GOALS

The main field of our activity is treatment of great variety of congenital and acquired anomalies of genitalia, as well as gender reassignment surgery. Every patient’s satisfaction in all aspects is our primary goal, and therefore we constantly strive to give our patients the best that novel surgery can offer.

SURGICAL WORK

Genital reconstructive surgery has always been a notable challenge in the field of genitourinary reconstruction because of the fact that it attaches huge importance to the functional and aesthetic aspects of this organ and the genital region as a whole. During the last decades, many operative procedures and their modifications for the treatment of both congenital and acquired anomalies are published. Based upon the established principles of reconstruction, as we strive forward in this difficult art, we also feel the need to adapt to growing demands of rewriting the stiff challenges of techniques, their  modifications, the long term results and futuristic issues which encompass this subspeciality.

One of the most common congenital anomalies is hypospadias. Repair of this anomaly has become easier with the Snodgrass principle for distal and buccal mucosa graft combined with genital flaps for proximal forms. However, the complication rate has not been minimized to a satisfactory outcome. Lengthening of the epispadiac penis presents the main aim in epispadias repair with a dilemma regarding correction of curvature, internal rotation, plication or graft techniques. The current management of patients with intersex, now named disorders of sex development, has resulted in updated etiological and outcome data as well as refined surgical procedures. Ambiguous genitalia play a role in gender differentiation and surgical treatment should be based on answers obtained from the psychosexual questionnaire of this population.

The degree of curvature, type of deformity, erectile dysfunction, and penile length are all characteristics that are assessed when choosing the best surgical intervention in Peyronie’s disease. The majority of procedures are usually plagued with some loss of length. The application of radical geometrical principles in creating and fashioning of the graft of an appropriate size leads to precise correction with adequate penile lengthening. A wide variety of medications, devices, and surgical interventions are available to patients with erectile dysfunction. Even though technological improvement of penile prosthesis lead to their rising popularity, strict indications and rigorous surgical principles for implantation should always be respected (followed) in order to avoid unnecessary surgery and possible complications with severe psychological consequences.

Modern technology results in frequent injuries which include penile trauma. Generally, reconstruction is very demanding and selected surgical options depend on etiology and severity of injury. Penile carcinoma is an aggressive disease with significant treatment-associated psychosexual morbidity. Despite high control rates with radical surgical approaches, organ-sparing surgery should be considered in order to achieve a better psychosexual life.

Last but not least, transgenderism is very often a misunderstood condition. Many think that a transsexual is an emotionally unstable person who has difficulties in dealing with life due to disorder in gender identity. The term transsexual came into professional and public usage in the 1950’s as defining a person who aspired to or actually lived in the anatomically contrary gender role, whether or not hormones had been administered or surgery had been performed. Therefore, genital sexual reassignment requires the combined team efforts of a psychiatrist, an endocrinologist, a plastic surgeon, a gynecologist and an urologist. Gender affirmation surgery (GAS), either in transmale or transfemale, is the last step in an individual’s transition and includes surgical procedures that will reshape the individual’s body into a body with the appearance of the desired gender.

To summarise various congenital and acquired penile anomalies, focusing on recent surgical techniques and their outcomes.

PROFESSIONAL COOPERATION

We have been developing a wide network of professional cooperation all around the world, with many hospitals and medical centers for urology, reconstructive surgery, genital surgery, sex reassignment surgery etc.

Regular guests on our workshops and lectures are experts in many fields of genital surgery – urology, reconstructive surgery, pediatric urology, gynecology etc. Many colleagues from different countries and institutions come to practice and learn with us, keeping each others up to date with the latest achievements in treating all genital anomalies.

We have constantly been participating in all important international meetings and congresses in genital surgery, and received many awards. As frequently invited speakers, we have been giving lectures, as well as performing demonstrative surgeries at hospitals and university institutions all around the world – Italy (Padua, Milano, Roma); Hungary (Budapest, Szeged, Pesc); Greece (Thessaloniki, Patras); Germany (Munich, Bonn, Berlin, Frankfurt); Poland (Warsaw); Portugal (Lisbon); USA (Miami, Detroit, New York); Brasil (Rio de Janeiro)