94 publications
Gender-affirming genital surgery research, including robotic peritoneal flap vaginoplasty, phalloplasty, metoidioplasty, complications, revisions, patient-reported outcomes, and registry work.
Plastic and reconstructive surgery. Global open · 2026
The intersection between urology and plastic surgery represents an important collaborative frontier in modern reconstruction. Defects involving the genitourinary and perineal regions frequently require the coordinated expertise of both specialties to...
Plastic and Reconstructive Surgery · 2026
Urology · 2026
Urology · 2025
To generate surgeon consensus on metoidioplasty and phalloplasty gender-affirming surgery outcomes statements using a modified Delphi method. We invited metoidioplasty and phalloplasty gender-affirming surgery surgeons to anonymously participate in a...
International journal of transgender health · 2025
Most transgender women have their prostate left in situ throughout and after their transition. Managing prostate‑related conditions in transgender women remains challenging due to the lack of clear recommendations. This review aims to summarize the...
Annals of surgery · 2025
To determine the outcomes of robotic peritoneal flap vaginoplasty. There is a lack of long-term outcomes data for gender-affirming vaginoplasty to inform patient decision-making. A retrospective cohort of 500 consecutive patients undergoing robotic...
BMJ Open · 2025
Annals of plastic surgery · 2025
The learning curve (LC) is the process of mastering a new technique. This study assesses the LC for robotic-assisted peritoneal flap gender-affirming vaginoplasty (RPGAV). A retrospective chart review of all consecutive patients undergoing RPGAV between...
JAMA network open · 2025
There is an urgent need for a validated gender-affirming care-specific patient-reported outcome measure (PROM). To field test the GENDER-Q, a new PROM for gender-affirming care, in a large, international sample of transgender and gender diverse (TGD)...
BJU international · 2025
Gender-affirming care has emerged as a critical component of healthcare, addressing the specific medical and psychosocial needs of transgender and non-binary individuals. In this review article, we address what we see as the most pressing evidence gaps in...
Clinics in Plastic Surgery · 2025
Archives of pathology & laboratory medicine · 2025
The use of hormonal therapy and gender-affirming surgery in the transgender community has been rising during the last several years. Although it is generally safe, hormonal therapy's link to testicular cancer remains uncertain. To review the incidence of...
Neurourology and urodynamics · 2024
With increased access to gender affirming care, the rate of vaginoplasties in the US has risen rapidly. Although some retrospective studies report high rates of lower urinary tract symptoms (LUTS) after gender affirming vaginoplasty, the type and severity...
Urology · 2024
To evaluate the incidence of gender-affirming phalloplasty and postoperative complications in a large population-based dataset. Retrospective cohort study was done using the California Department of Health Care Access and Information datasets which include...
Plastic and reconstructive surgery. Global open · 2024
Sexual health is critical to overall health, yet sexual history taking is challenging. LGBTQ+ patients face additional barriers due to cis/heteronormativity from the medical system. We aimed to develop and pilot test a novel sexual history questionnaire...
Transgender health · 2024
High quality data regarding long-term clinical and patient-reported outcomes (PROs) of genital gender-affirming surgery (GGAS) are lacking, and transgender and non-binary (TGNB) community voices have not historically been included in research development....
Urology · 2024
Transgender health · 2024
Gender-affirming vaginoplasty can involve profound postoperative challenges related to the typical healing process and potential complications. We present a qualitative analysis of the greatest challenges that individuals experience after vaginoplasty with...
Urology · 2024
Urology · 2023
To address instances when there is insufficient remnant tissue to perform revision following canal-deepening gender affirming vaginoplasty revisions as indicated by insufficient depth. Options for lining of the vaginal canal include skin grafts, peritoneal...
Plastic and reconstructive surgery. Global open · 2023
Patient-reported outcomes regarding sexual health are lacking or have not been validated for transgender patients following vaginoplasty. The aim of this study is to further characterize the difference in sexual health, genital self-image, and the...
Urology · 2023
1) To describe the authors' technique of anterolateral thigh (ALT) phalloplasty with staged skin graft urethroplasty and 2) to report the surgical outcomes and complications of this technique in a preliminary patient cohort. Following IRB (Institutional...
Plastic and Reconstructive Surgery Global Open · 2023
Urology · 2023
To describe the authors' experience with surgical management of complications following intestinal vaginoplasty and review the literature on incidence of complications following gender-affirming intestinal vaginoplasty. Retrospective chart review...
Plastic and reconstructive surgery · 2023
The 2 most common techniques for gender-affirming mastectomy are the double-incision free nipple graft and periareolar techniques. However, some patients are not well suited for either technique. When the nipples are high and on the pectoralis muscle, but...
Urology practice · 2023
Plastic and reconstructive surgery · 2023
Urologic complications in genital gender-affirming surgery are imperfectly measured, with existing evidence limited by "blind spots" that will not be resolved through implementation of patient-reported outcomes alone. Some blind spots are expected in a...
Plastic and reconstructive surgery · 2023
The number of transgender adolescents seeking gender-affirming surgery (GAS) in increasing. Surgical care of the adolescent transgender patient is associated with several unique technical, legal, and ethical factors. The authors present a review of the...
AMA journal of ethics · 2023
Use of body mass index (BMI) as a health care metric is controversial, especially in candidacy assessments for gender-affirming surgery. When considering experiences of fat trans individuals, it is important to advocate for equitable divisions of...
AMA journal of ethics · 2023
Surgeons often encounter patients with realistic goals yet who desire unrealistic means of achieving them. This tension is compounded when surgeons consult with patients eager to revise a prior gender-affirming procedure completed by another surgeon. Two...
Nature reviews. Urology · 2023
Seminars in plastic surgery · 2023
Genital surgery for the treatment of gender dysphoria has undergone significant evolution since its inception in the first half of the 20th century. Robotic approaches to the pelvis allow for improved visualization and reduced abdominal wall morbidity,...
Plastic and reconstructive surgery · 2022
Gender-affirming mastectomy, or "top surgery," has become one of the most frequently performed procedures for transgender and nonbinary patients. However, management of perioperative testosterone therapy remains controversial. Despite a lack of supporting...
Plastic and reconstructive surgery · 2022
Insufficient genital tissue has been reported as a barrier to achieving depth in gender-affirming vaginoplasty. The authors sought to characterize vaginal depth and revision outcomes in patients with genital hypoplasia undergoing robotic peritoneal flap...
Plastic and reconstructive surgery · 2022
Following gender-affirming penile inversion vaginoplasty or vulvoplasty, patients may seek vulvar revision procedures for a variety of common aesthetic and functional concerns. These indications for revision and accompanying techniques are not...
Urology · 2022
To describe the authors' experience diagnosing and managing intra-abdominal complications following robotic peritoneal flap vaginoplasty. The peritoneal flap vaginoplasty is a technique used to achieve consistent vaginal depth regardless of available natal...
Sexually transmitted diseases · 2022
Sexually transmitted infections (STIs) after penile reconstruction in transgender, nonbinary, and other gender expansive (T/GE) populations have not previously been described, despite known risk factors in the population. After T/GE penile reconstruction,...
Plastic and reconstructive surgery. Global open · 2022
Increased access to care and insurance coverage has led to an increase in gender-affirming surgeries performed in the United States. Gender-affirming phalloplasty has a variety of donor sites and surgical techniques including both pedicled and free flaps....
Plastic and reconstructive surgery. Global open · 2022
Gender-affirming mastectomy has become one of the most frequently performed procedures for transgender and nonbinary patients. Although there are a variety of potential surgical approaches available, the impact of technique on outcomes remains unclear....
Plastic and reconstructive surgery · 2022
The surgical treatment of gender incongruence with gender-affirming surgery requires a sophisticated understanding of the substantial diversity in patient expectations and desired outcomes. There are patients with gender incongruence who desire surgical...
Journal of Patient-Reported Outcomes · 2022
Plastic and reconstructive surgery · 2022
The journal of sexual medicine · 2022
Many patients have goals related to sexual health when seeking gender-affirming vaginoplasty, and previous investigations have only studied the ability to orgasm at cross-sectional timepoints. Our aim is to quantify the time to orgasm postoperative...
Plastic and reconstructive surgery · 2021
Gender-affirming surgery is becoming increasingly more common. Procedures including chest masculinization, breast augmentation, vaginoplasty, metoidioplasty, and phalloplasty routinely generate discarded tissue. The incidence of finding an occult...
Urology · 2021
To report our novel technique and mid-term follow-up for robotic-assisted laparoscopic vaginectomy (RALV), a component procedure of staged gender-affirming penile reconstructive surgery. The records of patients seeking gender-affirming penile...
The journal of sexual medicine · 2021
Current literature on surgical outcomes after gender affirming genital surgery is limited by small sample sizes from single-center studies. To use a community-based participatory research model to survey a large, heterogeneous cohort of transmasculine...
Urology · 2021
To present the technique and early outcomes of salvage neovaginal reconstruction using robotic dissection and peritoneal flap mobilization. Twenty-four patients underwent robotic peritoneal flap revision vaginoplasty from 2017 to 2020. A canal is dissected...
Urology · 2021
To describe the outcomes of single-stage and staged repairs in properly selected patients with phalloplasty anastomotic strictures. A bi-institutional retrospective review was performed of all patients who underwent anastomotic stricture repairs between...
Plastic and reconstructive surgery · 2021
The journal of sexual medicine · 2021
The limitations of metoidioplasty and phalloplasty have been reported as deterrents for transgender and other gender expansive individuals (T/GE) desiring gender affirming surgery, and thus penile transplantation, epithesis, and composite tissue...
Plastic and reconstructive surgery · 2021
To optimize neovaginal dimensions, several modifications of the traditional penile inversion vaginoplasty are described. Options for neovaginal lining include skin grafts, scrotal flaps, urethral flaps, and peritoneum. Implications of these techniques on...
Andrology · 2021
Therapeutic advances in urology · 2021
With the widespread dissemination of robotic surgical platforms, pathology previously deemed insurmountable or challenging has been treated with reliable and replicable outcomes. The advantages of precise articulation for dissection and suturing, tremor...
Journal of Gynecologic Surgery · 2021
Plastic and Reconstructive Surgery · 2021
Urological Care for the Transgender Patient · 2021
Urological Care for the Transgender Patient · 2021
PracticeUpdate · 2021
The journal of sexual medicine · 2021
The Journal of clinical endocrinology and metabolism · 2021
Plastic and Reconstructive Surgery · 2021
Plastic and Reconstructive Surgery · 2020
Plastic and Reconstructive Surgery · 2020
Clinical Imaging · 2020
Urology · 2020
Urology · 2020
Urology · 2020
PracticeUpdate · 2020
European urology · 2020
Robotic-assisted peritoneal flap gender-affirming vaginoplasty (RPGAV) with the da Vinci Xi system has been reported to be a safe alternative to traditional penile inversion vaginoplasty. Utilizing the Single Port (SP) robot system, our surgical approach...
Gender Confirmation Surgery: Principles and Techniques for an Emerging Field · 2019
The Urologic clinics of North America · 2019
Translational andrology and urology · 2019
Urology · 2019
To describe the technique of robotic remnant vaginectomy/excision of urethral diverticulum in transmen and report postoperative outcomes. Between 2015 and 2018, 4 patients underwent robotic remnant vaginectomy/excision of urethral diverticulum for relief...
The Urologic clinics of North America · 2019
As more transgender patients undergo gender-affirming genital reconstructive surgery, such as vaginoplasty and phalloplasty, it is imperative for health care providers, including urologists, to understand the new anatomy and most common complications to...
Urology · 2019
To evaluate the presenting complications of patients to reconstructive urologists after masculinizing gender affirming genital reconstructive surgery (GRS) performed elsewhere. We identified patients who underwent revision surgery by one of the co-authors...
Surgical endoscopy · 2019
Buccal mucosal grafts (BMG) are traditionally used in urethral reconstruction. There may be insufficient BMG for applications requiring large grafts, such as urethral stricture after gender-affirming phalloplasty. Rectal mucosa in lieu of BMG avoids oral...
The Journal of urology · 2019
We report multi-institutional outcomes in patients who underwent urethroplasty with a rectal mucosa graft. We used the TURNS (Trauma and Urologic Reconstructive Network of Surgeons) database to identify patients who underwent urethral reconstruction with...
The Journal of urology · 2019
Penile inversion vaginoplasty is the most common procedure for genital reconstruction in transwomen. While penile inversion vaginoplasty usually provides an excellent aesthetic result, the technique may be complicated by vaginal stenosis and inadequate...
UpToDate · 2018
Journal of Urology · 2018
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Clinics in plastic surgery · 2018
In the past decade, issues facing transgender individuals have come to the forefront of popular culture, political discourse, and medical study. The evaluating physician should have knowledge of the reconstructed anatomy, as well as potential postoperative...
Current urology reports · 2018
A growing number of transgender patients are seeking gender-affirming genital reconstructive surgery (GRS). These complex procedures have high complication rates. We describe common surgical pitfalls in GRS and approaches for minimizing complications....
Gender Affirmation Medical and Surgical Perspectives · 2017
Urology Times · 2017
The Journal of urology · 2017
The Urologic clinics of North America · 2017
In recent years, the issues of the transgender population have become more visible in the media worldwide. Transgender patients at various stages of their transformation will present to urologic clinics requiring general or specialized urologic care....
Urology Times · 2016
Therapeutic advances in urology · 2016
Urethral strictures or fistulas are common complications after phalloplasty. Neourethral defects pose a difficult reconstructive challenge using standard techniques as there is generally insufficient ventral tissue to support a graft urethroplasty. We...
Campbell-Walsh Urology, 13th Ed
Selvaggi
Comprehensive Atlas of Robotic Urologic Surgery
Gender Affirming Surgery