apical nevus of robbery

In May, S City has gradually become hotter.

The weather has been better recently, the sky is blue and the sun is shining brightly.The air in the city also seems to be much fresher than other times.

Su Rui got up early in the morning, tidied herself up, went into the kitchen to cook noodles, and knocked on Su Wei's door, "Su Wei, get up and have breakfast."

Su Wei wore a long-sleeved T-shirt and a pair of sweatpants, and opened the door with a chicken nest head on her head, and said, "Why is it so early, and the alarm clock hasn't sounded yet."

Su Rui said, "Hurry up and wash and eat."

Su Wei had no choice but to go into the bathroom to wash up, and after 2 minutes, she came out and sat at the dining table to eat with Su Rui.

Su Rui is already in the second year of master's degree, and will be transferred to the first year of doctoral degree in the next semester.

Su Wei has also been in City S for more than a year, because he is not familiar with the place in S City, and he doesn't have any buddies here, so apart from working privately, he really doesn't have the opportunity to mess around with buddies, so he does a good job , Wages have also increased a lot.

After Su Rui finished eating, she raised Su Wei's chin with her hand, and said, "Go and shave after eating, look at your appearance, you haven't shaved for a week, I won't talk about you, you Don’t pay attention to the image.”

Su Wei wiped her mouth with a tissue and said to Su Rui, "Just say that I don't pay attention to my image, why don't you take a good look at yourself. A shirt, a pair of jeans, short hair, no makeup, no makeup, no clothes Skirt, I see you like this, I'm going to call you brother. Dad has been worried that you don't have a boyfriend, so he asked me to introduce you. "

Su Rui said unhappily, "Who asked you to introduce me."

Su Wei said, "I won't introduce it to you. Introducing it to my buddies will also harm others, a tigress, a man-in-law."

Su Rui glared at Su Wei, "Don't go too far."

Su Wei hurriedly said with a smile, "I...I'm talking nonsense, don't take it to heart. Besides, it's good, good that you are popular now with your gender-neutral beauty. It's just that you don't talk about your boyfriend. When the time comes Just don’t bring a daughter-in-law back to Dad.”

Su Rui said angrily, "Get lost."

Su Wei didn't leave, Su Rui took her things and left first.

He reversed the car all the way, because he was already familiar with this route, so he arrived at the hospital around [-]:[-].

Su Rui had already registered online, so she went directly to Director Liu Zhitao of Plastic Surgery.

Director Liu is an authoritative expert in gender plastic surgery and gender reassignment.

Su Rui came for an examination two months ago. Through B-ultrasound, CT, sex chromosome examination, and hormone measurement, it has been confirmed that he is a true hermaphrodite.

46XY, female of social gender, with delicate facial features, 177cm in height, healthy in the past, no Adam's apple, and dysplasia of breasts.

external genitalia...

The diagnosis was true hermaphroditism. According to the judgment result, one side may be ovotestis and the other side may be ovary. It is recommended to remove the testicular tissue surgically.

These results were almost within Su Rui's speculation, so they were not completely unacceptable at first like other patients.

Su Rui sat in Dr. Liu's office again. When Dr. Liu saw him, he smiled and nodded at him.

The office door is closed, no one disturbs.

Dr. Liu is in his 40s, wears glasses, and is very gentle.

He said, "How's it going?"

Su Rui sat in the chair and said, "Fortunately, I haven't felt dizzy like before recently. I think I was too tired before, which caused the hormone imbalance. It has been cured recently."

Dr. Liu smiled and said, "You are a medical student yourself, so it's good to understand your condition. But what do you think about your operation?"

Su Rui said, "I don't have time recently. If I can, I hope to have surgery in the summer vacation. But my family doesn't know my situation, so I think I need to hire a nurse to take care of me."

Dr. Liu said, "You don't tell your family that we have no way to operate on you. I told you before."

Su Rui said, "But I don't want them to know."

Dr. Liu was persuasive, "I know your psychology, but no, you still have to tell your family members that we will not perform surgery on you without your family members' signature. Besides, if you tell your family members about this kind of thing, they will not accept it." will understand you."

Su Rui pursed her lips and remained silent for a while before saying, "Well, I'll go back and think about it."

Dr. Liu smiled and said, "You, you are too stubborn. Also, you were asked to consider choosing a gender before. What do you think?"

Su Rui's hair was cut short to match the ears, but slightly longer than boys'.

His skin is fair and delicate, his eyebrows are picturesque, he is tall and his legs are long, he is really a very beautiful person.

During these years, Dr. Liu has performed more than 100 cases of gender reassignment surgery for hermaphroditism, but she has only seen a few cases of people like Su Rui whose height and appearance are so perfect.

Dr. Liu saw that Su Rui was silent and could not give a timely answer, so he said, "You have been raised as a girl since childhood. In this matter, I thought you would definitely choose to be a woman. I know you know your own situation very well. , you also know that for patients like you, we always recommend female transfiguration surgery. Besides, you said that you are not very rich in money, and the cost of plastic surgery to become a woman is much less. Your vagina and vaginal opening are well developed. Very good, if you become a complete woman, your husband will probably not know about your previous situation when you fall in love and get married in the future, which will also be good for your future life."

Su Rui looked at him and said, "Thank you, Dr. Liu. It's actually not the problem. I have experienced some things since I grew up. In fact, I think I am a woman or a man, I am me, and I don't care about it. Question. I thought, well, I'll just have the orchiectomy, and I don't want to make any other changes."

Dr. Liu was a little surprised. He has also experienced many patients. Such requests are rare, but they are not uncommon.

There was one who was raised as a boy from a young age, grew up to be in his 20s, and later developed female secondary sexual characteristics, but he did not ask to be a full man in the end, but he himself was whatever he was.

Generally speaking, with such complete self-awareness, doctors sometimes have nothing to do with their self-awareness, and they just persuade them. He respects the patient's wishes very much.

Dr. Liu said, "If you think this way, we respect what you mean. I have also done complete sex reassignment surgery on people, so although some doctors believe that the patient must be a woman for the sake of physical health, but I think mental health It is also very important. For adult patients, I always follow the patient's wishes and try to satisfy the patient's psychological gender identification."

Having said that, he asked Su Rui again, "Didn't you fall in love at all in these years?"

In fact, most of the patients in Dr. Liu's hands are adults who are married. For the sake of their lover, they can often choose a certain gender very firmly. Of course, there are also many divorced later.

Su Rui smiled at Dr. Liu, and said, "There are, too. But thinking about my situation, I always feel that being with people is also hurting people, so let's forget it later."

Dr. Liu said with a smile, "You are so beautiful, there are quite a few suitors. In fact, you don't need to worry too much about this problem. There are also many patients who get married after surgery and have a harmonious relationship. The happiness of husband and wife and family is completely excluded from your heart. Often it is not your physical problems that cause you to have no partner, but your inner problems. In fact, I still hope you can think about it again. Your conditions are very good. Plastic surgery It will be better for your future life to become a complete woman. However, as long as you think about it and keep the current appearance, we fully respect your wishes."

Su Rui nodded, "Thank you doctor."

After that, Su Rui went to check the hormones again, because he was still a little hesitant, so he still didn't decide on the operation in the end.

In fact, Su Rui still faces a problem. Even if he really wants to have plastic surgery and become a complete girl, he doesn't have the money for the operation.

The results of the hospital examination will be sent to his mailbox at that time, so he is going to go back directly.

Su Rui came down from the upstairs and walked out of the hospital gate, because this is a private hospital, the cost is expensive, and it is not covered by medical insurance, so it is not as crowded as the affiliated hospital of Su Rui School.

Standing in front of the gate, he took out his hat from his bag to put it on, when he suddenly noticed a shadow flickering on one side.

Then there was the sound of branches, and the sound of something heavy falling to the ground.

Su Rui looked over there instantly and found that someone had jumped off the building.

Su Rui ran over there quickly, and other people saw it, so everyone ran over to check the situation.

Su Rui threw away the bag and hat in her hand, and found that the patient who jumped from the building fell on the tree and was blocked by a branch, but did not die on the spot.

He hurriedly stopped the person who was going to touch the patient, and the doctor had already run over. Su Rui said that the patient was still breathing and asked to rescue him quickly.

The one who jumped from the building was a girl, about 20 years old, ordinary-looking, barely handsome, very short, wearing a hospital gown.

Doctors and nurses quickly carried the patient away and into the emergency room.

Su Rui just took the bag, put on the hat again, and was about to leave.

There were too many people begging to die in the hospital, but this was the first time Su Rui witnessed it with his own eyes. He was a little touched. He didn't know if such a young life could be saved.

Some family members of other patients knew the girl who jumped off the building, and they said next to her, "The one on the same floor as my son said she was neither male nor female, but she was not sure if it was male or female. She just had an operation and became a woman." , but his husband is about to divorce her, and the whole ward knew that she was suffering from depression, so she jumped off the building just like that."

Su Rui was a little surprised, and she stopped when she was about to walk away, but someone else was already saying, "Oh, that's so pitiful."

"I don't know if I can save him or not."

"I heard that this kind of man and woman can't bear children even after surgery. How can a man not divorce if he wants to have offspring?"

"But it's too bad to get divorced at this juncture."

"I heard that there are quite a few such patients in this hospital."

"Because the doctor here is famous."

……

Su Rui looked at them before walking away.

After walking a few steps, I looked back at the place where the girl fell. The staff had already washed the floor with water, and even the blood was hard to see.

Xie Linyun's car was supposed to go into the underground parking lot, but he seemed to see Su Rui from a distance, so he asked Chen Jian to drive the car directly in front of the building. The distance was closer, and Xie Linyun realized that it was really Su Rui, but he didn't move.

It was at this time that the jumping incident happened. Xie Linyun sat there and watched Su Rui go to the person who jumped from the building. After a while, the person who jumped from the building was carried to the hospital before Su Rui left. At that time, he didn't look at the car Xie Linyun was in.

It has been more than a year, and Xie Linyun didn't expect that he still remembered Su Rui so clearly. He obviously cut short hair, and his temperament and image were a little different from before. He was more neutral, but he still recognized him at first sight. came out, and it was still so far away.

Xie Linyun didn't want to see him, but when he saw him, he realized that he couldn't forget him all the time, and his heart seemed to be held by a hand, and he grabbed it tightly.

The author has something to say: a new volume has started, and in this volume, the two of you will have a sweet talk about love, I hope you won’t be bored to the point of shouting "show affection, let’s break up quickly" haha~~~

There may be three forms of gonads in true hermaphrodites: (3) bilateral type: both sides are ovotestis; (1) lateral type: one side is a testis, and the opposite side is an ovary; (2) unilateral type: Ovotestis on one side, testis or ovary on the other side.Among them, the ovotestis is the most common. The characteristics of the ovotestis with clear demarcation under direct vision are: the testis is soft and pink, and the texture of the ovary is hard, yellow and white.The reproductive ducts on each side coincide with the gonads on the same side, that is, the ovary has the fallopian tube and the testis has the vas deferens.

B-ultrasound, CT and other imaging and sex chromosome examination, adrenal cortex hormone and sex hormone determination are important diagnostic methods. Surgical exploration and bilateral gonadal biopsy are necessary.

治疗

Early diagnosis and treatment of hermaphroditism is extremely important, as changing gender after 2 years of age will cause serious psychological trauma.Except for female pseudohermaphroditism, almost all of them fail to achieve fertility. The purpose of treatment is to achieve sexual life as much as possible, and karyotype sex is not the final target that patients should achieve.The principle of treatment for true hermaphroditism is to select sex based on gonads, chromosomes, reproductive tract, external genitalia, etc. combined with social gender, psychological requirements, sexual function, etc., surgically resect gonads and internal reproductive tracts that do not match the selected gender, and perform internal and external genital plastic surgery.Corresponding sex hormone therapy was given during puberty.

For patients with 46XY46XX or 46XY karyotype true hermaphrodites, if the development of the penis is close to normal, there is a functional testis in one side of the scrotum, and the opposite side is an ovary or ovotestis, the testis can be kept as a male rearing.

资料表明:约1.91%的真两性畸形患者可能发生性腺的恶性肿瘤,多见于46XY核型和具有Y染色体嵌合体的患者(10.3%),而46XX者可能性为2.7%。

If patients with true hermaphroditism come to the doctor before puberty, especially preschool age, and the ovary and uterus are well developed, because vaginal forming is easier to succeed than penile and urethral forming, regardless of gender, female transfiguration surgery should be considered as much as possible.The patient's social gender is an adult female, and her vulva and secondary sexual characteristics are female. Considering the psychological requirements of the patient and her family members, sexual function and other aspects, the orchiectomy of bilateral ovotestes was performed, and estrogen and progesterone supplementation were performed.

The above is from the thesis of Dr. Chen Xuesong.