SECOND OPINIONS

Second Opinions and Failed Prior Repairs

Who this is for

Men whose problem came back or never improved after earlier treatment, or who were told there's nothing more to be done. Revision work is a large part of reconstructive urology, and a second look often turns up options.

Problems I commonly see

Strictures that returned after dilation, urethrotomy, or a prior urethroplasty. Penile implants that failed, moved, wore through, or became infected. Artificial sphincters that stopped working, or leakage that continued after a sling or sphincter. Failed childhood hypospadias repair. Buried penis that returned after surgery. Curvature that persisted after Peyronie's treatment. Ureteral narrowing after scopes or stents didn't hold. Urinary side effects of radiation.

What to expect

The visit follows the same steps as any first visit, with more time for your history. I'll go through what was done before, why it may not have worked, and every reasonable option, including not operating. If surgery makes sense, I'll explain the plan and the realistic trade-offs.

Records to gather

Operative notes from every prior procedure, not just discharge summaries. The actual images, not only the reports, for retrograde urethrograms, VCUGs, and CT or MRI scans, on disc or through an image-sharing link. Cystoscopy reports. Renograms (kidney scans) and CT urograms for ureter problems. For implants and sphincters: the brand, model, and implant date, often listed on your implant card. Recent urine culture results, any pathology reports, and a current medication list.

Start with a video visit

If you live farther away, a first visit by video lets us go through your history and records together and plan any testing, so an in-person trip is worth making.

How to start

Book online or call (516) 535-1900 and mention that you're seeking a second opinion. Send records ahead of the visit when you can.

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