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Sex reassignment surgery for male-to-female involves reshaping the male genitals into a form with the appearance of, and, as far as possible, the function of female genitalia. Prior to any surgeries, patients usually undergo hormone replacement therapy (HRT), and, depending on the age at which HRT begins, facial hair removal. There are associated surgeries patients may elect to, including facial feminization surgery, breast augmentation, and various other procedures.
Knee pain facts Knee pain is a common problem with many causes, from acute injuries to complications of medical conditions. Knee pain can be localized to a specific area of the knee or be diffuse throughout the knee. Knee pain is often accompanied by physical restriction. A thorough physical examination will usually establish the diagnosis of knee pain. The treatment of knee pain depends on the underlying cause. The prognosis of knee pain is usually good although it might require surgery or other interventions.
Transvenous cardiac pacing, also called endocardial pacing, is a potentially life saving intervention used primarily to correct profound bradycardia. It can be used to treat symptomatic bradycardias that do not respond to transcutaneous pacing or to drug therapy.
Urological surgeons have become proficient at performing complex pelvic urological procedures, such as radical prostatectomy, using the laparoscopic approach. Declan Murphy and Daniel Moon share their experience of four less common procedures they have performed recently using laparoscopic techniques. These include: excision of a urachal cyst; partial cystectomy for endometriosis (combined endoscopic-laparoscopic approach); repair of an intra-peritoneal bladder rupture; and repair of a ureteric injury (combined endoscopic-laparoscopic approach).
Indications for intervention in patients with a renal artery aneurysm (RAA) include the following [20, 8, 13, 14] : Rupture Symptomatic RAA - Hypertension (from associated renal artery stenosis, refractory to medical management), pain, renal ischemia or infarction secondary to embolization from the aneurysm sac RAAs in females who are pregnant or are contemplating pregnancy Diameter greater than 2 cm Enlarging RAA RAA associated with acute dissection Currently, there is no consensus regarding the size at which an RAA should be repaired in an asymptomatic patient. Experts have recommended RAA repair at diameters ranging from 1.5 to 3 cm, [8] though most suggest 2 cm. Some reports have even suggest that larger asymptomatic saccular aneurysms may be managed expectantly. Note that aneurysm rupture at a diameter of 1.5 cm has been reported. Complete calcification of the wall of the aneurysm sac manifests in about 40% of patients. This was once believed to confer protection against rupture [21] ; however, this belief has since been questioned. [30] Asymptomatic, small (<2 cm in diameter) RAAs do not usually require treatment. One notable exception is an RAA in a woman who is pregnant or contemplating pregnancy. In view of the increased risk of rupture in such cases, even small asymptomatic aneurysms should be repaired in this population. For diagnosis and preinterventional planning, gadolinium-enhanced magnetic resonance angiography (MRA) and computed tomography (CT) angiography (CTA) with three-dimensional (3D) reconstruction have essentially replaced conventional arteriography. Regular follow-up examination with ultrasonography (US) or CT) is recommended in patients who are treated expectantly. Spontaneous cure by thrombosis of small aneurysms has been described. Further refinements in endovascular techniques may allow more RAAs to be treated in this manner. So far, excellent short- and intermediate-term results have been described in the literature [40] ; however, there remains a need for further long-term outcome data.
Thalassemia (thal-uh-SEE-me-uh) is an inherited blood disorder characterized by less hemoglobin and fewer red blood cells in your body than normal. Several types of thalassemia exist, including alpha-thalassemia, beta-thalassemia intermedia, Cooley's anemia and Mediterranean anemia. Hemoglobin is the substance in your red blood cells that allows them to carry oxygen. The low hemoglobin and fewer red blood cells of thalassemia may cause anemia, leaving you fatigued. If you have mild thalassemia, you may not need treatment. But, if you have a more severe form of thalassemia, you may need regular blood transfusions. You can also take steps on your own to cope with fatigue, such as choosing a healthy diet and exercising regularly.