MUSC background

Treating Patients with Genitourinary Deformities

Improving Quality of Life for Patients with Genitorurinary Abnormalities

Under the leadership of Thomas E. Keane, MBBCh, Chair of the Department of Urology, urological surgeons are advancing their use of robot-assisted surgery beyond prostatectomies into numerous complex procedures. Female reconstructive surgery, including sacral colpopexy and incontinence surgeries, are regularly performed, as are bladder diverticulectomies and replacement of damaged ureters with a segment of ilium. Robotic surgery enables the surgeon to operate through a number of small incisions as opposed to open surgery’s larger incision. The robotic ports are placed through these small incisions and the robot is then attached to the ports. This technology provides greater magnification, resulting in greater precision, reduced bloodloss, and often shorter hospital and recovery time.

Genitourinary (GU) surgeon Harry S. Clarke, M.D., PhD, Professor of Urology, and his colorectal and plastic surgery colleagues at MUSC have also developed innovative surgical procedures offered by few others in the nation. Among them is a unique treatment for prostato-rectal fistula, an opening between the GU tract in the area of the prostate and the rectum that can develop after radiotherapy or cryosurgery for prostate cancer. The patient undergoes an evaluation and biopsy of the fistula and, if there is no malignancy present, he is given a course of hyperbaric oxygen therapy to optimize the health of the tissues. The team of surgeons (Dr. Clarke, colorectal surgeon Kerry L. Hammond, M.D., and plastic surgeon M. Lance Tavana, M.D.) dissect the diseased area, isolate the GU tract from the rectum, close the fistula, and then transfer healthy tissue from the cremasteric muscle or the gracilis muscle. The MUSC team has performed more than 25 of these repairs, changing the lives of men who were facing a permanent colostomy and social ostracism because of the inability to maintain hygiene.

Dr. Thomas E. Keane, Chair of MUSC’s Department of Urology, is the new Editor-in-Chief of Urology Today. Dr. Keane specializes in both robot-assisted surgery and open surgeries using the perineal approach, critical in patients for whom abdominal access is not feasible.