International Functional and Reconstructive Urology Update Archives

Genital Affirmation: Surgical Anatomy and Complications

Posted by Dmitriy Nikolavsky, MD | 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.

Functionalizing the Utility of @X/(Twitter) in Your Practice

Posted by Seth A. Cohen, MD, FACS | Sep 2024

Seth A. Cohen, MD, FACS, explores the role of social media, particularly X (formerly Twitter), in enhancing professional development for medical practitioners. In this 11-minute presentation, Cohen explains that X can be a powerful tool for physicians, offering opportunities for networking, research collaborations, patient education, community engagement, and increasing visibility for one’s specialty. He emphasizes that X is a “town square” for modern communication, allowing physicians to share knowledge, advocate for healthcare issues, and keep up to date with the latest research through journal handles and hashtags.
By curating relevant content and maintaining professionalism, physicians can maximize the potential of X while maintaining a work-life balance. The presentation encourages medical professionals to engage thoughtfully with social media to promote their work and foster greater connections in the field.

Psychology of Achievement

Posted by Stephen A. Blakely, MD | Sep 2024

Stephen A. Blakely, MD, delves into the psychology of achievement, focusing on how passion and dedication can drive success, particularly in medical education and training. In this 12-minute presentation, Blakely emphasizes his personal commitment to helping trainees and highlights the inadequacy of traditional responses to trainees’ struggles. He explores three key concepts from positive psychology: grit, growth mindset, and deliberate practice.

Surgical Education Post-Pandemic

Posted by Granville L. Lloyd, MD | Sep 2024

Granville L. Lloyd, MD, reflects on how the pandemic has influenced surgical education and its evolution. In this 11-minute presentation, Lloyd highlights the shift in teaching practices, noting the pandemic’s significant impact, pushing educational methods away from the traditional hospital and operating room settings.

Lloyd asserts that increased focus on data entry and administrative tasks has diminished job satisfaction for many. He laments that current residents spend more time in front of computers than interacting with patients, a stark contrast to earlier times. The pandemic introduced new educational challenges, particularly regarding the shift to virtual learning platforms like Zoom and the rise of telehealth.
Lloyd advocates for a return to in-person education and fostering a learning environment centered on a passion for medicine. While disruptive, the pandemic is a potential opportunity to rethink how medical education can better align with these values, moving beyond metrics to a more fulfilling professional journey.

OAB – Tier 3, Tibial Nerve Stim – eCoin

Posted by Jason M. Kim, MD | Sep 2024

Jason M. Kim, MD, introduces the eCoin device, a small, 2.3-centimeter implant used for tibial nerve stimulation to treat bladder control issues. In this 8-minute presentation, Dr. Kim briefly overviews the eCoin implantation kit and procedure.
Dr. Kim praises the high quality of the kit and ease of implantation. The process takes around five minutes, with the majority of the time spent ensuring a secure three-layer closure.
Kim shares the device’s effectiveness, with 75% of patients experiencing significant symptom relief after one year. His presentation concludes with a discussion on patient preferences, comparing the eCoin implant with traditional options like Botox and sacral neuromodulation.