Dmitriy Nikolavsky, MD

Dmitriy Nikolavsky, MD

SUNY Upstate Medical University

Syracuse, New York

Dr. Dmitriy Nikolavsky earned his medical degree from Wayne State University School of Medicine in 2005 after completing his Bachelor’s degree in Biochemistry at University of Detroit Mercy in 2000. He completed his internship in General Surgery in 2007 and subsequently his residency in Urology in 2011, both at William Beaumont Hospital in Royal Oak, Michigan. He went on to train at the University of Colorado as a Fellow in Genitourinary Reconstruction in 2011. He then joined the faculty at SUNY Upstate Medical University in Syracuse, NY with an appointment as Assistant Professor in Urology and Director of Reconstructive Urology in 2012, promoted as Associate Professor in 2017 and Professor in 2021.

Dr. Nikolavsky runs a busy practice that focuses on reconstructive urology. His clinical interests include urethral reconstruction, fistula, male incontinence and correction of complications of transgender surgery. He holds a wide array of research interests, encompassing both clinical and patient-reported outcomes of urologic reconstruction, and development of novel techniques for urethral and ureteral reconstruction. He is working in collaboration with several centers in the US and worldwide on projects ranging from bench research to clinical outcomes studies.

Dr. Nikolavsky is a member of the American Urological Association (AUA), the Societe Internationale d’Urologie (SIU), World Professional Association for Transgender Health (WPATH) and Society of Genitourinary Reconstructive Surgeons (GURS) where he was elected to the Board of Directors in May 2019. Between 2011 and 2015, he has served as the Program Director/AUA Liaison for the Russian Language Session at the AUA annual meeting. In 2019 Dr. Nikolavsky was elected to the Board of Directors a Young Urologist Member of the Northeastern Section of the American Urological Association.

Talks by Dmitriy Nikolavsky, MD

Posterior Stenosis – Post-Radiation or Anti-BPH Procedures

Posterior Stenosis – Post-Radiation or Anti-BPH Procedures

Posted by | Sep 2024

Dmitriy Nikolavsky, MD, discusses urethral stricture and stenosis management following radiation and anti-BPH procedures, highlighting surgical challenges, outcomes, and the evolution of treatment strategies.

In this 11-minute presentation, Nikolavsky explores the differences in stricture occurrence across treatment types. Surgical approaches are tailored based on oncologic status, patient preference, and local tissue health. Buccal mucosal grafts for dorsal urethroplasty are highlighted as a promising technique. Notably, dorsal-only urethroplasty has demonstrated comparable success to EPA with a lower incidence of postoperative incontinence.

Dr. Nikolavsky emphasizes the difficulties of traditional excision procedures in radiated fields, proposing dorsal-only urethroplasty as a better alternative due to its minimal disruption of adjacent structures. He shares evidence from multi-institutional studies that support its efficacy.

With a call to challenge established dogmas, Nikolavsky underscores the need to refine guidelines and expand the use of innovative approaches like dorsal urethroplasty to improve patient outcomes.

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Penile/Panurethral and Fossa Navicularis Strictures

Penile/Panurethral and Fossa Navicularis Strictures

Posted by | Sep 2024

Dmitriy Nikolavsky, MD, focuses on penile strictures and discusses their etiology, anatomical considerations, and treatment options. In this 10-minute presentation, Dr. Nikolavsky shares that current surgical techniques have shifted from multi-stage procedures to single-stage approaches using buccal mucosal grafts, which have shown improved success and lower complication rates. Key procedures discussed include the Asopa and Kulkarni techniques.
The discussion highlights evolving strategies for managing urethral strictures, underscoring a trend towards less invasive, more effective interventions prioritizing patient outcomes and satisfaction. The advancements in this field indicate a significant move towards transurethral approaches, with ongoing research aiming to refine and improve surgical techniques.

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Genital Affirmation: Surgical Anatomy and Complications

Genital Affirmation: Surgical Anatomy and Complications

Posted by | Sep 2024

Dmitriy Nikolavsky, MD, draws on his 12-year experience in managing complications from gender-affirming surgeries, starting with an admission of initial unfamiliarity with the procedures. In this 21-minute presentation, Nikolavsky begins by emphasizing the importance of competent, sensitive healthcare, as many transgender patients report mistreatment in medical settings.
Dr. Nikolavsky outlines surgical procedures such as vaginoplasty and phalloplasty. He describes the steps to create a neovagina, including penile inversion techniques, and highlights common complications like strictures, fistulas, and prolapse. For phalloplasty, the steps involve creating urethral extensions and penile structures, with complications such as urethral strictures and fistulas also being common. He shares photos, illustrations, and a short video to illustrate the steps and possible complications in the procedures.
The importance of postoperative care, including dilation protocols for vaginoplasty patients, is highlighted, as failure to adhere can lead to neovaginal obliteration. Dr. Nikolavsky also touches on long-term issues, such as the need for prostate monitoring in trans women due to the retained prostate after surgery, and managing complications that arise from using various tissues, including gastrointestinal segments.

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