Causes of declining libido in women

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.

ACTUAL CATHETERIZATION A clinical view of insertion into the male urethra. A 14 french coude cath was used.

A video showing the process of childbirth via vaginal delivery.

At one time, women who had delivered by cesarean section in the past would usually have another cesarean section for any future pregnancies. The rationale was that if allowed to labor, many of these women with a scar in their uterus would rupture the uterus along the weakness of the old scar. Over time, a number of observations have become apparent: Most women with a previous cesarean section can labor and deliver vaginally without rupturing their uterus. Some women who try this will, in fact, rupture their uterus. When the uterus ruptures, the rupture may have consequences ranging from near trivial to disastrous. It can be very difficult to diagnose a uterine rupture prior to observing fetal effects (eg, bradycardia). Once fetal effects are demonstrated, even a very fast reaction and nearly immediate delivery may not lead to a good outcome. The more cesarean sections the patient has, the greater the risk of subsequent rupture during labor. The greatest risk occurs following a “classical” cesarean section (in which the uterine incision extends up into the fundus.) The least risk of rupture is among women who had a low cervical transverse incision. Low vertical incisions probably increase the risk of rupture some, but usually not as much as a classical incision. Many studies have found the use of oxytocin to be associated with an increased risk of rupture, either because of the oxytocin itself, or perhaps because of the clinical circumstances under which it would be contemplated. Pain medication, including epidural anesthetic, has not resulted greater adverse outcome because of the theoretical risk of decreasing the attendant’s ability to detect rupture early. The greatest risk of rupture occurs during labor, but some of the ruptures occur prior to the onset of labor. This is particularly true of the classical incisions. Overall successful vaginal delivery rates following previous cesarean section are in the neighborhood of 70 This means that about 30of women undergoing a vaginal trial of labor will end up requiring a cesarean section. Those who undergo cesarean section (failed VBAC) after a lengthy labor will frequently have a longer recovery and greater risk of infection than had they undergone a scheduled cesarean section without labor. Women whose first cesarean was for failure to progress in labor are only somewhat less likely to be succesful in their quest for a VBAC than those with presumably non-recurring reasons for cesarean section. For these reasons, women with a prior cesarean section are counseled about their options for delivery with a subsequent pregnancy: Repeat Cesarean Section, or Vaginal Trial of Labor. They are usually advised of the approximate 70successful VBAC rate (modified for individual risk factors). They are counseled about the risk of uterine rupture (approximately 1in most series), and that while the majority of those ruptures do not lead to bad outcome, some of them do, including fetal brain damage and death, and maternal loss of future childbearing. They are advised of the usual surgical risks of infection, bleeding, anesthesia complications and surgical injury to adjacent structures. After counseling, many obstetricians leave the decision for a repeat cesarean or VBAC to the patient. Both approaches have risks and benefits, but they are different risks and different benefits. Fortunately, most repeat cesarean sections and most vaginal trials of labor go well, without any serious complications. For those choosing a trial of labor, close monitoring of mother and baby, with early detection of labor abnormalities and preparation for

Another video showing different technique of child birth

3D ultrasound of IUD in uterus

examination of the lungs and respiration of newborn and children

Meningitis is a common life-threatening medical emergency caused by infectious and non-infectious agents. Rapid and accurate evaluation by history and clinical examination is helpful to guide further specific investigation and treatment. Kernig's sign, Brudzinski's sign, and nuchal rigidity are bedside diagnostic signs used to evaluate suspected cases of meningitis. The presence of meningeal irritation, however, is not pathognomonic for meningitis.

Part 2. Full Obstetric examination and normal delivery by Egyptian doctor Hussein Sulayman and the video is in English showing: Obstetric Examination Episiotomy Obstetric Forceps Obstetric Instruments

Bimanual Hip Examination of the Female genitalia

A video showing vaginal delivery

A video showing the steps of cesarean section surgery

This video demonstrates the use of an episiotomy to facilitate vaginal delivery of a baby

a video showing the process of child birth or delivery using forceps

Breast reduction can relieve strain from shoulder straps, neck, back, and upper arms.
It can provide an uplift to help clothes fit and look better. Traditionally, insurance companies would provide benefits for a broad range of breast sizes and gram weight of tissue to be removed from each breast. At present most insurance companies limit authorization when the doctor plans to remove less than 500gm weight per breast. Since many patients present with symptoms in a D cup to DD cup, often, the very removal of over 500 grams weight may reduce the breasts too much. This amount of reduction may not be in harmony with body shape. Newer methods of breast assembly after reduction, will tighten things using internal brassiere techniques that also compact and reduce breast volume. Therefore, a gram weight reduction of 500gms in some patients combined with internal tightening efforts, could pose an over-reduction. With the unreliability of insurance support in some cases, it is best not to look solely at gram weight in the surgical planning of breast reduction. When excess skin and weight is removed, the improved location of the breasts on the chest will give marked relief of symptoms.

Surgery takes from 2 to 5 hours and can be done as an outpatient or with a brief overnight stay. When possible, no scarring other than around the areola can be planned which follows the Brazilian and French methods (Goes and Benelli). For very large reductions, a vertical method, or T pattern approach is offered. Recovery is a few days, with special care to avoid strain for 4 to 6 weeks. Some soreness may persist for a few weeks. The breasts can appear tight, swollen, and bruised at first, but will usually settle to their near final look by 6 weeks. There may be sutures to be removed in some cases. Costs relate to the severity of the sag, and weight of the breasts.

The operation can make a stunning change in body image, relief of upper body symptoms, and offer a cosmetic lift to naturally sloping breasts.

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.

Physical exam by a urologist including kidney, testicular and prostate exam.

This is the biggest known operation ever.The Whipple procedure(pancreatoduodenectomy) is the most common operation performed for pancreatic cancer and may be used to treat other cancers such as small bowel cancer. Surgeons remove the head of the pancreas, most of the duodenum (a part of the small intestine), a portion of the bile duct and sometimes a portion of the stomach. After the pancreatoduodenectomy, the surgeon reconstructs the digestive tract. At Mayo Clinic, surgeons perform more than 100 Whipple procedures annually. Patients leave the hospital in an average of 14 days.

The Stevens Laser Bra works to create a more permanent breast lift for women with sagging breasts, and can be combined with other surgery at Marina Plastic Surgery in Los Angeles, including breast augmentation or reduction, to create a long-lasting, natural transformation of the breast area.