethral stricture is a recurring condition if the underlying problem isn’t addressed. Procedures like urethral dilation or direct vision internal urethrotomy (cutting the stricture from the inside) are quick outpatient treatments, but they come with high recurrence rates. Each time these are repeated, they increase the risk of the stricture worsening because tearing or cutting the tissue creates more scarring as it heals.

The best long-term solution is urethroplasty, an open surgery designed to permanently resolve the issue. Based on the stricture’s length, severity, and location (evaluated through a retrograde urethrogram X-ray and a brief cystoscopy), we decide on one of two main approaches:

1. Anastomotic Urethroplasty: Removing the scarred section and reconnecting the healthy ends.

2. Substitution Urethroplasty: Using a graft, typically from buccal (cheek) tissue, to widen the urethra.

All evaluations and surgeries are performed under my care to create a personalized plan that ensures lasting results and gets you out of this cycle for good.

“My urologist mentioned a new method of urethral dilation called Optilume. Does Tulane Urology offer this treatment?”

“I had a car accident in 2020 and underwent a urethroplasty in 2021 in another state, but my urethra wasn’t fixed. I’ve been using a suprapubic tube ever since, changing it myself. I’ve seen a few urologists, but they told me it’s not fixable. Can you help?”

Post-pelvic fracture urethral stricture is a complex and challenging condition that requires specialized skills and equipment to repair. After completing a fellowship focused on these surgeries and teaching them in regions with higher rates of pelvic fracture urethral disease, I have developed a proven track record of success with these procedures.

It’s important to note that before surgery, no procedures, including urethral dilation, should be performed for at least three months. After the surgery, you’ll need to have a catheter in place for three weeks. Once the healing period is over, we’ll perform another X-ray to confirm that the urethra is open and functioning properly.

If you’d like to explore your options, we can schedule an evaluation to create a plan tailored to your specific condition.

“I had prostate surgery two years ago. I was fine for three months, but then urinary difficulties came back. I’ve had a couple of dilations since. What should I do?”

It sounds like you may have developed a urethral stricture or bladder neck contracture, which can sometimes occur after prostate surgery. While dilations can provide temporary relief, they often don’t offer a long-term solution and may lead to more scarring with repeated procedures.

The best approach is to evaluate the underlying issue with imaging, such as a retrograde urethrogram and cystoscopy, to determine the exact location and severity of the obstruction. Based on the findings, we can recommend a definitive treatment plan, which might include surgical options like urethroplasty or bladder neck reconstruction.

These treatments aim to provide a permanent solution and significantly improve your quality of life. I’d recommend scheduling a consultation so we can assess your condition and develop a personalized treatment plan.

“Do you perform prostate surgery?”

Yes, we offer all types of prostate surgeries, including minimally invasive, endoscopic, and robotic procedures. The type of surgery you need will depend on your prostate’s size (evaluated through imaging) and the findings from a cystoscopy.

The treatment plan is a mutual decision—we’ll discuss your options, I’ll provide my recommendations, and together we’ll decide on the best approach. This ensures you’re fully informed and comfortable with the treatment plan.

“I have incontinence after my prostate surgery. Can you help me?

Does my insurance cover that?”

Yes, we perform a variety of incontinence surgeries to address different causes, including incontinence after prostate surgery and other conditions. One of the most effective options is the artificial urinary sphincter, which involves placing a cuff around the urethra and a pump near the scrotum. The cuff keeps the urethra closed—when you want to urinate, you simply press the pump to release the pressure.

Before surgery, we’ll evaluate your specific condition to determine the best treatment option for you. Most insurances cover these surgeries, but we’ll confirm your coverage details during your first visit to ensure everything is in place before proceeding. Let’s schedule a consultation to discuss your options and create a personalized treatment plan!

Questions & Answers

Visit TulaneUrology.com

Clinic Locations

EJGH Clinic

4224 Houma Blvd., Suite 300
Metairie, LA 70006

Tel: 504.503.7500 (Front Desk)
Tel: 504.988.8864 (One Call Service)

Tulane Medical Center
Downtown Clinic

1415 Tulane Avenue, 3rd Floor
New Orleans, LA 70112

Tel: 504.988.5271 (Front Desk)
Tel: 504.988.8864 (One Call Service)

Questions & Answers

Visit TulaneUrology.com

Clinic Locations

EJGH Clinic

4224 Houma Blvd., Suite 300 Metairie, LA 70006

Tel: 504.503.7500 (Front Desk) Tel: 504.988.8864 (One Call Service)

Tulane Medical Center Downtown Clinic

1415 Tulane Avenue, 3rd Floor New Orleans, LA 70112

Tel: 504.988.5271 (Front Desk) Tel: 504.988.8864 (One Call Service)

4224 Houma Blvd., Suite 300
Metairie, LA 70006

Tel: 504.503.7500 (Front Desk)
Tel: 504.988.8864 (One Call Service)

Tulane Medical Center
Downtown Clinic

1415 Tulane Avenue, 3rd Floor
New Orleans, LA 70112

Tel: 504.988.5271 (Front Desk)
Tel: 504.988.8864 (One Call Service)