Objective To measure spermatogenesis abnormalities in transwomen at the time of sex reassignment surgery (SRS) and to analyze the association between hormonal therapy duration and infertility severity. Design Retrospective study. Setting University hospital. Patients One-hundred seventy-three transwomen who underwent SRS from January 2000 to December 2015. Interventions All orchidectomy specimens were retrospectively reviewed and classified. History of hormonal therapy duration was retrieved from medical records. Main Outcome Measures Histological examinations of orchidectomy specimens were performed to assess spermatogenesis. Results One-hundred seventy-three orchidectomy specimens were evaluated. Histological examinations showed maturation arrest in 36.4%, hypospermatogenesis in 26%, Sertoli cell-only syndrome in 20.2%, normal spermatogenesis in 11%, and seminiferous tubule hyalinization in 6.4% of the specimens. Spermatogenesis abnormality severity was not associated with the total therapy duration (P = 0.81) or patient age at the time of surgery (P = 0.88). Testicular volumes and sizes were associated with spermatogenesis abnormality severity (P = 0.001 and P = 0.026, right testicle and left testicle, resp.). Conclusion(s) Feminizing hormonal treatment leads to reductions in testicular germ cell levels. All transwomen should be warned about this consequence, and gamete preservation should be offered before starting hormonal treatment.
Background: Maxillofacial injury is a common injury in trauma patients. The incidence, associated injuries and causes have been never reported for King Chulalongkorn Memorial Hospital (KCMH). Objectives: To report the incidence, associated injuries, age groups, treatments, and behavioral risks in maxillofacial patients who were admitted to KCMH in the past decade. Methods: We conducted a retrospective descriptive analysis of patients from January 1, 2006, to December 31, 2015, to evaluate the age groups, causes, sites of facial bone fracture, associated injuries, treatments, and behavioral risks. Results: There were 1,275 patients (79% male and 21% female). The most common age group was 21-30 years (30.6%), followed by 11-20 years (19.5%) and 31-40 years (18.8%). The most common cause of injury was motorcycle accident (39.7%), and the most common associated injury was head injury (58%). The total number of fractures were 1,526, with the most common fracture site being the zygomaticomaxillary complex (38.6%), followed by mandible (21.8%) and nasal bone (17.8%). Most fractures were treated using open reduction and internal fixation with plates and screws. Conclusions:The main cause of maxillofacial injury is motorcycle accident even though the government launched a policy named "Decade of Action for Road Safety 2011-2020" to reduce road traffic deaths. Thailand continues to need stronger law enforcement to reduce risky motorcycle driving behavior.
BackgroundDonor site seroma is the most common complication after latissimus dorsi (LD) flap harvest. This study aimed to evaluate the efficacy of negative-pressure wound therapy (NPWT) in preventing donor site seroma formation after the harvest of an LD flap for breast reconstruction. MethodsIn this prospective matched-pair study, 40 patients in whom an LD flap was harvested for breast reconstruction were enrolled. NPWT was used in 20 patients, and in a control group composed of another 20 patients, the conventional donor site dressing technique was used. Information was collected regarding postoperative complications, the incidence of seroma, total drainage volume, the number of percutaneous seroma aspirations, and the volume aspirated. ResultsIn the NPWT group, the incidence of seroma formation after drain removal was significantly lower than in the control group (15% vs. 70%; odds ratio=0.07; relative risk, 0.24). Both the mean percutaneous aspirated volume (P=0.004) and the number of percutaneous aspirations (P=0.001) were also significantly lower in the NPWT group. There were no significant differences in the total drainage volume or the duration of wound drainage between the NPWT dressing group and the control group (P>0.05). ConclusionsThis study showed that NPWT is a promising tool for reducing the incidence of seroma formation after removing the drain at the donor site after LD flap harvesting. It is a simple and safe technique.
This paper reviews the development of gender reassignment in Thailand during the period of 1975–2012, in terms of social attitude, epidemiology, surgical patients' profile, law and regulation, religion, and patients' path from psychiatric assessment to surgery. Thailand healthcare for transsexual patients is described. Figures related to the number of sex reassignment surgeries performed in Thailand over the past 30 years are reported. Transsexual individuals are only apparently integrated within the Thail society: the law system of Thailand in fact, does not guarantee to transsexuals the same rights as in other Western countries; the governmental healthcare does not offer free treatments for transsexual patients. In favor of the transsexual healthcare, instead, the Medical Council of Thailand recently published a policy entitled “Criteria for the treatment of sex change, Census 2009.” The goal of this policy was to improve the care of transsexual patients in Thailand, by implementing the Standards of Care of the World Professional Association of Transgender Health. Currently, in Thailand, there are 6 major private groups performing sex reassignment surgery, and mostly performing surgery to patients coming from abroad. Particularly, the largest of these (Preecha's group) has performed nearly 3000 vaginoplasties for male-to-female transsexuals in the last 30 years.
Negative pressure wound therapy (NPWT) is a technique using vacuum dressing to promote wound healing in complicated wound. However, for many patients, the application and removal of the NPWT is source of procedural pain. The authors hypothesized that administering cold sterile water into the NPWT sponge would decrease pain during dressing changes. A prospective randomized controlled study was conducted on 27 patients who were undergoing 81 NPWT wound dressing changes (n = 81) at a single institution between October 2016 and September 2017. Each patient had 3 NPWT dressing changes. Cold sterile water (5.74 °C), room temperature sterile water (26.89 °C), and nothing were randomized and administered in the NPWT tubing into the sponge 10 minutes before changing the dressing in each and every procedure. Pain scores were assessed using a 0 to 10 numeric pain scale. Patients administered with cold water reported less pain than those administered with room temperature sterile water during the dressing change (4 vs 5.67; P < .003), and much less pain than those with nothing instilled before dressing change (4 vs 6.59; P < .001). There is no statistically significant difference in pain score between using the room temperature sterile water group and the control group that instilled nothing (5.67 vs 6.59; P = .065). This study has shown that cold water administered through the suction tubing before the dressing change had a better reduction in pain score than using room temperature sterile water and the control group.
scite is a Brooklyn-based organization that helps researchers better discover and understand research articles through Smart Citations–citations that display the context of the citation and describe whether the article provides supporting or contrasting evidence. scite is used by students and researchers from around the world and is funded in part by the National Science Foundation and the National Institute on Drug Abuse of the National Institutes of Health.
hi@scite.ai
10624 S. Eastern Ave., Ste. A-614
Henderson, NV 89052, USA
Copyright © 2024 scite LLC. All rights reserved.
Made with 💙 for researchers
Part of the Research Solutions Family.