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Bone marrow examination refers to the pathologic analysis of samples of bone marrow obtained by bone marrow biopsy (often called a trephine biopsy) and bone marrow aspiration. Bone marrow examination is used in the diagnosis of a number of conditions, including leukemia, multiple myeloma, anemia, and pancytopenia. The bone marrow produces the cellular elements of the blood, including platelets, red blood cells and white blood cells. While much information can be gleaned by testing the blood itself (drawn from a vein by phlebotomy), it is sometimes necessary to examine the source of the blood cells in the bone marrow to obtain more information on hematopoiesis; this is the role of bone marrow aspiration and biopsy.
Anterior vaginal wall relaxation (cystocele) is one of the most commonly diagnosed forms of pelvic organ prolapse in women. More than 200,000 cystocele repairs are completed yearly, however to date the procedures that are completed do not provide very high cure rates and/or poor anatomic outcomes. Successful treatment of anterior vaginal wall prolapse remains one of the most challenging aspects of pelvic reconstructive surgery we face. We have developed very good procedures that provide excellent support for the posterior wall (ie rectoceles) and the apex of the vagina (ie vaginal vault prolapse) and reproduce normal anatomy. We were one of the first centers in the country to utilize grafts in rectocele repairs and have seen improved cure rates to over 90% with minimal complications. It has been known for many years that abdominal sacralcolpopexy with placement of a mesh graft at the top of the vagina for vaginal vault prolapse is the most successful procedure in the literature. We have made advancements with this procedure as well in being able to offer our patients a laparoscopic minimally invasive approach for sacralcolpopexy, with the same excellent cure rates (>92%) and with hospital stays typically less than 24 hours and reduced complications. However the anterior wall has been one of the most difficult compartments in the vagina to get good anatomic results and high cure rates with traditional repairs and at the same time not cause sexual dysfunction, pain with intercourse, voiding dysfunction (ie incontinence or urgency/frequency syndrome), or a shortened or scarred down vagina. The transobturator approach was developed as a less invasive way to place an anterior wall graft (see below) however this still involved blind needle passes and the graft did not support the apex of the vagina, therefore the search for improvements in these procedures is ongoing.
A Fistulotomy is the surgical opening or removal of a fistulous tract. They can be performed by excision of the tract and surrounding tissue, simple division of the tract, or gradual division and assisted drainage of the tract by means of a seton; a cord passed through the tract in a loop which is slowly tightened over a period of days or weeks.
Fistulas can occur in various areas of the human body, and the location of the fistula influences the necessity of the procedure. Some, such as ano-vaginal and perianal fistulas are chronic conditions, and will never heal without surgical intervention.
plantar fasciitis and calcaneal spur can be treated by EPFR with calcanean drilling - endoscopic plantar fascia release علاج الشوكة العظمية للكعب بالمنظار د. أسامة الشاذلي مدرس جراحة العظام واستشاري جراحات و مناظير القدم والكاحل كلية الطب جامعة عين شمس