Dr. Dmitriy Nikolavsky is a Reconstructive Urologist who serves as an Associate Professor of Urology and Director of the Reconstructive Urology department at SUNY Upstate Medical University, Syracuse NY. In addition to offering primary Metoidioplasty and Vaginoplasty surgeries, Dr. Nikolavsky is also an expert at treating post-operative urinary complications and provides long term follow-up care for patients who have undergone gender-affirming genital reconstructive surgery.
One or Two Stage Buccal Augmented Urethroplasty has a High Success Rate in Treating Post Phalloplasty Anastomotic Urethral Stricture
Matthew R Beamer, Jessica Schardein, Nabeel Shakir, Min Suk Jun, Rachel Bluebond-Langner, Lee C Zhao, Dmitriy Nikolavsky. Urology. 2021 Jun 10;S0090-4295(21)00471-4.
Single-stage repairs are feasible for patients with anastomotic strictures who have well vascularized tissue and no prior single-stage buccal mucosa augmented urethroplasty failures. Staged repairs are feasible for patients with poor tissue quality. Proper patient selection is important for successful reconstruction.
Single-stage Double-face Buccal Mucosal Graft Urethroplasty for Neophallus Anastomotic Strictures.
Schardein J, Beamer M, Hughes M, Nikolavsky D. Urology. 2020 Sep;143:257.
After gender-affirming phalloplasty the anastomosis between the perineal urethra (pars fixa) and the penile urethra is the most common site of stricture. Excisional urethroplasty after phalloplasty is known to have high failure rates due to poor vascularization of neourethra. Our objective is to demonstrate the feasibility of a single-stage repair of neophallus anastomotic strictures using a “double-face” urethroplasty technique.
Prostato-Neovaginal fistula repair in a patient with prior transurethral resection of prostate
Rebecca Sager, Daniela Kaefer, Michael Hughes, Natasha Ginzburg, Dmitriy Nikolavsky. Urology Video Journal, Volume 6, June 2020.
A 65-year-old transgender female with severe incontinence presented for a repair of prostato-neovaginal fistula. She had undergone TURP for symptomatic benign prostatic hyperplasia (BPH) prior to penile-inversion vaginoplasty performed at different institutions. After vaginoplasty, patient developed urinary incontinence at the time of vaginal packing removal. Cystoscopy demonstrated fistulae between neovagina and urethra, just proximal to the verumontanum. Patient agreed only to a reconstructive option that would not compromise patency of neovagina. Dorsal BMG inlay and ventral urethral closure can be used for a novel application in repair of prostato-neovaginal fistula. Watch video on YouTube »
A Surgical “Sewing Machine” For Rapid Graft Quilting and Suturing In Challenging Spaces
Jessica Schardein, Kathryn A. Scott, Gennady Bratslavsky, Stephen Blakley, Dmitriy Nikolavsky. Urology Video Journal, Volume 6, 2020.
The use of grafts is commonly employed in urologic reconstructive surgery. In poorly accessible surgical areas, graft fixation can be difficult. To improve the efficiency of quilting and suturing in challenging spaces, an improvised surgical “sewing machine” (ISSM) was developed. Watch video on YouTube »
Transgender Surgery and Outcomes: Focused for the FPMRS Provider.
Hughes M, Nikolavsky D, Ginzburg N. Female Pelvic Med Reconstr Surg. 2020 Apr;26(4):259-262.
As visibility of the transgender population increases, understanding of the social, psychological, medical, and surgical aspects of these patients care is vital for the practicing female pelvic medicine and reconstructive surgery urologist. The aim of this review is to describe proper terminology, psychosocial considerations specific to transgender patients, in addition to outlining contemporary surgical techniques and complications.
Management of Vaginoplasty and Phalloplasty Complications.
Schardein JN, Zhao LC, Nikolavsky D. Urol Clin North Am. 2019 Nov;46(4):605-618.
Although there have been several modifications to prior techniques as well as development of new techniques over the years, complications are still common after vaginoplasty and phalloplasty. This article focuses on the most common complications as well as the evaluation and management of those complications.
Presenting Complications to a Reconstructive Urologist After Masculinizing Genital Reconstructive Surgery.
Dy GW, Granieri MA, Fu BC, Vanni AJ, Voelzke B, Rourke KF, Elliott SP, Nikolavsky D, Zhao LC. Urology. 2019 Oct;132:202-206.
To evaluate the presenting complications of patients to reconstructive urologists after masculinizing gender affirming genital reconstructive surgery (GRS) performed elsewhere. There are several common presenting urologic complications after masculinizing GRS. Patients may present to reconstructive urologists early after GRS performed elsewhere. The long-term outcomes of GRS deserve further study.
Urologic Complications After Phalloplasty or Metoidioplasty.
Nikolavsky D, Hughes M, Zhao LC. Clin Plast Surg. 2018 Jul;45(3):425-435.
Transgender anatomic definitions and a synopsis of common urologic complications specific to transmen, including urethrocutaneous fistulae, neourethral strictures, and persistent vaginal cavities are discussed.
Urologic Sequelae Following Phalloplasty in Transgendered Patients.
Nikolavsky D, Yamaguchi Y, Levine JP, Zhao LC. Urol Clin North Am. 2017 Feb;44(1):113-125.
Transgender patients at various stages of their transformation will present to urologic clinics requiring general or specialized urologic care. Knowledge of specifics of reconstructed anatomy and potential unique complications of the reconstruction will become important in providing urologic care to these patients. In this article, we have concentrated on describing diagnosis and treatment of the more common urologic complications after female-to-male reconstructions: urethrocutaneous fistulae, neourethral strictures, and symptomatic persistent vaginal cavities.