What is an Undescended Testis?
An undescended testis is a defect that happens before birth when a testicle has still not moved to its correct position, which is the scrotum or the bag of skin hanging below the penis.
This condition usually affects one testicle, but, in a few cases, the condition may effect both testicles, thereby keeping them undescended.
An undescended testis is commonly seen in premature male child.
In most cases, Undescended testis gets recti�ed on its own, as the undescended testis moves to its appropriate position within the �rst few months of life.
However, if this condition is not corrected on its own till 6 months of age, then a surgery is required to move the testicle in to its correct position.

What are the signs or symptoms of an Undescended Testicle
If you cannot see or feel a testicle in the baby’s scrotum, then this may be due to an undescended testicle.
When the foetus is still developing, testicles are formed inside the abdomen.
In normal development of the foetus, the testicles descend from the abdomen, into the scrotum, through the tube-like passage, into the groin (inguinal canal).
The above process, happens in the last couple of months of normal foetal development. When this process is halted or delayed, it leads to the condition called Cryptochordism or Undescended Testicle.

When should you consult a doctor an undescended testicle ?
An undescended testicle gets identi�ed in the post birth examination of the baby boy.
If this happens, the baby boy will need to be examined regularly, and you should check with your doctor on the frequency of the baby boy’s examination.
It is often noticed, that if the testis has not moved to the scrotum within 6 months, chances are, the condition may not get recti�ed on its own.
Getting the baby boy treated for undescended testicle may lower the risk of complications in the future, like testicular cancer and infertility.
Some boys may have been born with normal testicles at birth, but the same might appear missing later. This may happen due to the following reasons:

Retractile Testicle – In this, the testicle moves back and forth, between the scrotum and groin. This may happen due to a muscle reflex in the scrotum, and may be easily guided into the scrotum with the hand, during the physical examination.
Ascending testicle – In this condition, the testicle moves back to the groin and cannot be guided back to the scrotum with the hand. This is also called acquired undescended testicle.
The corrective surgery is orchidopexy means fixing the testis in scrotum. The testis lying inside the abdomen needs laparoscopic orchidopexy.
It is best to speak to your paediatrician or doctor if you see any changes in your son’s genitals or are concerned about his developments.
To book an appointment with Dr. Prashant Jain, the best paediatric surgeon in Delhi, Call (+91) 8766350320.

Risk factors of Undescended Testicles
Factors that might increase the chances of having an undescended testicle are:

Premature birth of the baby boy
Low birth weight of the infant
Complications associated with Undescended Testicles
Testicles need to be cooler than the normal body temperature, so they can develop and function normally. This environment is provided by the scrotum. In case of an incorrect placement of the testicle, following are the complications that may arise:

Testicular Cancer – develops in the cells of the testicles that produce immature sperms. Men with undescended testicles are at a higher risk of having testicular cancer. This risk increases if the testis is located in the abdomen instead of the groin, and when both testicles are affected. While the cause of cells developing into testicular cancer is still unknown, surgical correction may reduce the chances but does not eliminate the risk completely.
Fertility problems – Men with undescended testicles may develop low sperm count, poor quality sperm and reduced fertility the condition is ignored or left untreated for a long time.
Other complications associated with Undescended testicles are:
Testicular Torsion – This condition is painful as it cuts off the blood supply to the testicle. This happens when the spermatic chord, which contains blood vessels, nerves and the tube which carries semen, gets twisted. If left untreated, it may result in the loss of the testicle. Men with Undescended Testicles are ten time more prone to testicular torsion than the ones with normal testicles.
Inguinal Hernia – Happens when a part of the intestine pushes into the groin, if the opening between the abdomen and the inguinal canal is too loose.
Trauma – The testicle may be prone to damage from the pressure against the pubic bone, if it is located in the groin.
To know more or to book an appointment with Dr. Prashant Jain, the best paediatric surgeon in India, Call (+91) 8766350320.

Diagnosis of Undescended Testicle
Doctors may recommend the following types of surgery for the diagnosis and treatment in case of an undescended testicle.

Laparoscopy – Laparoscopy helps �nd out an intra-abdominal testicle. A small incision is made in the abdomen, post which, a small tube containing a camera is inserted.
In some cases, an additional surgery may be needed if the doctor cannot rectify the testicle’s
position during laparoscopy.
In case laparoscopy shows the absence of a testicle or a small remnant of the testicular tissue, then the same is removed.
Open surgery – This type of a surgery, requires a slightly bigger incision when testis is lying in groin.
Post the birth of a boy, if the doctor notices that the boy’s testicles are missing in the scrotum, he may do a few tests to see if the testicles are undescended or are absent.
If left untreated or undiagnosed, absence of testicles may cause serious medical problems post birth.
It is not recommended to go for an ultrasound or an MRI for the diagnosis of an Undescended Testicle.
Treatment of an Undescended Testicle
Treatment helps in moving the undescended testicle in to it’s appropriate position in the scrotum.
It is recommended that surgical intervention happens before 18 months of the child’s age. Earlier the treatment happens, better it may be, as treating the infant before one year, may reduce complications.
Following are the different treatment for Cryptochordism or Undescended Testicle:
Surgery
The process of the surgeon, moving the testicle back into the Scrotum and stitching it to place, is called Orchiopexy. Laparoscopy or surgery is used to carry out this process.
A number of factor’s, such as, the infant’s health or the level of the surgery’s complication, may determine how soon the surgery or correction of the undescended testicle can be carried out.
The surgery may be recommended when the child is between 6-12 months old. Early surgery reduces the risk of complications in the future.
The surgeon removes the tissue, in case he sees that the tissue has not developed properly or is an abnormal or a dead tissue.
The surgery also repairs an Inguinal Hernia that may occur due to the Undescended Testicle.
Post surgery, the testicles are regularly monitored to con�rm if it is staying in place and is developing properly. This is done through physical exams, Ultrasound examination of the scrotum and by testing of hormonal levels.

Other Treatments
Saline Testicular Prosthesis treatment, which gives the scrotum a normal appearance, may be considered, if one or both testicles are missing or did not survive post surgery.
An Endocrinologist or a hormone specialist may be referred if the child does not have even one testicle which is healthy.
Endocrinologist helps with future hormone treatments that are necessary to bring about puberty and physical maturity.
Results
Orchiopexy, mostly has a 100% success rate. Post surgery, the fertility for males with Undescended Testicle is nearly normal, however, for males with two Undescended Testicles, the chances are 65%.
While surgery might reduce the risk of testicular cancer, it still does not eliminate it.

Lifestyle changes and remedies at home for Undescended Testicles:
It is important to ensure that the testicles are developing normally, even after the child’s surgery. Being aware of the development of your son’s body and checking the position of his testicles regularly, helps him in the long run. This can be done while changing the diaper or while bathing him.
Talk to your son about the physical changes that are about to happen, when he reaches puberty.
Teach and encourage him to check his testicles regularly, as self-examination can help with the early detection of tumors.
How to cope with and support your son with Undescended Testicle Your son may be uneasy or sensitive about looking different, especially if he has to change his clothes in front of his friends or classmates, in a sports or in a school drama changing room. Guide him with the following tips, to help him deal with anxiety

Practice him to come up with a response if he is asked or teased about his condition
Let your son know that he is healthy, even if one or both the testicles are missing, and that there are two testicles in the scrotum
Teach your son to use the right words when he is talking about testicles or scrotum
To make the condition less noticeable, let your son wear loose-�tted swimming trunks or boxer shorts, so he is comfortable while changing clothes in front of others
Be watchful or aware of any behavioural changes, like not enjoying the sports or activities he he earlier used to
Speak to him about testicular prosthesis and discuss if it is a good option for him
What to ask your doctor if your son has undescended testicles
An undescended testicle is a birth defect, and is identi�ed in the post birth examination. This condition is monitored through regular examination of your infant. Here are a few questions that you can ask your family doctor or your paediatrician:

What are the different tests that my son will need to undergo?
Which option would you recommend as a treatment?
Can you recommend a specialist, to whom i can show my son’s condition.
to build my knowledge about my son’s condition, can you recommend a few websites or give me some brochures that i can read at home
How frequent should my son’s appointments be?
To monitor any changes in the undescended testicle, how can i examine the scrotum at home?

Fractional Laser Resurfacing

What is fractional resurfacing?
Fractional resurfacing is an advanced technology in which only a small fraction of the skin receives the laser light. The laser delivers a series of high precision microbeams that create narrow, deep columns of tissue penetration well below the epidermis (skin surface) and into the dermis, while preserving the surrounding healthy tissue from damage. This “fractional� treatment allows the skin to heal much faster than if the entire area were treated at once, using the body’s natural healing process to create new, healthy skin cells.

What conditions does fractional resurfacing treat?
Fractional resurfacing is very effective on fine lines and wrinkles (including around the eyes), age or sun spots, acne scars, surgical scars and sun damage.

What is the recovery time?
The healthy cells in unlasered areas promote rapid healing of the entire treatment area, resulting in faster recovery time and minimal side effects. The result is softer, smoother and healthier skin without a prolonged healing period.

Vesicoureteric Reflux
Vesicoureteral Reflux Causes, Symptoms And Treatments
Kidneys are important organ for urine formation. Normally, urine flows into the bladder through ureters. However, in some children, urine from the bladder flows back through the ureters. This condition is known as Vesicouretral reflux (VUR) and is common in infants and children. It can be unilateral or bilateral. This could cause infections and damage your kidneys. VUR affects about 10% of children. Although most can grow out of this condition, people who have severe cases may need surgery to protect their kidneys.

This condition should not be ignored as it damages the function of kidneys and can lead to high blood pressure later in life. The risk of kidney damage is greatest during the first 6 years of life.

Causes of VUR:
A flap valve is located where the ureter joins with the bladder. Usually, the valve allows only a one-way flow of urine from the ureters to the bladder. Sometımes, a defective flap valve allows urine to flow backward. This can affect one or both ureters. This is called “primary vesicoureteral reflux.�

Sometimes VUR can be because of blockage at the bladder outlet(Posterior urethral valve or abnormality of the bladder functions (Neurogenic bladder) that can causes urine to push back into the ureters.

This back flow of urine is responsible for recurrent urinary tract infections and damage of kidney (Renal scarring).

Symptoms:
Urinary tract infection is one of the commonest presentation seen in children younger than the age of 5.

Common symptoms are:

Foul smelling or cloudy urine
Fever
Burning or pain while urinating
Frequency and urgency of urine
Vomiting

Infants may have following symptoms.

Diarrhoea.
Poor feeding.
Fever
Increased irritability
Also ultrasound scan done during pregnancy showing swelling in kidneys can be because of VUR.

Diagnosis Of VUR:
VUR can often be suspected by ultrasound before a child is born or if child has urinary tract infection. Ultrasound may show dilatation of drainage system of kidney (Pelvi-calyceal system and ureter) called as hydronephrosis, but this does not prove that reflux is present.

VUR is diagnosed using an X-ray of the bladder known as voiding cystourethrogram (VCUG). In this procedure, a thin, soft tube (catheter) is placed in the bladder through the urethra. Dye is then introduced into the bladder through the tube. X-ray pictures are taken to see if the dye flows back into the ureters. Based upon the severity, VUR is categorized into five grades. Milder grade of VUR does not require any treatment. All infants with urinary tract infection and other older children with frequent urinary tract infections with or without hydronephrosis should a be considered for VCUG test.

Treatment Options For Management Of VUR:
There are 3 main options for managing or treating VUR. One should understand the risks, benefits, and follow-up of each treatment.

Antibiotic: It is used to prevent infections until VUR goes away by itself. This treatment may take several years, and children must take medication every day. These children need to be reassessed for VUR and renal damage on regular basis. However, long term treatment with antibiotics may cause the bacteria to become resistant, increasing the risks of recurrent infections.

Surgery: This type of treatment cures most children. Surgery is good option for high grade reflux. This can be performed by open or laparoscopic technique.

Endoscopic treatment (Deflux Injection): In this day care procedure, the medication is injected where the ureter joins the bladder. Deflux is a safe and effective treatment for VUR. A gel is introduced into the body where the ureters meet the bladder. This procedure is performed as a day care procedure. Deflux gel is placed at the spot where the ureters connect to the bladder with the help of a small camera called a cystoscope (a type of endoscope used to view the bladder). Eventually, new tissue grows around the gel, preventing the reflux of urine. Usually, there will be no pain after the procedure. Deflux is used for the treatment of all grades of VUR in children. Many children have success after one injection; while some may need more injection procedures. However lower the grade of VUR, the better it works. Also, the procedure works better for children who have reflux in only one ureter.

Q-Switch for Tattoo/ Nevus Removal

Extremely short pulse, Q-switched (QS) laser systems can successfully lighten or eradicate a variety of pigmented lesions. Pigmented lesions that are treatable include freckles and birthmarks including some congenital melanocytic naevi, naevi of Ota/Ito and Becker naevi. The QS laser systems can also selectively destroy tattoo pigment without causing much damage to the surrounding skin. The altered pigment is then removed from the skin by scavenging white blood cell.

How will my skin react to the treatment?
During treatment the tattoo will appear to have a white surface layer which is the first initial sign that the process is working. This is caused by the breaking down of pigment and the reaction to the laser, this colouring will subside within a couple of hours. Immediately after treatment the surrounding skin is likely to show a red discoloration and a small amount of pinpoint bleeding may occur. The feeling can be compared to a mild sunburn where swelling and redness may last for one week. Over the next few days a small amount of blistering may occur followed by a scab or thin crust, which should be left untouched to eventually fall off. The skin will remain red for a few days to a week or two and begin to heal on its own.

All of these reactions are a normal response to the removal process and the way in which the body begins to heal.

How many treatments will I need?
Generally the average required number of treatments varies from 3-8 depending on various indications. Dr. Megha Modi will guide you according to your skin condition.

What are post treatment care?
Post treatment care is vital to ensure the treated area heals effectively to achieve your desired results. The following steps should be carefully executed:

Apply an aloe vera or antiseptic ointment to the treatment area
Avoid direct sun exposure during the entire healing process and ensure adequate SPF sun cream is applied and/or clothing is covering the area (this includes tanning beds).
Avoid prolonged exposure to water and avoid excessive heat in the skin for 48 – 72hours post treatment. Excess moisture will hinder the wound/scab from healing
Avoid scratching, picking or touching the direct or surrounding area
Cold packs or a cool cloth may be applied if further discomfort persists

Does tattoo removal hurt?
A client can expect to feel a level of discomfort however pain is an individual experience. Most may compare the pain to a flick from an elastic band.

Thread Lifting In Dwarka
What exactly is Thread Lift
Thread lifting is one of the finest procedure to redefine the facial contours and reverse some Signs Of Ageing which can help you in creating a remarkable difference to attain a youthful face.

Signs of ageing include - loosening of skin causing sagging, folds and creases due to loss of muscle mass, bone density and decreased production of elastin and collagen.

Thread lifting is a revolutionizing alternative to surgical face lift, as it is minimally invasive so it brings new hope for those who are afraid of traditional surgeries.

It is a non -surgical and quick procedure with minimum downtime and no major risks involved.

Wonders of Thread Lifting

Thread lifting helps in elevating the sagging skin of cheeks, neck, chin and jaws. So this option of anti ageing treatment is a boon especially for those who are in their middle ages ( mid thirties to late fifties )

It has also proven to be effective in younger patients who desire certain cosmetic procedures to enhance their facial feature like Eyebrow Lifting, double chin etc.

As thread lifting works against the pulling effect of gravity, it also allows jaw line reshaping establishing a chiseled frame

The results of thread lifting allows the patients to regain self confidence.

The restoration of vitality that comes post procedure is unparalleled

The trimmed face due to skin tightening also helps in reducing the visibility of fine lines and wrinkles thus making the overall appearance fresh, smooth and youthful

Somber expressions due to loose, dull and tired looking skin are replaced making the patient feel happy and stress free about their facial appearance.

How it works
So as to tighten the skin, strands of specially designed threads are inserted into the facial skin with the help of fine needles along different directions in order to create a mesh of threads resulting in firm and elevated tissues.

These barbed threads are dissolvable and the effects are long lasting (usually up to 2-3 yrs). The Polydiaoxanone threads are placed in the subcutaneous plane under the ptosed facial skin.

Local anesthetic agent is applied so there is minimum discomfort to the patient.

Thread lifting enhances production of elastin and collagen thereby increasing the durability of the results due to collagen remodelling.

Results of skin tightening and rejuvenation can be observed instantly post procedure but the toning and overall elevation keeps improving over next few months.

Why Us
We at Dermaheal Skin and Hair Clinic offer variety of anti ageing and cosmetic treatments. We ensure to provide hassle free and comfortable experience to our patients which motivates them in overcoming their doubts and fears regarding the procedures. As a result, a sense of self esteem is rebuilt along with cheerful satisfaction.

Dr. Navjot Singh Arora personally assesses and counsels the patient before planning the treatment, ensuring to modify it according to individual’s requirements.

Thread lifting can be combined with various other procedures varying from patient to patient.

Patients are properly counseled regarding the maintenance after the procedure has been performed to enhance the effectiveness of the treatments.