April 23, 2019

A Mission to Expand Specialized Genitourinary Procedures

By Jessica DeLong, MD

 

The complex disorders that require genitourinary and pelvic floor reconstructive surgery are often highly disruptive, painful and embarrassing, yet access to specialists is limited or non-existent in many parts of the country and world. 

These are significant quality-of-life issues that most men and women don’t like to discuss: urethral stricture disease, fistulas, incontinence, erectile dysfunction, hypospadias, Peyronie’s disease and vaginal prolapse, to name just a few. 

Hampton Roads patients are fortunate to have access to five reconstructive urologists at the Devine-Jordan Center for Reconstructive Surgery and Pelvic Health, the largest such group in the United States. The advanced plastic surgery techniques pioneered by the center’s founding physicians have transformed the lives of patients affected by birth defects, traumas, and a variety of medical and surgical treatments. 

As subspecialists, I believe we also have a responsibility to spread our expertise to reach suffering children and adults around the globe, as well as to help train the physicians, nurses, anesthesiologists and technicians who can treat many others.  

For six years, my colleague Ramón Virasoro, MD, and I have traveled to the Dominican Republic to provide sustainable urology care, initially on trips with the nonprofit Physicians for Peace. In 2016, we co-founded the first fellowship in the Caribbean for genitourinary reconstructive surgery and have graduated one fellow, with another currently in training. 

We have now taken another step forward: incorporating a non-governmental organization (NGO) called Surgery and Anesthesia for Everyone, Inc. The goal is to provide access to quality surgical and anesthetic care in low- and middle-income countries. 

Working in partnership with an anesthesiologist in Argentina, we aim to train enough specialists in the Dominican Republic over the next three years to cover its population’s needs, with future plans to extend into possibly Bolivia and Argentina with additional programs.  

We also have formed an exciting new partnership with Eastern Virginia Medical School Global Health, a co-sponsor of our most recent trip to the Dominican Republic. This cooperative effort should provide unique educational exchange and service opportunities for medical students, residents and fellows at EVMS. 

Since 2013, we have treated more than 200 Dominican patients through mission trips, which are scheduled at least twice a year. Some of their stories are truly heartbreaking. One patient I remember in particular was a 52-year-old manual laborer who had suffered from urethral stricture disease for 35 years, relying on a catheter following a crush injury at work. I corrected his problem in 90 minutes, allowing him to go back to his job and support his family. 

On each trip, we train at least 10 residents and attending physicians, along with five or more anesthesia residents. We also give didactic talks to audiences of 80-plus health care professions and have used telemedicine and online education programs to further expand that impact. 

Patients with complicated genitourinary conditions should not hesitate to reach out for care; we can help so many who may have given up hope. As for all specialists – whether in urology or another field – we should do our best to bring advanced services to as many people as possible. The work is difficult, but it will surely bring you great joy.

Dr. DeLong is a specialist in pelvic floor and genitourinary reconstruction at Urology of Virginia’s Devine-Jordan Center in Virginia Beach, and an Assistant Professor of Urology at Eastern Virginia Medical School. She is Board certified in Urology. Urologyofva.net