Genitourethral Reconstruction

To write an editorial is always a good opportunity to say thanks to my coeditors Salvatore Sansalone and Peter Rehder for all the work they have done and to the authors of the many high-class manuscripts. Reconstructive urology and andrology are still a very new research direction in the field of urology. For this reason we should specially take care to produce innovative research results. These results should not only reflect the so-called mainstream research but should focus on serving the patients. Here we are particularly keen not to repeat past mistakes from other disciplines. Reconstructive urology is a highly specialized field of urology that restores both structure and function to the gen-itourinary tract. can require reconstructive surgery. The urinary bladder, ureters (the tubes that lead from the kidneys to the urinary bladder) and genitalia are other examples of reconstructive urology. The goal in penile reconstruction is to either create or restore both functional and aesthetic phallus. This includes the ability not only to void while standing, from the tip of the phallus, but also to achieve sexual function, with a sensate penis of sufficient bulk to allow for penetration. Generally, the extent of the defect dictates the means of reconstruction we chose for our patients. A surgical defect may range from one involving a single tissue or structure (i.e., skin or urethra) to a total penectomy defect, requiring microsurgical reconstruction. The buried penis presents another interesting problem that demands a somewhat different surgical approach and procedure. The classical reconstructive surgery in this field is reconstruction after resection of urethral strictures. Here we discuss two different techniques with perineal access in this issue. Perineal ureterostomy is an option to manage complex and/or recurrent urethral strictures and is necessary after ure-threctomy and/or penectomy. Both techniques are associated with about 20% recurrence rate and the patient should be informed about this risk. Urinary diversion after cystectomy is an important field of reconstruction, which is very often associated with urinary retention and urinary incontinence. In the study of M. ˙ Zyczkowski et al., the authors present a surgical modification during cystectomy with orthotopic ileal neobladder. The authors could demonstrate that sacrocolpopexy with polypropylene tape as valuable surgical modification during cystectomy with orthotopic ileal bladder is a valuable surgical method which provides patients with a better quality of life. Another field in this context is transgender surgery. This is a highly complex and specified …