Dmitriy Nikolavsky, MD, presented “Genital Affirmation: Surgical Anatomy and Complications” during the 1st International Functional and Reconstructive Urology Update on August 30, 2024, in Denver, Colorado.

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How to cite: Nikolavsky, Dmitriy. “Genital Affirmation: Surgical Anatomy and Complications.” August 30, 2024. Accessed Nov 2024. https://grandroundsinurology.com/genital-affirmation-surgical-anatomy-and-complications/

Genital Affirmation: Surgical Anatomy and Complications – Summary

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.

 

About The 1st International Functional and Reconstructive Urology Update (IFRUU)

The International Functional and Reconstructive Urology Update is a multi-day meeting focused on functional and reconstructive urology (FRU). FRU is a rapidly expanding subspecialty with the vision to improve the lives of all patients with urinary disorders. The IFRUU conference aims to equip practitioners with the tools to manage patients with functional urologic disorders effectively. The inaugural IFRUU conference took place from August 28-30, 2024 in Denver, Colorado.

For further educational activities from this conference, visit our collection page.