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Medical procedures

01

Congenital abnormalities and anomalies of genitalia in children & adults

  • Hypospadias–all forms, distal or proximal (1 or 2-stage repair, primary and redo procedure, esppecially redo procedures in adults!)
  • Epispadias (total penile disassembly, grafting, urethral reconstruction)
  • Disorder of sexual development – intersex (all types of feminization and masculization procedures)
  • Penile curvature (plication, grafting)
  • Buried penis (penile skin reconstruction)
  • Phimosis (circumcision)
  • Undescended testicle (orchiopexy)
  • Inguinal and umbilical hernias (hernia repair)
  • Varicocele (ligation of v. sepraticae)
  • Posterior urethral valves (endoscopic resection)
  • Testicular atrophy or agenesia (implantation of testicular prosthesis)
02

Abnormalities and anomalies of kidney, ureter and bladder

  • Hydronephosis (pyeloplasty, percutaneous nephrostomy)
  • Ectopic kidney (repair or nephrectomy)
  • Tumors-Wilms (partial or radical nephrectomy)
  • Pyelon and ureteral duplication (heminephrectomy, pyelo-pyelostomy, ureteral anastomosis)
  • Ureteral reconstruction
  • Vesicoureteral reflux (ureters re-implantation or endoscopic instillation of Deflux ® gel)
  • Bladder diverticulum (radical repair of the bladder)
  • Neurogenic bladder (augmentation procedures)
  • Ureterocele (endoscopic of open repair)
3

Urethral surgery

  • Urethral strictures-all types: anterior and posterior urethra (urethroplasty with buccal mucosa graft, penile skin flap or end-to-end anastomosis)
  • Balanitis xerotica obliterans (stricture repair, glans resurfacing procerdures)
  • Urethral trauma
  • Urethral fistulas
  • Male incontinence- congenital, iatrogenic after prostatectomy, neurogenic (slings: ARGUS, AdVance, ATOM or artificial sphincter implantation– AMS 800 and Zephyr ZSI 375)
4

Female genital surgery

  • Female urethral strictures
  • Hypertrophic clitoris
  • Hypertrophic labia minora
  • Urethral cysts
  • Stress incontinence (sling implantation)
  • Vaginal agenesis - Mayer-Rokitansky syndrome (vaginal reconstruction using recto-sigmoid colon)
5

Male genital surgery

  • Penile augmentation (ligamentolysis and dermal-fat graft enhancement)
  • Buried penis or trapped penis after radical circumcision (repair with free grafts or vascularized flaps)
  • Peyronie – induratio penis plastica (tunica albuginea plication, grafting procedures, prostheses implantation)
  • Erectile dysfunction (implantation of inflatable or malleable penile prosthesis – AMS, Zephyr, Coloplast, Promedon)
  • Penile disproportion (reduction corporoplasty)
  • Penile body or glans injury — accidental or iatrogenic injury repair
  • Penile fracture (immediate or delayed repair)
  • Micropenis - total phalloplasty procedures
  • Low-stage penile cancer (organ sparing surgery)
6

Transsexual surgery according to Standards of Care

Female to male gender reassignment surgery:

  • Total phalloplasty (microvascular free flap – latisimuss dorsi or radial forearm flap)
  • Urethral reconstruction, glans, reconstruction, implantation of peniole prosthesis
  • Metoidioplasty - including vaginectomy, clitoral release and straightening, urethral reconstruction, scrotoplasty and implantation of the testicular prosthesis

Male to female gender reassignment surgery:

  • Vaginoplasty – penile inversion technique (including penectomy, bilateral orchiectomy, creation of the vagina using penile inversion technique, clitoroplasty, vulvoplasty)
  • Vaginoplasty – sigmoid vaginoplasty (including penectomy, bilateral orchiectomy, creation of the vagina using sigmoid colon segment, clitoroplasty, vulvoplasty)

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