Reconstructive urology

Bringing world-class reconstructive management for patients in South Australia with a wide range of conditions

Dr. Ned Kinnear

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Reconstructive urology: an overview

Dr. Kinnear treats a wide range of reconstructive conditions

Dr. Kinnear understands that for many patients, having issues with erectile dysfunction, urinary tract strictures and incontinence can be incredibly difficult. Through world-class fellowship training, Dr. Kinnear is skilled with reconstructive surgery techniques to assist you and also help guide you to the right decision for you. Dr. Kinnear also provides warm and approachable consults given the sensitive nature of many of these conditions.

Seeing a urologist for reconstructive issues with the urinary tract can be scary. We’re here to help and be with you every step of the way.

  • This is a narrowing in the urine tube connecting the bladder to the outside world.

  • Abnormal bladder function due to nerve damage from a range of conditions, including diabetes, childbirth, pelvic surgery or radiation, trauma, spinal cord injury or multiple sclerosis.

  • Inability to achieve and sustain an erection that is satisfactory

  • Leakage of urine

  • This is also called a pelvic-ureteric junction obstruction or PUJO. A PUJO is a narrowing where the kidney’s drainage system joints the drain pipe.

  • Narrowing of the kidney’s drain pipe or otherwise known as the ureter.

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Urethral strictures

What is a urethral stricture?

  • The urine pipe (urethra) often reacts to inflammation or injury by scarring inwards

  • A urethral stricture is an abnormal narrowing of the urethra.

    • Iatrogenic (a complication of another medical intervention, such as traumatic urinary catheter insertion, radiotherapy or cystoscopy)

    • Idiopathic (unknown)

    • Trauma

    • Gonococcal infection

    • Symptoms

    • Urine flow that is slow, painful or sprays

    • Incomplete bladder emptying

    • Haematuria (blood in the urine)

    • Urine tract infections

    • Urine still dribbling after urination is felt to have completed

    • Ejaculation that is low volume or painful

  • Choosing treatment depends on a multitude of factors. Dr. Kinnear will take you comprehensively discuss the following as needed with you.

    Patient factors:

    • Patient preference

    • Other medical conditions

    • Past radiotherapy

    • Prior penile trauma or surgery

    Disease factors

    • Stricture number, location, length & diameter

    • Past stricture treatments

    • Presence of lichen sclerosis

    • Observation

    • Urethral dilatation

    • Urethral stricture incision (internal urethrotomy)

    • Buccal mucosal graft urethroplasty

    • Excision & primary anastomosis urethroplasty

  • Procedures offered includes:

    • Retrograde urethrogram: to map the urethra

    • Education in performing self-catheterisation: to teach patients to use catheters to drain their bladder

    • Rigid urethroscopy + (regular) urethral dilatation: to stretch urethral strictures

    • Rigid urethroscopy + Optilume urethral dilatation: to stretch urethral strictures using a drug-coated balloon

    • Rigid urethroscopy + direct vision internal urethrotomy: incisions to open urethral strictures

    • Buccal mucosal graft urethroplasty: tissue from inside the cheek is used to widen the urethral stricture

    • Excision and primary anastomosis urethroplasty: the narrow section of urethra is removed, and cut ends of the urethra are carefully re-joined

    • Perineal urethrostomy: an opening for urethra is created in the skin between the scrotum and anus

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Reconstructive urology.

Fellowship excellence.

Clinical experience.

Dr. Ned Kinnear finds reconstructive urology a meaningful way to help improve the lives of patients. With reconstructive urology often involving sexual and urinary health, there can be awkwardness, stigma and difficulty talking about it.

Dr. Kinnear understands this and provides an approachable and confidential environment to discuss these sensitive issues. With detailed work ups and thorough conversations, he hopes to provide the best treatment for you.

Procedures and investigations for other conditions

    • Video urodynamics: the gold standard investigation to understand bladder function

    • Education in non-surgical treatment

    • Rigid cystoscopy + onabotulinum (Botox) injection: to treat overactive bladder

    • Education in non-surgical treatment, including tablets, penile injections and vacuum erection devices

    • Implantable penile prosthesis

    • Artificial urinary sphincter

    • ATOMS sling

    • Advance sling

    • Laparoscopic pyeloplasty

    • Robotic assisted pyeloplasty

    Both are keyhole procedures to rectify the underlying cause of obstruction at the ureter-pelvic junction

    • Rigid cystoscopy + ureteric stent insertion

    • Rigid ureteroscopy + laser endopyelotomy or balloon dilatation

    • Robotic assisted buccal mucosal graft ureteroplasty

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