Though it’s not often a part of the public conversation, many Ukrainian soldiers are returning home from war with severe injuries to their genitalia – sometimes from mine blasts, sometimes from torture, or outright castration undergone during Russian captivity.
However, the Ukraine 1991 Foundation is restoring soldiers’ sexual and reproductive functions – giving them a chance to have intercourse, father children, and lead normal lives again, in stark contrast to the seemingly hopeless depression, leading even to suicide, among earlier generations of soldiers who suffered similar injuries.
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Kyiv Post’s Jason Smart interviewed Olha Taniushkina, a doctor and project manager;, Gennady Bratslavsky, the organization’s founder; and Denis Bohush, a military doctor, neuropsychologist, and psychotherapist – about Ukraine 1991 Foundation and the challenges faced by many veterans wounded in Russia’s full-scale invasion of Ukraine.
Kyiv Post: Is it true that Russia castrates Ukrainian soldiers? Are there any estimates of how many men have suffered the loss of genitalia during the course of the war?
Olha Taniushkina: In Ukraine, there are more than 10,000 soldiers with injuries below the body armor. These are injuries to the genitourinary system that require complex reconstructive plastic surgery or prosthetic genitalia.
However, we will be able to provide accurate data only after the war, and now, for security reasons, we operate only with approximate figures, which are staggering, and each figure is a life that doctors are trying to save.
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Ukrainian prisoners in Russia are not only abused, but are often subjected to various types of torture, which of course affects the entire body, and even if there is no outright castration, being in captivity often affects functional changes that lead to reproductive disorders.
During the first year of our project, more than 300 soldiers have already been operated on, including patients who underwent highly complex reconstructive interventions to restore their internal and external genitalia, and some of them have already received prosthetic genitalia.
Psychological recovery of such patients is a complex process, and many men need psychotherapeutic support to adapt.
KP: Following the surgery, are men able to resume normal sexual activity? Are they able to urinate normally?
Olha Taniushkina: The biggest advantage for a soldier after such complex surgeries is returning to the front line. Almost all of our patients have returned to the Armed Forces of Ukraine because they are able to live a fully functional life again.
If, before the operation, they were dependent on catheters and auxiliary systems for urination, now they are absolutely healthy men.
And yes, they are able to have sex and even most of them managed to preserve their reproductive function – which is the most important component in such surgeries.
KP: If a man loses his testicles, does that result in a permanent loss of sexual desire? What can be done for him?
Denys Bohush: The loss of a testicle is a condition for implantation, and testicular implants perfectly reproduce the lost organ, and hormone replacement therapy can help restore testosterone levels and maintain sexual desire.
Special prostheses allow you to have a healthy sex life. If the testicles are lost, then of course, a woman will not be able to get pregnant. This is where the sperm bank of military personnel becomes an important factor, so that strong soldiers can produce a strong new generation.
Psychological recovery of such patients is a complex process, and many men need psychotherapeutic support to adapt.
There are three important factors here: the individual work of the patient himself, processing his anxieties and depressions. The social component is extremely important, especially the relationship with his partner. If such a woman properly supports the wounded soldier, it contributes in many ways to their quality of life, including sex.
And then there is the professional psychological factor – the help of professional psychologists and psychotherapists, sometimes sexologists. In this context, psychotherapy and cognitive behavioral therapy, physiotherapy, EMDR, equine-assisted therapy, etc. are also important.
KP: How can we provide psychological assistance to these survivors? What is the efficiency and prospects of recovery – full or partial?
Denys Bohush: First, it is important to identify such patients. This is very difficult because only a very limited circle of family members usually knows about their trauma. Usually, the soldiers are embarrassed to talk about it and go through these terrible emotions alone.
Secondly, each person has different reactions to such trauma: from very bad, with suicidal, anxious and depressive manifestations, to neutral, when a person compensates for this problem with something.
Thirdly, after getting acquainted with our project, the survivors become hopeful and expectant of recovery.
It gives them hope for a life of normalcy, sometimes with full recovery of sexual function. And this dramatically improves the patient’s mental state.
The loss of a sexual organ is not the end of a man’s life – this is the motto behind the project.
KP: Your project, the “Silent Traumas of War,” is helping men with war-related genitourinary injuries to restore use of their genitalia – what is the genesis of this effort?
Olha Taniushkina: The loss of a sexual organ is not the end of a man’s life – this is the motto behind the project in Ukraine to provide prosthetic male organs and restore sexual and reproductive function to wounded soldiers.
During the active hostilities in Ukraine, we’ve seen a large number of soldiers with mine-blast wounds below the body armor, including those who sustained genital injuries in captivity.
These are specific injuries that require complex reconstructive urological surgery and involve prosthetic genitalia.
Unfortunately, Ukraine had no experience of such surgical interventions, so the founders of the Ukraine 1991 Foundation, Professor Gennadiy Bratslavsky (US) and Dr. Alex Golubenko (US) decided to create a reconstructive urology project in 2023.
The main goal of the project is returning the servicemen to a life of normalcy. We aim to introduce advanced methods of reconstructive urology by engaging international specialists.
In addition to conducting joint operations, we also train Ukrainian doctors and create conditions for their practice at Ukrainian hospitals, provide them with the necessary equipment, as well as penile and testicular prostheses.
KP: What countries are involved in this international project? How is it organized?
Olha Taniushkina: We partner with specialists from the US, Mexico, Spain and Brazil. This allows Ukrainian doctors to learn new techniques and participate in trainings with world-class specialists, and most importantly, it allows us to organize medical missions to Ukraine to conduct joint surgical interventions for wounded soldiers.
KP: How was the decision made to focus on reconstructive urology?
Gennady Bratslavsky: Firstly, I am from Ukraine, and I could not ignore the war. From the first days of the full-scale invasion, we began to actively help Ukrainians by providing humanitarian aid, cars, and medicine.
In 2022 I founded the American charity Ukraine 1991 Foundation, and when many soldiers with mine-blast wounds below the body armor and castrated in captivity appeared in Ukraine, and the soldiers needed complex reconstructive surgeries and prosthetic genitalia, I realized, as a urological surgeon, that international experience would be indispensable in treating such patients.
That’s how I came up with the idea of creating a project that would unite Ukrainian and American doctors.
This is not just about saving lives, but also a chance to return wounded soldiers to a fulfilling life with the restoration of their sexual and reproductive function.
It is important that soldiers who have suffered severe injuries are able to father children because it is the very future for which we are heroically defending our country.
KP: How has your experience been so far?
Gennady Bratslavsky: I have a lot of respect for Ukrainian doctors for their choice to continue their work in a situation of war.
They are providing medical care without the proper facilities available in the United States and are dealing with a large number of wounded.
This war has brought completely new traumas that the world has never seen before, and Ukrainian doctors are eager to learn as quickly as possible to provide the best care possible.
During our operations at the military hospital, we saw a lack of equipment and supplies, and it became our goal to keep helping them.
To scale up the project, it is necessary for doctors to undergo additional training in foreign clinics specializing in reconstructive urology, for the state to purchase penile prostheses and the necessary equipment, and for patients to have access to permanent hormone replacement therapy. Without this, the project will not be able to run effectively.
As of today, these needs are covered by our fund, but in the future, we believe that the system will improve and every patient will receive the necessary treatment and the doctors will have all the opportunities to provide such medical care.
KP: How does the loss of genitals affect the mental state of soldiers?
Denys Bohush: Injuries to the genitourinary system or the loss of a sexual organ are considered to be the most psychologically and emotionally challenging for any man, soldier or civilian. With such injuries, their male identity is compromised and this complicates the process of rehabilitation after surgery.
The servicemen suffer physical injuries, but most of the soldiers who were in the combat zone have mental trauma. In general, this results in mental disorders that manifest themselves in the form of PTSD, post-concussion syndrome and others.
As for the loss of a sexual organ, after such a trauma, young men, especially, experience difficult emotions and are prone to suicide.
Their wives and girlfriends wait for them, and it is very difficult when this happens in the family. And, by the way, it is often the wives who seek help first, rather than the guys themselves.
If there is no such woman, the close circle of such a man may never become aware of the problem.
KP: If someone wants to help with the work you are doing, how can they contact you?
Olha Taniushkina: As of today, the state does not provide such patients with penile and testicular implants, and the Ukraine 1991 Foundation is accumulating donations for the purchase of such implants, as well as for the provision of other expendables required for such operations.
It is also extremely important for the survivors to receive qualified psychological support, which is also a major financial cost, but often worth the saved lives of patients who are one step away from suicide.
KP: How can someone contribute financially to your work?
Those interested in donating can donate to:
Name of the recipient: CO FOUNDATION UKRAINE 1991
Recipient code: 45620908
Recipient’s account: UA343052990000026008016236926
Name of the bank: JSC CB ‘PRIVATBANK’
The permanent medical team includes:
Professor Gennady Bratslavsky, MD Phillip Capozzi, MD Endowed Professor of Urology Chair, Department of Urology SUNY Upstate Medical University, Syracuse, NY
Wagner Aparecido França, MD, PhD, Hospital do Servidor Público Estadual São Paulo, Iamspe. Rua Pedro de Toledo
Dmitriy Nikolavsky, MD SUNY Upstate Medical University, Professor, Department of Urology Syracuse, NY. Ramón Virasoro, MD
Visiting Professor, Urology Division, Department of Surgery, University of Colorado
Dr. Porfirio Damián López Alvarado. Associate professor of Urology Hospital Adolfo López Mateos I.S.S.S.T.E. Attending urologist Hospital Ángeles Universidad.
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