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Urology faculty improving care for difficult reconstructive issues

Mellon in OR procedure

Mellon in OR procedure

As a urologist specializing in reconstructive urology, Matthew Mellon, MD, treats patients from all over the country dealing with conditions that can be deeply personal and private.

“I often tell patients, ‘we will treat you like family,’ and we mean this,” said Mellon, an associate professor of urology with Indiana University School of Medicine Department of Urology. “Honesty and being up front about expectations and outcomes is very important in this field.”

These conditions include urethral strictures, incontinence, erectile dysfunction and more, which are issues that can be hard for many patients to talk about. Mellon answers some common questions about the most common reconstructive urology conditions affecting men and what their options are.

What is reconstructive urology and what are the most common conditions you treat in men?

Reconstructive urology is a sub-specialty area which focuses on the treatment of conditions or complications someone gets from prior surgery, trauma or other medical interventions. Some of the most common conditions can range from urethral strictures, radiation injury and incontinence to genital cancers and urinary fistulas. The goal is to restore proper functioning of the urinary tract and improve the quality of life for many of our patients. Our field can be especially satisfying, providing our patients with normalcy to their lives.

How serious are these conditions?

Many of the disease states that we see in clinic are varied. Some focus on quality of life issues like erectile dysfunction. Others are non-life threatening (strictures, fistulas, incontinence), but can progress and lead to more serious problems. At the other end of the spectrum are genital cancers which can be life defining if not addressed appropriately.

What are the treatment options?

One of the most challenging aspects of reconstructive urology is the large spectrum of treatment options we offer to our patients. Many conditions will be treated surgically, some with major restorative procedures that can often involve other surgical specialties such as plastic surgery, colorectal and oncology. Alternatively, in selected patients, a non-surgical approach is warranted. Every patient is unique and bring their own complexity and treatment plan, which need to be tailored to the individual.

Why is it important for men to be aware of these issues?

Although urology is a surgical specialty, we serve as men’s health experts and many of us use this role to advocate for proper health screening and preventative medicine, much like a primary care provider. Some of our conditions, like erectile dysfunction, can be a harbinger of more serious medical conditions such as heart disease and stroke. Other genital conditions create anxiety and apprehension and many men delay or avoid doctor’s appointments. Unfortunately, these delays can lead to more serious conditions if not treated earlier.

What is your biggest piece of advice for men struggling with erectile dysfunction?

There is a treatment for you. Some men need rehabilitation and oral medications, and some men need surgery. We take a personalized approach that works for the individual. There is no reason to give up hope.

What is your biggest piece of advice for men struggling with male urinary incontinence?

This is a chronic condition that can really erode quality of life. Don’t be afraid to seek treatment. There are many men just like you who have these issues and they can be improved. Learn your options. 

The views expressed in this content represent the perspective and opinions of the author and may or may not represent the position of Indiana University School of Medicine.

Christina Griffiths

Christina is the media relations specialist for the IU School of Medicine Dean's Office of Strategic Communications.