Genitourinary Trauma Reconstruction

Genitourinary trauma reconstruction is a specialized approach to repairing the long term effects of injuries to the penis, urethra, scrotum, or perineum. These injuries can create lasting physical and emotional challenges, especially when the initial trauma did not heal correctly or when deeper structures such as nerves, blood supply, or urinary channels were affected. Many patients develop ongoing problems such as chronic pain, difficulty urinating, loss of sensation or function, fistulas, strictures, or visible deformities that impact confidence and intimate relationships.

Because these issues rarely improve on their own, advanced reconstructive surgery is often required to restore normal function, continence, sensation, and appearance. Genitourinary trauma reconstruction focuses on rebuilding damaged tissues, repairing urinary structures, and correcting both functional and aesthetic complications that may appear months or years after the original injury. At The Institute for Advanced Reconstruction, our surgeons provide highly specialized care for patients who are medically stable but still living with the long term consequences of trauma, offering hope and lasting improvement even in the most complex cases.

Many people who come to us have already gone through emergency treatment or wound closure elsewhere, but are still living with:

• Difficulty urinating or urinary obstruction
• Persistent pain or nerve-related discomfort
• Changes in sensation or sexual function
• Penile or scrotal deformity after trauma or prior surgery
• Fistulas or abnormal openings
• Scarring or tissue loss in the perineum
• Loss of confidence or intimacy because of visible or functional changes

If you’ve experienced these symptoms following a traumatic injury, early evaluation by a specialist can prevent long-term complications.

Genitourinary trauma can result from:

• Falls or straddle injuries
• Motor vehicle accidents
• Crush injuries or workplace accidents
• Animal or human bites
• Burns or thermal injury
• Cancer-related surgery or radical resection
• Self-inflicted trauma
• Post-radiation complications

Even when the emergency phase is handled appropriately, secondary complications are common, especially when nerves or urethral structures are involved.

Many patients come to us after being told that nothing more can be done or after multiple unsuccessful surgeries elsewhere. Our reconstructive approach is highly specialized and nerve-sparing whenever possible, with the goal of restoring both function and quality of life. Depending on the location and severity of injury, treatment may include:

Complex Urethroplasty
Used when trauma causes scar tissue or strictures that block urine flow. This procedure rebuilds or reconnects the urethra to restore normal urination.
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Buccal Graft Urethroplasty
In more severe injuries, a graft from the inner cheek is used to reconstruct longer or more damaged segments of the urethra for durable, long-lasting results.
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Urethrocutaneous Fistula Repair
Closes abnormal openings between the urethra and the skin, stopping urine leakage and restoring normal function.
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Robotic-Assisted Reconstruction
Used for select complex injuries where minimally invasive access improves precision and recovery while protecting nerves and blood supply.
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Soft Tissue Reconstruction
Repairs tissue loss or deformity involving the scrotum, penis, or perineum using advanced reconstructive techniques that restore both form and function.
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Nerve-Sparing Repair
When nerves are injured or at risk, microsurgical preservation or reconstruction helps protect or restore sensation and sexual function.
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Each patient’s surgical plan is tailored to the pattern of injury, not just the visible defect. We rebuild form and function.

You may benefit from reconstructive surgery if you:

• Have lasting pain, deformity, or loss of function after trauma
• Developed urinary symptoms (stricture, leakage, fistula) after injury
• Experienced scarring that affects comfort, confidence, or intimacy
• Previously had a repair that improved appearance but not function
• Were told you must “just live with it” or that no more options exist

Not sure if your injury qualifies? Our specialists routinely evaluate complex and delayed cases. A consultation with one of our nerve specialists can help provide the clarity you need on next steps.

Do I need emergency care or reconstructive care?

If your injury is recent or involves active bleeding, open wounds, or acute pain, go immediately to the nearest ER. Once long-term complications become clear, reconstruction is performed after you are medically stable.

How long after the injury can reconstruction still be done?

Weeks, months, or even years later. Many patients come to us after living with symptoms for a very long time. It is rarely “too late” for reconstruction.

Can sensation or sexual function be restored after trauma?

In many cases, yes. Because our team specializes in microsurgical nerve preservation and reconstruction, we can often restore sensation, improve function, or prevent further decline.

What if I already had a repair that didn’t resolve my symptoms?

We frequently treat patients after a first surgery elsewhere was cosmetic or incomplete. Reconstruction can address deeper nerve, urethral, or blood supply issues that weren’t corrected initially.

I feel embarrassed talking about this. Is that common?

Yes. Many patients delay care because of shame, fear, or uncertainty. This is a normal reaction and a major reason this dedicated trauma reconstruction service exists.

Will insurance cover urethroplasty or related procedures?

In most cases, yes. Urethral reconstruction is generally considered medically necessary. Visit our insurance information page for more information, or contact our financial coordinators to confirm your coverage.

Do I need a referral to see a specialist at The Institute?

No referral is required. Patients may request an appointment directly. If another doctor referred you, we will collaborate with your care team to ensure seamless communication.

How do I know if The Institute is the right place for me?

Patients travel to us from across the country and around the world because of our rare expertise in pelvic and urologic nerve surgery. If you’ve been struggling without answers, our team can provide a clear diagnosis and treatment plan.