Before the gender reassignment procedure begins, patients must have intense counseling to ensure they are aware of the implications, physically and psychologically of changing genders.
Sexual reassignment surgery for male-female patients is often known as MTF transgender surgery. Male-female gender reassignment procedures are less complex than female-male procedures and often it is impossible to tell that a patient has undergone sexual reassignment surgery. Male to female gender reassignment surgery can cost between $7000 and $30,000 depending on the location and the amount of surgeries necessary.
The information on this site is not a substitute for diagnosis or treatment from a licensed medical practitioner. Men with Peyronie’s disease may seek surgery to treat the symptoms of the condition.  These methods are typically reserved for men who have not responded to other forms of treatment and are experiencing severe curving of the penis, pain, impotence or erectile dysfunction.
Peyronie’s disease is a condition that causes the penis to become abnormally curved and painful when erect.
Anyone with an email account is familiar with the torrent of emails for creams, pills, patches, pumps and even surgeries promising to increase penis size; for a price. Radiology Department of the Medical Centre Alkmaar and the Rijnland hospital, Leiderdorp, the Netherlands.
January 21, 2009Perianal fistula is a common disorder that often recurs because of infection that was missed at surgery. This is the circular upper border of the puborectal muscle which is digitally palpable upon rectal examination.
Internal sphincter: continuance of the circular smooth muscle of the rectum, involuntary and contracted during rest, relaxes at defecation. The puborectal muscle has its origin on both sides of the pubic symphysis, forming a 'sling' around the anorectum. On axial and coronal MR-images the different layers of the anal sphincter and the surrounding structures can be displayed perfectly. A perianal fistula is an abnormal connection between the epithilialised surface of the anal canal and the skin.
Obstruction of anal gland which leads to stasis and infection with absces and fistula formation (most common cause). The most widely used classification is the Parks Classification which distinguishes four kinds of fistula: intersphincteric, transsphincteric, suprasphincteric and extrasphincteric. The extrasphincteric fistula is uncommon and only seen in patients who had multiple operations.

A superficial fistula is a fistula that has no relation to the sphincter or the perianal glands and is not part of the Parks classification.
These are more often due to Crohns disease or anorectal procedures such as haemorrhoidectomy or sphincterotomy. A localizer in three directions is needed in order to align the T2 sequences axial and coronal to the anal canal. T2W images without fatsat better display the anatomy, while the fatsat images better depict the fistulas. The drawing on the left illustrates the anal clock, which is the surgeon's view of the perianal region when the patient is in the supine lithotomy position (2). The defect through the internal and external sphincter at 6 o'clock is clearly visible and more apparent on the fat sat images.
On the left axial T2W-fatsat images of a transsphincteric fistula with the mucosal opening at 11 o'clock.
On the left coronal T2W-images of a small abscess in the left ischioanal fossa, the fistula runs through the levator ani.
Axial fatsat images depict the transmural inflammation with infiltration of the mesenteric fat.
This patient was already known to have an intersfincteric fistula, the mucosal defect is at 1 o'clock.
MR Imaging Classification of Perianal Fistulas and Its Implications for Patient Management. Laser treatment for benign prostatic hyperplasia (BPH) is therapy that removes obstructing prostatic tissue from the urethra.
Other names for laser prostate therapy include: photoselective vaporization of the prostate, laser prostatectomy, laser prostate ablation, or laser enucleation of the prostate. If the counselor and the patient decide gender reassignment surgery is appropriate, patients must complete a course of hormone replacement therapy (HRT).The process of HRT in male-female transsexuals will encourage the growth of breast tissue and will reduce the amount of facial and body hair. Male-female gender reassignment involves the removal of the male genitalia (penis, testes and scrotum) and the creation of female genitalia (vagina). Patients must take care to avoid infection post-surgery and may be required to have follow up appointments to ensure the constructed vagina does not narrow and cause problems urinating. If you are experiencing a serious medical condition call your local emergency services or your doctor. Peyronie’s disease is believed to be caused by trauma to the penis which causes the growth of fibrous scar tissue.

They are one of the most experienced practices performing in-office laser prostate ablation on the west coast. The procedure for male-female SRS can be completed in one surgery and may be performed by a cosmetic surgeon or a urologist.An incision is made into the scrotum and the testes are removed.
Following surgery, the reconstructed genitals allow patients to have sexual intercourse without complications. Peyronie’s disease can make it painful and difficult for a man to achieve an erection or enjoy sexual intercourse. Laser therapy is minimally invasive and therefore can be performed in the office setting or in the outpatient surgical setting. Only around half the men diagnosed with Peyronie’s disease experience symptoms severe enough to require surgery. Men with Peyronie’s disease may seek treatment to correct penile deformity and relieve painful erections.
Pain from the procedure is minimal and patients rarely need pain medication after laser therapy. A second labiaplasty surgery may be necessary to improve the appearance of the vulva once the vagina has healed.Pre-operative male-female transgender patients often have breast augmentation before the sex reassignment surgery to allow them to adjust to living and dressing as a woman.
The adjustment to life as a woman may take years, and often patients require ongoing psychological help in order to mentally adjust to the change. The day following the procedure, most patients notice improved urinary stream, better bladder emptying and reduced urinary symptoms. Sometimes hormone replacement therapy can stimulate breast growth enough that this surgery is not necessary.To help patients look like as female as possible, surgeons can perform facial feminization surgery (FFS) on male-female reassignment patients before or after their genital reassignment surgery. FFS creates a more feminine appearance to the face by defining the cheekbones and re contouring areas of the face which appear masculine.
A common additional cosmetic procedure for male-female patients is a trachea shave to reduce the size of the Adams apple.

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