To Ukraine on a Mission

UH urologists make medical mission trip to perform pelvic trauma surgeries

In the wee hours just after midnight, a small cadre of surgeons from University Hospitals crossed into Ukraine from Poland, armed with medical supplies and expertise on a mission to transform lives. Over six days, their surgeries reversed some of the physical trauma incurred in the past few years of war by 21 soldiers and refugees.

The medical mission was months in the making for UH urologists Laura Bukavina, MD, Shubham Gupta, MD, Kirtishri Mishra, MD, and Andrew Drozd, MD.

“It has been humbling to help provide operative solutions to complex urologic traumatic injuries in the brave soldiers fighting to maintain Ukraine’s sovereignty,” said Dr. Drozd, a fourth-year urological resident and second-generation Ukrainian-American whose grandparents emigrated from Ukraine after World War II. He grew up bilingual and immersed in Ukrainian traditions. On the recent trip, he worked in the OR and helped to translate for American colleagues.

“Working with our counterparts in Ukraine was an extreme privilege. Having the chance to educate and impart surgical techniques to help them care for both wounded warriors and civilians was incredible.”

UH Urology team during Ukraine medical mission October 2023.

The surgeons concurrently ran three operating rooms, with as many as five Ukrainian surgeons scrubbed in and assisting or observing to learn the UH surgeons’ techniques. The cases were filmed for additional viewing and teaching. As Dr. Bukavina noted, trauma is not a specialty common in Europe, and certainly not in a country thrust into a war it had not anticipated.

After their late-night arrival, the UH surgeons started their cases at 7 a.m. in a Lviv civilian hospital. For two days, they operated on five refugees and civilians, correcting many genitourinary injuries.

Then they traveled to a military hospital at an undisclosed location, where they saw the real damage of the war’s bullets and bombs.

The UH team witnessed soldiers disfigured by mines, where blasts had torn the perineum from their rectum to their scrotum. They saw men with penile injuries, urethral and kidney disruption, and soldiers’ whose bellies had been shattered with scores of bullets.

Many of the men, only in their 20s, had colostomy bags. Most also had excessive scar tissue from multiple previous surgeries – in some cases as many as a dozen – already in their young lives.

Over four days, the UH team performed 16 cases, many taking five to eight hours.

 UH Urology team during Ukraine medical mission October 2023.

“These patients were very complex; we’re just not used to that level of disruption,” says Dr. Bukavina, the Ukrainian-born urologic oncologist who planned the mission. “The amount of trauma is five times more than anything we see in the US. And in Ukraine, many surgeons are not acquainted with the techniques involved in  reconstructive urology. They simply don’t have the training to help.”

“It’s not like going into what we call a ‘virgin belly,’ there is a slot of scar tissue with every subsequent surgery” Dr. Bukavina added. “The surgeons were astonished at our training, our professionalism and expertise, and the rapport we had working together so well. They were very appreciative.”

The patients and their families, who travel to be with their recovering loved ones, were beyond grateful. An added bonus: Dr. Mishra also performed implants for erectile dysfunction on two patients. The soldiers presented him with their battalion emblems for performing this surgery. The surgeons were given multiple gifts, including figurines crafted from Russian ammunition that had fallen on their soil, and soldiers’ own medals.

“They were thankful to be the chosen for reconstruction,” said Dr. Bukavina, on her fourth medical mission to her homeland since the war began 20 months ago. “All of them said they didn’t think this was possible.

“We’re very used to the luxuries of life in the USA. In Ukraine, reconstructive surgery as we performed is currently not available, and many considered it to be a gift. And when someone gives you that gift, to give you your life back, patients are incredibly thankful. It was beautiful.”

Dr. Drozd found it a profound privilege to utilize his surgical skills to help Ukrainians.