Burns & Contractures are treated at Vasudhan.
What is hypospadias?
Hypospadias is a birth defect found in boys in which the urinary tract opening is not at the tip of the penis. Bending of the penis on erection may be associated and is known as chordee. The cause of hypospadias is not yet known, but it results from lack of complete development of the urethra. The condition occurs once in approximately 350 male births,. When we see a boy with hypospadias there is a 20% chance of finding this in another family member such as father or a brother. While surgery is better early in your child’s life from a psychological point of view, it can also be performed at a later age when necessary. There are different degrees of hypospadias, some minor and others more severe. We name the types of hypospadias according to their anatomic location, but one must always determine whether or not there is associated chordee.
Why does hypospadias need to be repaired?
Surgical correction of hypospadias involves straightening of any chordee and then extension of the urinary tube (urethra) out to the tip of the penis (the glans). The ability to stand and urinate is important for boys. When the urethra opens before it reaches the glans a boy may be unable to stand and urinate with a direct stream.The youngster who has to sit down to urinate on a toilet is at a painful social disadvantage. A straight penis is necessary for satisfactory sexual function. Although this may not seem to be an important matter in childhood, this is a crucial concern later in life. Early childhood is generally the best time for correction of hypospadias and/or chordee.
How are hypospadias and chordee repaired?
We recommend that the children have surgery to correct hypospadias at about six to nine months of age. Although we try and correct most children with one operation, about 10% will require a second surgical procedure to manage complications. If that is necessary, the second operation is delayed for one year. By performing the first operation early in life, both operations can be completed before the child is finished toilet training.
The operations performed to correct the hypospadias vary according to the degree of abnormality. The extra foreskin is sometimes needed to construct a new urethra. When the operation is completed, the extra skin is removed so the child will look circumcised. To protect the newly constructed urethra (neourethra) the urine is usually diverted with a stent (a silastic tube through the neourethra). We also leave a plastic dressing on the penis, which can be removed by the parent at home.
The prognosis is excellent for normal functioning and appearance of the penis following surgery. When they reach maturity, almost all patients will be able to have normal sexual relations and father children.
What is the Sex Change Surgery/Sex Reassignment Surgery (SRS)?
Sex change surgery/sex reassignment surgery refers to the administration of surgery to change the sex appearance according to one’s sex identity. There are two kinds of surgery. Genital surgical sex reassignment: surgery of the genitalia and/or breasts performed for the purpose of altering the morphology in order to approximate the physical appearance of the
genetically other sex. Non genital surgical sex reassignment: any and all other surgical procedures of non-genitalia or non-breast, conducted for the purpose of effecting a more masculine appearance in a genetic female or for the purpose of effecting more feminine appearance in a genetic male.
As a former step of SRS, there is a hormonal sex reassignment, which is the administration of androgen to genotype females, and administration of estrogen and/or progesterone to genotype males, for the purpose of effecting somatic changes in order for the patient to more closely approximate the physical appearance of the other sex.
When is SRS performed?
The time that people start feeling of belonging to the opposite sex is 2-3 years of age. According to the outcome of many researches, early treatment would prevent unnecessary sufferings. Physical outcome of an early treatment can be expected to be more satisfactory by comparison with starting later, especially MFs (male to female}. This is an enormous and lifelong advantage instead of having to live with a deep voice and other scar. Thus, the earlier the SRS is performed, the easier transsexuals can adjust themselves according to their sex identity, and they can avoid the confusion about themselves. But SRS is usually performed at the age of 18-21. There are two reasons for this long delay. First, most children with gender identity disorder will not grow up to become transsexuals. Second, adolescents in many countries are still legally dependent on the consent of their parents when deciding on medical treatment.
How does transsexuals feel after SRS?
On the whole, most of the transsexuals who have performed SRS were satisfied with sex change itself. Nevertheless, many of them were dissatisfied with the way their new physical Appearance. The reason for dissatisfaction is first, MFs have to do with retention of bodily features and aspects of the overall appearance that could not be changed completely by either surgery or hormonal manipulation. For example, remains of the beard, large feet and hands, quality of the voice, and persistence of Adam’s apple. Social pressure on woman to pay more attention to their appearance is also one of the reason. FM transsexuals are usually dissatisfied with their new genitals. But, the most important thing is that they could live in the new gender role feeling that their identity is fitting to themselves. They have more comfortable relationship with other people around their environment.
What Is Vitiligo?
Vitiligo (vit-ill-EYE-go) is a pigmentation disorder in which melanocytes (the cells that make pigment) in the skin, the mucous membranes (tissues that line the inside of the mouth and nose and genital and rectal areas), and the retina (inner layer of the eyeball) are destroyed. As a result, white patches of skin appear on different parts of the body. The hair that grows in areas affected by vitiligo usually turns white.
The cause of vitiligo is not known, but doctors and researchers have several different theories. One theory is that people develop antibodies that destroy the melanocytes in their own bodies. Another theory is that melanocytes destroy themselves. Finally, some people have reported that a single event such as sunburn or emotional distress triggered vitiligo; however, these events have not been scientifically proven to cause vitiligo.
Who Is Affected by Vitiligo?
About 1 to 2 percent of the world’s population, or 40 to 50 million people, have vitiligo. Ninety-five percent of people who have vitiligo develop it before their 40th birthday. The disorder affects all races and both sexes equally.
Vitiligo seems to be more common in people with certain autoimmune diseases (diseases in which a person’s immune system reacts against the body’s own organs or tissues). These autoimmune diseases include hyperthyroidism (an overactive thyroid gland), adrenocortical insufficiency (the adrenal gland does not produce enough of the hormone called corticosteroid), alopecia areata (patches of baldness), and pernicious anemia (a low level of red blood cells caused by failure of the body to absorb vitamin B-12However, most people with vitiligo have no other autoimmune disease.
Vitiligo may also be hereditary, that is, it can run in families. Children whose parents have the disorder are more likely to develop vitiligo. However, most children will not get vitiligo even if a parent has it, and most people with vitiligo do not have a family history of the disorder.
What Are the Symptoms of Vitiligo?
People who develop vitiligo usually first notice white patches (depigmentation) on their skin. These patches are more common in sun-exposed areas, including the hands, feet, arms, face, and lips. Other common areas for white patches to appear are the armpits and groin and around the mouth, eyes, nostrils, navel, and genitals.
Will the Depigmented Patches Spread?
There is no way to predict if vitiligo will spread. For some people, the depigmented patches do not spread. The disorder is usually progressive, however, and over time the white patches will spread to other areas of the body. For some people, vitiligo spreads slowly, over many years. For other
people, spreading occurs rapidly. Some people have reported additional depigmentation following periods of physical or emotional stress.