Dr. Karl Coutinho is a fellowship-trained reconstructive urologist with advanced training in genitourinary trauma, urethral reconstruction, and prosthetic surgery. He is a founding member of the Society of Gender Surgeons and is part of the multidisciplinary Gender Affirming Medical and Microsurgical Associates (GAMMA) surgical team, where he works alongside gender-affirming plastic and reconstructive surgeons.
In many masculinizing genital procedures, Dr. Coutinho focuses on the urologic and urethral portions of reconstruction while the plastic surgery team performs complementary reconstructive portions. This collaborative model is particularly important because urethral reconstruction, soft-tissue coverage, flap blood supply, wound healing, and future prosthetic surgery all affect one another. Every patient’s anatomy, prior operations, and goals are different, so care is individualized and often staged.
Dr. Coutinho has specialized experience in complex urethral reconstruction, including strictures that occur after gender-affirming surgery. His academic work in stricture disease includes serving as a Co-Primary Investigator for ROBUST III, co-authoring randomized trial publications, and presenting four-year stricture-treatment results at a 2025 American Urological Association regional meeting.
He has also lectured on open reconstructive technique in a presentation titled ‘Excision & Primary Anastomosis Urethroplasty: Pushing the Limits.’ Post-phalloplasty and post-metoidioplasty strictures are different from strictures in a native urethra, so these credentials do not replace individualized gender-affirming expertise; rather, they add a deep urethral-reconstruction foundation to his multidisciplinary work with the GAMMA team.
