I n t r o d u c t i o n : This paper provides an in-depth analysis of the anatomical and morphome... more I n t r o d u c t i o n : This paper provides an in-depth analysis of the anatomical and morphometrical attributes of the popliteal artery (PA) in human fetuses. Additionally, it showcases significant interindividual variation in branching patterns, which are of great clinical importance in the context of vascular surgery and interventional radiology. A i m : The purpose of this research was to systematically examine and categorize the anatomical and morphometrical diversities observed in the PA among a 166 sample of human fetuses at various gestational stages, spanning from 16 to 30 weeks of pregnancy.
Carotid plaques are frequently seen in patients who have suffered from an episode of stroke. Conv... more Carotid plaques are frequently seen in patients who have suffered from an episode of stroke. Conversely, the risk of stroke is strongly correlated with the presence of carotid plaques [1]. Thrombus formed on atherosclerotic plaques, as well as the plaques themselves, may migrate and embolize the intracranial arteries, resulting in an artery-toartery embolic cerebral infarction. Apart from cardiac and carotid artery surgery, in which the risk of stroke perioperatively is well recognized [2], the incidence of stroke in the general surgical population is reported to be between 0.2 and 0.7% [3]. Approximately 40% of cases of stroke in this population were attributable to cardiogenic embolism associated with atrial fibrillation, followed by carotid arterial disease, which accounts for approximately 10% of perioperative cerebrovascular disease. In order to prevent the accidental release of thrombus formed on atheromatous plaques, as well as the the accidental release of plaque itself, blood pressure should be kept within the patient’s normal range [3]. Additionally, hyperextension of the neck should be avoided because it can stretch the carotid artery, thereby causing intimal tears which can act as a nidus for thrombus formation [4]. Recently, ultrasound guidance for central venous catheterization has gained in popularity, and it has been shown to reduce the time required for catheterization, to increase the overall success rate, and to reduce the rate of complications. We have surveyed the presence of carotid plaques perioperatively, and have noted that a considerable number of patients have carotid plaques. Of 20 patients who were examined for the presence of carotid plaques perioperatively (14 men, 6 women; age range 46–82 years, median 67, average 66.25), using a Philips CX50 device equipped with a linear 12-MHz transducer probe (Philips, Andover, MA, USA) or a GE Vivid7 Pro equipped with a linear 10-MHz transducer probe (GE, Pollard Woods, UK), our skilled cardiovascular ultrasound technicians diagnosed 12 patients as having carotid plaques and 4 patients as having carotid stenosis. In some of the patients, these findings were highly likely to cause cerebral infarction. For example, in the 77-year-old man whose ultrasound image is shown in Fig. 1a, the presence of carotid plaque was apparent in his right common carotid artery. In the longitudinal section, the ultrasound morphology of the plaque was heterogeneous, consisting of hypoechoic and echo-lucent parts, as indicated by the arrows in Fig. 1b, c. Such parts contain deposits of lipids and cholesterol, respectively, and are highly associated with an increased risk of stroke [5]. Because there was a possibility of compressing the common carotid artery during the insertion of the catheter, puncture of the ipsilateral side had to be avoided, and the patient must be followed postoperatively with the use of anticoagulants. In longitudinal views in another patient, a 58-year-old man (Fig. 1d, e), the plaque bulged from the carotid arterial wall and appeared as if it would be unstable upon pressure. Hence, cannulation of the ipsilateral side must be avoided in this patient, and careful control of blood pressure would be required. Y. Asakura (&) Department of Anesthesiology, Nagoya Kyoritsu Hospital, 1-172 Hokke, Nakagawa-ku, Nagoya 454-0933, Japan e-mail: [email protected]
The risk of complications associated with femoral venous catheterization could be potentially red... more The risk of complications associated with femoral venous catheterization could be potentially reduced if the procedure was performed at the location where the cross-sectional area (CSA) of the vessel is the largest. The diameter of the femoral vein depends on leg position as well as the distance from the inguinal ligament. We determined the CSA of the right femoral vein in three different leg positions at two distances from the inguinal ligament.
This is a PDF file of an article that has undergone enhancements after acceptance, such as the ad... more This is a PDF file of an article that has undergone enhancements after acceptance, such as the addition of a cover page and metadata, and formatting for readability, but it is not yet the definitive version of record. This version will undergo additional copyediting, typesetting and review before it is published in its final form, but we are providing this version to give early visibility of the article. Please note that, during the production process, errors may be discovered which could affect the content, and all legal disclaimers that apply to the journal pertain.
Medical & Biological Engineering & Computing
In the final paper, all affiliations have been renumbered in ascending order. The original articl... more In the final paper, all affiliations have been renumbered in ascending order. The original article has been corrected.
The inferolateral triangle is a surgical skull base triangle used as a neurosurgical landmark. Th... more The inferolateral triangle is a surgical skull base triangle used as a neurosurgical landmark. There are few reports of its measurements with little attention paid to anatomical variations. The inferolateral triangle was measured in ten adult human cadaveric heads via dissection then direct measurement and five participants undergoing neuroimaging using tracing features. In the cadavers, mean lengths (mm) of the superior, anterior, and posterior borders were 17.0 (± 5.5), 12.9 (± 1.7), and 17.8 (± 3.3), respectively, with mean area of 97.85 (± 28.17) mm2. In the participants, mean lengths (mm) of the superior, anterior, and posterior borders were 17.35 (±4.01), 14.36 (±1.36), and 18.01 (±2.43), respectively, with mean area of 113.6 (±25.46) mm2. No statistical difference in triangle areas between groups was found. Intimate understanding of the inferolateral triangle is essential to skull-based surgery; Knowing its anatomy and variations aids in surgical planning and understanding of regional pathology.
Medical & Biological Engineering & Computing
Understanding the 3D cerebral vascular network is one of the pressing issues impacting the diagno... more Understanding the 3D cerebral vascular network is one of the pressing issues impacting the diagnostics of various systemic disorders and is helpful in clinical therapeutic strategies. Unfortunately, the existing software in the radiological workstation does not meet the expectations of radiologists who require a computerized system for detailed, quantitative analysis of the human cerebrovascular system in 3D and a standardized geometric description of its components. In this study, we show a method that uses 3D image data from magnetic resonance imaging with contrast to create a geometrical reconstruction of the vessels and a parametric description of the reconstructed segments of the vessels. First, the method isolates the vascular system using controlled morphological growing and performs skeleton extraction and optimization. Then, around the optimized skeleton branches, it creates tubular objects optimized for quality and accuracy of matching with the originally isolated vascular...
Patient: A 66-year-old woman, who had a bilateral free-end edentulous mandible and no experience ... more Patient: A 66-year-old woman, who had a bilateral free-end edentulous mandible and no experience with dentures, was examined for the chief complaint of masticatory dysfunction on left side of dental arch. A unilateral distal extension removable partial denture (RPD) replacing lower-left molars was selected. Tomographic images were obtained using Fluorine-18 NaF positron emission computerized tomography (NaF-PET)/ computed tomography (CT) before the RPD use and at 1, 6, and 13 weeks after the RPD use to observe the metabolic changes in residual bone caused by the RPD use. PET standardized uptake values (SUVs) and CT values were calculated for lower-left edentulous site (test side) and lowerright edentulous site (control side). As a result, SUVs on the control side remained static after the RPD use, whereas those on the test side increased at 1 and 6 weeks after the RPD use and then decreased. However, CT images showed no obvious changes in the bone shape and structure beneath RPD, and CT values both on the control and test sides did not change either. Discussion: This report shows that NaF-PET could detect bone metabolic changes soon after the RPD use, which cannot be detected by clinical Xrays. The SUV changes may be a mechanobiological reaction to the pressure due to the RPD use, and wearing of the RPD may increase the bone turnover beneath denture. Conclusion: This report demonstrates that wearing of an RPD increases bone turnover beneath denture immediately after the RPD use without clinically detectable changes in bone structure or volume.
Anatomical variation of the thoracic splanchnic nerves is as diverse as any structure in the body... more Anatomical variation of the thoracic splanchnic nerves is as diverse as any structure in the body. Thoracic splanchnic nerves are derived from medial branches of the lower seven thoracic sympathetic ganglia, with the greater splanchnic nerve comprising the more cranial contributions, the lesser the middle branches, and the least splanchnic nerve usually T11 and/or T12. Much of the early anatomical research of the thoracic splanchnic nerves revolved around elucidating the nerve root level contributing to each of these nerves. The celiac plexus is a major interchange for autonomic fibers, receiving many of the thoracic splanchnic nerve fibers as they course toward the organs of the abdomen. The location of the celiac ganglia are usually described in relation to surrounding structures, and also show variation in size and general morphology. Clinically, the thoracic splanchnic nerves and celiac ganglia play a major role in pain management for upper abdominal disorders, particularly chronic pancreatitis and pancreatic cancer. Splanchnicectomy has been a treatment option since Mallet-Guy became a major proponent of the procedure in the 1940s. Splanchnic nerve dissection and thermocoagulation are two common derivatives of splanchnicectomy that are commonly used today. Celiac plexus block is also a treatment option to compliment splanchnicectomy in pain management. Endoscopic ultrasonography (EUS)-guided celiac injection and percutaneous methods of celiac plexus block have been heavily studied and are two important methods used today. For both splanchnicectomies and celiac plexus block, the innovation of ultrasonographic imaging technology has improved efficacy and accuracy of these procedures and continues to make pain management for these diseases more successful.
Introduction. Submandibular abscesses often appear as a consequence of negligence in maintaining ... more Introduction. Submandibular abscesses often appear as a consequence of negligence in maintaining hygiene and oral health; however, sometimes as a result of the lack of anatomical obstacles in this body area, inflammatory processes can easily spread to neighboring space, as well as distant locations, reaching even the mediastinum. Case report. A 26-yearold woman without a clinically relevant history was admitted to the Maxillofacial Surgery Department because of an abscess involving the submandibular and parapharyngeal space on the left side. It is likely that initially the submandibular abscess reached subsequently the parapharyngeal space, turning into the neck phlegmon with an extremely rapid clinical course despite appropriate treatment. Eventually, the submandibular abscess covered the neck space and moved to the mediastinum where the empyemas were created, necessitating life-saving thoracic surgery. Conclusion. Only conscious prophylaxis and prohealth attitude of the patients c...
Introduction: Iatrogenic nerve injury during surgery is a major source of concern for both patien... more Introduction: Iatrogenic nerve injury during surgery is a major source of concern for both patients and surgeons. This study aimed to identify the nerves most commonly injured during surgery, along with the commonly associated operative procedures. Materials and Methods: A literature search was conducted using the PubMed database to identify nerves commonly injured during surgery, along with the surgical procedure associated with the injury. Results: The following eleven nerves, ranked in order with their associated surgical procedures, were found to be the most commonly injured: (1) intercostobrachial nerve in axillary lymph node dissections and transaxillary breast augmentations, (2) vestibulocochlear nerve in cerebellopontine tumor resections and vestibular schwannoma removals, (3) facial nerve in surgeries of the inner ear and cheek region, (4) long thoracic nerve in axillary lymph node dissections, (5) spinal accessory nerve in surgeries of the posterior triangle of the neck and cervical lymph node biopsies, (6) recurrent laryngeal nerve in thyroid surgeries, (7) genitofemoral nerve in inguinal hernia and varicocele surgeries, (8) sciatic nerve in acetabular fracture repairs and osteotomies, (9) median nerve in carpal tunnel release surgeries, (10) common fibular nerve in varicose vein and short saphenous vein surgeries, and (11) ulnar nerve in supracondylar fracture surgeries. Conclusion: Although the root cause of iatrogenic nerve injury differs for each nerve, there are four unifying factors that could potentially decrease this risk for all peripheral nerves. These four
This is a PDF file of an article that has undergone enhancements after acceptance, such as the ad... more This is a PDF file of an article that has undergone enhancements after acceptance, such as the addition of a cover page and metadata, and formatting for readability, but it is not yet the definitive version of record. This version will undergo additional copyediting, typesetting and review before it is published in its final form, but we are providing this version to give early visibility of the article. Please note that, during the production process, errors may be discovered which could affect the content, and all legal disclaimers that apply to the journal pertain.
An estimated 1.4% of the population worldwide has been diagnosed with Gender Dysphoria, as define... more An estimated 1.4% of the population worldwide has been diagnosed with Gender Dysphoria, as defined by the Diagnostic and Statistical Manual of Mental Disorders. Gender reassignment, which holistically encompasses psychotherapy, hormonal therapy and genital and nongenital surgeries, is considered the most effective treatment for transgender non-conforming patients afflicted with gender dysphoria. Little research is currently available identifying the psychosocial needs of the transgender population and their access to preventative and primary care during this transitioning process. This article presents an overview of the evolution and current approaches to genital surgical procedures available for both male-to-female, as well as female-to-male gender-affirmation surgeries. This article is protected by copyright. All rights reserved.
I n t r o d u c t i o n : This paper provides an in-depth analysis of the anatomical and morphome... more I n t r o d u c t i o n : This paper provides an in-depth analysis of the anatomical and morphometrical attributes of the popliteal artery (PA) in human fetuses. Additionally, it showcases significant interindividual variation in branching patterns, which are of great clinical importance in the context of vascular surgery and interventional radiology. A i m : The purpose of this research was to systematically examine and categorize the anatomical and morphometrical diversities observed in the PA among a 166 sample of human fetuses at various gestational stages, spanning from 16 to 30 weeks of pregnancy.
Carotid plaques are frequently seen in patients who have suffered from an episode of stroke. Conv... more Carotid plaques are frequently seen in patients who have suffered from an episode of stroke. Conversely, the risk of stroke is strongly correlated with the presence of carotid plaques [1]. Thrombus formed on atherosclerotic plaques, as well as the plaques themselves, may migrate and embolize the intracranial arteries, resulting in an artery-toartery embolic cerebral infarction. Apart from cardiac and carotid artery surgery, in which the risk of stroke perioperatively is well recognized [2], the incidence of stroke in the general surgical population is reported to be between 0.2 and 0.7% [3]. Approximately 40% of cases of stroke in this population were attributable to cardiogenic embolism associated with atrial fibrillation, followed by carotid arterial disease, which accounts for approximately 10% of perioperative cerebrovascular disease. In order to prevent the accidental release of thrombus formed on atheromatous plaques, as well as the the accidental release of plaque itself, blood pressure should be kept within the patient’s normal range [3]. Additionally, hyperextension of the neck should be avoided because it can stretch the carotid artery, thereby causing intimal tears which can act as a nidus for thrombus formation [4]. Recently, ultrasound guidance for central venous catheterization has gained in popularity, and it has been shown to reduce the time required for catheterization, to increase the overall success rate, and to reduce the rate of complications. We have surveyed the presence of carotid plaques perioperatively, and have noted that a considerable number of patients have carotid plaques. Of 20 patients who were examined for the presence of carotid plaques perioperatively (14 men, 6 women; age range 46–82 years, median 67, average 66.25), using a Philips CX50 device equipped with a linear 12-MHz transducer probe (Philips, Andover, MA, USA) or a GE Vivid7 Pro equipped with a linear 10-MHz transducer probe (GE, Pollard Woods, UK), our skilled cardiovascular ultrasound technicians diagnosed 12 patients as having carotid plaques and 4 patients as having carotid stenosis. In some of the patients, these findings were highly likely to cause cerebral infarction. For example, in the 77-year-old man whose ultrasound image is shown in Fig. 1a, the presence of carotid plaque was apparent in his right common carotid artery. In the longitudinal section, the ultrasound morphology of the plaque was heterogeneous, consisting of hypoechoic and echo-lucent parts, as indicated by the arrows in Fig. 1b, c. Such parts contain deposits of lipids and cholesterol, respectively, and are highly associated with an increased risk of stroke [5]. Because there was a possibility of compressing the common carotid artery during the insertion of the catheter, puncture of the ipsilateral side had to be avoided, and the patient must be followed postoperatively with the use of anticoagulants. In longitudinal views in another patient, a 58-year-old man (Fig. 1d, e), the plaque bulged from the carotid arterial wall and appeared as if it would be unstable upon pressure. Hence, cannulation of the ipsilateral side must be avoided in this patient, and careful control of blood pressure would be required. Y. Asakura (&) Department of Anesthesiology, Nagoya Kyoritsu Hospital, 1-172 Hokke, Nakagawa-ku, Nagoya 454-0933, Japan e-mail: [email protected]
The risk of complications associated with femoral venous catheterization could be potentially red... more The risk of complications associated with femoral venous catheterization could be potentially reduced if the procedure was performed at the location where the cross-sectional area (CSA) of the vessel is the largest. The diameter of the femoral vein depends on leg position as well as the distance from the inguinal ligament. We determined the CSA of the right femoral vein in three different leg positions at two distances from the inguinal ligament.
This is a PDF file of an article that has undergone enhancements after acceptance, such as the ad... more This is a PDF file of an article that has undergone enhancements after acceptance, such as the addition of a cover page and metadata, and formatting for readability, but it is not yet the definitive version of record. This version will undergo additional copyediting, typesetting and review before it is published in its final form, but we are providing this version to give early visibility of the article. Please note that, during the production process, errors may be discovered which could affect the content, and all legal disclaimers that apply to the journal pertain.
Medical & Biological Engineering & Computing
In the final paper, all affiliations have been renumbered in ascending order. The original articl... more In the final paper, all affiliations have been renumbered in ascending order. The original article has been corrected.
The inferolateral triangle is a surgical skull base triangle used as a neurosurgical landmark. Th... more The inferolateral triangle is a surgical skull base triangle used as a neurosurgical landmark. There are few reports of its measurements with little attention paid to anatomical variations. The inferolateral triangle was measured in ten adult human cadaveric heads via dissection then direct measurement and five participants undergoing neuroimaging using tracing features. In the cadavers, mean lengths (mm) of the superior, anterior, and posterior borders were 17.0 (± 5.5), 12.9 (± 1.7), and 17.8 (± 3.3), respectively, with mean area of 97.85 (± 28.17) mm2. In the participants, mean lengths (mm) of the superior, anterior, and posterior borders were 17.35 (±4.01), 14.36 (±1.36), and 18.01 (±2.43), respectively, with mean area of 113.6 (±25.46) mm2. No statistical difference in triangle areas between groups was found. Intimate understanding of the inferolateral triangle is essential to skull-based surgery; Knowing its anatomy and variations aids in surgical planning and understanding of regional pathology.
Medical & Biological Engineering & Computing
Understanding the 3D cerebral vascular network is one of the pressing issues impacting the diagno... more Understanding the 3D cerebral vascular network is one of the pressing issues impacting the diagnostics of various systemic disorders and is helpful in clinical therapeutic strategies. Unfortunately, the existing software in the radiological workstation does not meet the expectations of radiologists who require a computerized system for detailed, quantitative analysis of the human cerebrovascular system in 3D and a standardized geometric description of its components. In this study, we show a method that uses 3D image data from magnetic resonance imaging with contrast to create a geometrical reconstruction of the vessels and a parametric description of the reconstructed segments of the vessels. First, the method isolates the vascular system using controlled morphological growing and performs skeleton extraction and optimization. Then, around the optimized skeleton branches, it creates tubular objects optimized for quality and accuracy of matching with the originally isolated vascular...
Patient: A 66-year-old woman, who had a bilateral free-end edentulous mandible and no experience ... more Patient: A 66-year-old woman, who had a bilateral free-end edentulous mandible and no experience with dentures, was examined for the chief complaint of masticatory dysfunction on left side of dental arch. A unilateral distal extension removable partial denture (RPD) replacing lower-left molars was selected. Tomographic images were obtained using Fluorine-18 NaF positron emission computerized tomography (NaF-PET)/ computed tomography (CT) before the RPD use and at 1, 6, and 13 weeks after the RPD use to observe the metabolic changes in residual bone caused by the RPD use. PET standardized uptake values (SUVs) and CT values were calculated for lower-left edentulous site (test side) and lowerright edentulous site (control side). As a result, SUVs on the control side remained static after the RPD use, whereas those on the test side increased at 1 and 6 weeks after the RPD use and then decreased. However, CT images showed no obvious changes in the bone shape and structure beneath RPD, and CT values both on the control and test sides did not change either. Discussion: This report shows that NaF-PET could detect bone metabolic changes soon after the RPD use, which cannot be detected by clinical Xrays. The SUV changes may be a mechanobiological reaction to the pressure due to the RPD use, and wearing of the RPD may increase the bone turnover beneath denture. Conclusion: This report demonstrates that wearing of an RPD increases bone turnover beneath denture immediately after the RPD use without clinically detectable changes in bone structure or volume.
Anatomical variation of the thoracic splanchnic nerves is as diverse as any structure in the body... more Anatomical variation of the thoracic splanchnic nerves is as diverse as any structure in the body. Thoracic splanchnic nerves are derived from medial branches of the lower seven thoracic sympathetic ganglia, with the greater splanchnic nerve comprising the more cranial contributions, the lesser the middle branches, and the least splanchnic nerve usually T11 and/or T12. Much of the early anatomical research of the thoracic splanchnic nerves revolved around elucidating the nerve root level contributing to each of these nerves. The celiac plexus is a major interchange for autonomic fibers, receiving many of the thoracic splanchnic nerve fibers as they course toward the organs of the abdomen. The location of the celiac ganglia are usually described in relation to surrounding structures, and also show variation in size and general morphology. Clinically, the thoracic splanchnic nerves and celiac ganglia play a major role in pain management for upper abdominal disorders, particularly chronic pancreatitis and pancreatic cancer. Splanchnicectomy has been a treatment option since Mallet-Guy became a major proponent of the procedure in the 1940s. Splanchnic nerve dissection and thermocoagulation are two common derivatives of splanchnicectomy that are commonly used today. Celiac plexus block is also a treatment option to compliment splanchnicectomy in pain management. Endoscopic ultrasonography (EUS)-guided celiac injection and percutaneous methods of celiac plexus block have been heavily studied and are two important methods used today. For both splanchnicectomies and celiac plexus block, the innovation of ultrasonographic imaging technology has improved efficacy and accuracy of these procedures and continues to make pain management for these diseases more successful.
Introduction. Submandibular abscesses often appear as a consequence of negligence in maintaining ... more Introduction. Submandibular abscesses often appear as a consequence of negligence in maintaining hygiene and oral health; however, sometimes as a result of the lack of anatomical obstacles in this body area, inflammatory processes can easily spread to neighboring space, as well as distant locations, reaching even the mediastinum. Case report. A 26-yearold woman without a clinically relevant history was admitted to the Maxillofacial Surgery Department because of an abscess involving the submandibular and parapharyngeal space on the left side. It is likely that initially the submandibular abscess reached subsequently the parapharyngeal space, turning into the neck phlegmon with an extremely rapid clinical course despite appropriate treatment. Eventually, the submandibular abscess covered the neck space and moved to the mediastinum where the empyemas were created, necessitating life-saving thoracic surgery. Conclusion. Only conscious prophylaxis and prohealth attitude of the patients c...
Introduction: Iatrogenic nerve injury during surgery is a major source of concern for both patien... more Introduction: Iatrogenic nerve injury during surgery is a major source of concern for both patients and surgeons. This study aimed to identify the nerves most commonly injured during surgery, along with the commonly associated operative procedures. Materials and Methods: A literature search was conducted using the PubMed database to identify nerves commonly injured during surgery, along with the surgical procedure associated with the injury. Results: The following eleven nerves, ranked in order with their associated surgical procedures, were found to be the most commonly injured: (1) intercostobrachial nerve in axillary lymph node dissections and transaxillary breast augmentations, (2) vestibulocochlear nerve in cerebellopontine tumor resections and vestibular schwannoma removals, (3) facial nerve in surgeries of the inner ear and cheek region, (4) long thoracic nerve in axillary lymph node dissections, (5) spinal accessory nerve in surgeries of the posterior triangle of the neck and cervical lymph node biopsies, (6) recurrent laryngeal nerve in thyroid surgeries, (7) genitofemoral nerve in inguinal hernia and varicocele surgeries, (8) sciatic nerve in acetabular fracture repairs and osteotomies, (9) median nerve in carpal tunnel release surgeries, (10) common fibular nerve in varicose vein and short saphenous vein surgeries, and (11) ulnar nerve in supracondylar fracture surgeries. Conclusion: Although the root cause of iatrogenic nerve injury differs for each nerve, there are four unifying factors that could potentially decrease this risk for all peripheral nerves. These four
This is a PDF file of an article that has undergone enhancements after acceptance, such as the ad... more This is a PDF file of an article that has undergone enhancements after acceptance, such as the addition of a cover page and metadata, and formatting for readability, but it is not yet the definitive version of record. This version will undergo additional copyediting, typesetting and review before it is published in its final form, but we are providing this version to give early visibility of the article. Please note that, during the production process, errors may be discovered which could affect the content, and all legal disclaimers that apply to the journal pertain.
An estimated 1.4% of the population worldwide has been diagnosed with Gender Dysphoria, as define... more An estimated 1.4% of the population worldwide has been diagnosed with Gender Dysphoria, as defined by the Diagnostic and Statistical Manual of Mental Disorders. Gender reassignment, which holistically encompasses psychotherapy, hormonal therapy and genital and nongenital surgeries, is considered the most effective treatment for transgender non-conforming patients afflicted with gender dysphoria. Little research is currently available identifying the psychosocial needs of the transgender population and their access to preventative and primary care during this transitioning process. This article presents an overview of the evolution and current approaches to genital surgical procedures available for both male-to-female, as well as female-to-male gender-affirmation surgeries. This article is protected by copyright. All rights reserved.
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