Complex Gender Reassignment Surgery: How It Ushered A New Life & Revealed Exact Sexual Identity In An International Patient

When 20-year-old Salma (name changed for confidentiality) visited Fortis Hospital, Bannerghatta little did she know how it could become a life-changing experience, for her and her family. Hailing from an ultra-conservative country, life was never easy for this youngster who was suffering from a Disorder of Sex Development. 

To be precise in explaining what exactly was ailing this youngster let us first think about the most common question any parents would face soon after having a baby, “Is that a boy or a girl?” Like all other parents, Sabina’s parents were no exception, though they had a girl child, and she was raised as a female till 10 years old but this rare disorder which hits only 1 in every 2000 kids started presenting with Masculine Secondary Sexual characteristics in her body, pushing them into dismay. After fighting back social stigma, emotional trauma, and physical difficulties, the patient with the support from family decided to go for a Gender Reassignment Surgery and consulted the expert doctors at Fortis Hospital, Bannerghatta Road for the treatment. 

Surprising it may sound, DSD though a rare condition is not unusual, and modern medicine is offering various invasive and non-invasive techniques in dealing with this intensely emotional and physically taxing disorder. 

Before you read further on how this individual underwent a successful Gender Reassignment Surgery at Fortis Hospital, Bannerghatta Road, Bengaluru, here’s what you should know about DSD.

What Is a Disorder of Sex Development?

Disorder of Sex Development formerly known as intersex is a group of around 60 conditions where biological sexual identification of the child is unclear. This happens due to the mismatch between the chromosomes, the outward appearance of the genitals, or genetic material owing to the complex interactions between the genes and hormones. 

How To Know If The Child Has DSD?

The symptoms in patients with DSD can be present in infancy, childhood, or even during teenage and they may vary. Few cases may have mild DSD which can be corrected with minimal surgical interventions. 

What Are Mild DSDs?

Clitoromegaly: It is a condition where a girl’s clitoris is larger than the average size

Hypospadias: Under this condition, the boy’s urinary opening is at the underside of the penis than at the tip

Severe Or Significant DSD:

Known as Ambiguous DSD, it is a rare condition where the gender of the child cannot be determined by looking at the genitals. This difference can be caused due to:

• Genetic changes that could have been inherited and non-inherited
• Intake of certain medications during pregnancy that can trigger hormonal changes in the fetus
• Lack of own hormonal stimulation in the baby while in the tummy
• A developmental problem where the lower abdomen or urinary bladder were not formed properly

How Doctors At Fortis Hospital Ushered A New Life to ‘S’?

When the patient visited the expert urologists, urology surgeons at this world-class facility, she and her family were anxious, hoping to find a solution for a lifetime. After running a few tests, the individual was diagnosed with male Pseudohermaphroditism, a condition in an individual with external genitalia that resembles those of a female testis. On further evaluation, the patient was found to have male gonads intra-abdominal testicles, underdeveloped penis, and perineal Hypospadias, and a rudimentary vagina.

Karyotyping - a test that pairs and studies the order of chromosomes to understand the individual’s genetic mapping revealed that the patient had 46, XY karyotype which is a genetic condition that reveals that the patient is dealing with a genetic male who was under masculinized during fetal development.

After assessing the physical, emotional, and mental wellbeing of the patient, doctors recommended Gender Reassignment Surgery. Dr. Mohan Keshavamurthy –Director- Department of Urology- Urology, Uro-oncology, Andrology - Transplant & Robotic Surgery, said, “While conducting a gender reassignment surgery from a male to a female is easy, the female to a male reassignment is a complex and time-consuming process.

The surgeons worked on the reassignment procedure by moving an undescended testicle into the scrotum and permanently fix it there using the Da Vinci system. It was followed by repair of perineal Hypospadias wherein the opening of the urethra is like that of a female, by constructing 10cm of the additional tube using Buccal mucosa a technique known as buccal mucosal urethroplasty, and the rudimentary vagina was excised.

Also, a malleable penile prosthesis was inserted into the rudimentary corpora tissue that enlarges with blood for the process of male erection and enables him to perform sexually as a potent male. Malleable Penile Implant Is an Effective Therapeutic Option in Men with Erectile Dysfunction.

Dr. Basavaraj Neelgar- Consultant Urology, Uro-oncology, Andrology - Transplant & Robotic Surgery, Fortis Hospital, Bangalore, also stated that “Gender Reassignment Surgery (GRS) has become more common today in India as recognition both social and legal is provided for the LGBTQ+ community. The need to allow a person to have an appropriate body habitus to the make-up of the mind is extremely important for the holistic living.”

The most advanced and sophisticated procedure Buccal mucosa that was successfully performed on the patient according to NCBI, is an ideal urethral substitute because of ease of harvest, surgical handling characteristics, hairlessness, compatibility in a wet environment, and its early in-growth and graft survival. Because of these unique characteristics, buccal mucosa has endeared itself to the realm of reconstructive urology.”

After undergoing this Complex Gender Reassignment Surgery at Fortis BG Road, Bengaluru the patient stayed in the hospital for a week and was discharged in full health, to lead a new life!

For More Information on Urological Conditions and Treatments: Contact: Fortis Hospital, Bannerghatta Road, Phone: +91 9663367253

Also Read: https://fortisbangalore.com/speciality/best-urology-kidney-hospital-bangalore