 |
| Tell your Friend(s) | |||||
|
Premarital Medical Check up - the Medical Horoscope ; Why ? (August, 2005) Premarital Medical Check up - the Medical Horoscope ; Why ? Correctable health problems in the male are many and varied. Focussing on the important aspect of sexuality and ability to procreate the following may be mentioned: Phimosis: this is a condition where the foreskin on tip of penis cannot be easily retracted. If severe and if the opening in prepuce (foreskin) is very small, a person may go through entire life span without ever exposing the glans, without ever cleaning the part and hence very liable to develop cancer or repeated infection in that part in later life. In him sex life maybe quite normal. Lesser degrees of Phimosis would also have the above mentioned problem. In addition, during sexual act, the foreskin may retract and get stuck in that position, leading to an emergency situation. This condition, known as "paraphimosis" needs urgent surgical help. Another problem is "tear" or a "cut" in the prepuce leading to brisk & alarming bleeding after sexual intercourse. The bridegroom may have to rush to the doctor after the first night with his wife! If this condition is detected by a doctor, he would advise a simple operation called "circumcision" under local anaesthesia and without need for any hospitalization. Ideally this operation should be done 3 months or more before marriage. Varicocele is distension and tortuosity of veins in the scrotum along the cord (spermatic cord ) and testis. This may produce mild pain and often it is ignored by the patient. If present for a long time, it may affect the function of testis on one or both sides and may even lead to sterility. This is due to the damage to testes and reduction in the sperm count in the semen of the person. If detected by doctor and even if it has slightly affected the sperm count, corrective surgery for varicocele will protect the testes and leads to improvement in the sperm count and hence after married life he will be able to have children. Gynaecomastia is a condition where the young adult male has an unusually large and prominent breasts. In majority of such instances it is a harmless condition and such a person can lead a perfectly normal life including sexual life and ability to procreate. But in a few such persons, there will be some hormonal imbalance. In these persons, the testis may be underdeveloped, sperm count in the semen may be very low or even absent and generally they tend to be somewhat obesce and have less facials hairs - moustache and beard. If diagnosed early and with some hormone therapy by experienced endocrinologists, there may be considerable improvement. Even sperm count may improve after treatment. Whether or not there is any hormonal deficiency, the very prominence of the beast may be quite embarrassing to the young man. He would be shy, hesitant to wear any tight dress and would avoid outdoor games particularly those where the prominent breasts show. Such persons should be supported by parents by getting rid of prominence of breasts by surgery. Previously open operation by small cuts was the practice. Nowadays we perform liposuction through tiny puncture, one on each side, hardly leaving any visible scar and with better aesthetic result. Surgery for this condition - gynaecomastia - should be completed 4 - 6 weeks before date of marriage or earlier. Those who are not likely to be able to have children will have the dilemma, whether to disclose this to the bride's parents/relatives. They have to have a frank discussion to decide on some other method of having children (test tube baby etc) or even consider adoption. Thankfully, almost always, even in such persons their sexual prowess is quite normal since testosterone (male hormone) is available in sufficient quantity. Proper counseling of the bride and groom and their close relatives by the doctor will make such marriages successful. Otherwise there would be lots of problems in both families after marriage. Few other conditions like "hypospadias" in the male, if sufficiently severe in degree may be incompatible with normal sex life. This condition can be fully corrected by one or more stages of Plastic Surgical repair. This condition should be attended to and all stages of surgery completed at least 3 months or more before the proposed date of marriage. Many young adults have lots of misconceptions and apprehensions about sexual matters in general. They are worried about effects of masturbation and nocturnal emissions which are very common in young men. They need to be counseled regarding these matters and also about methods of contraception and how to plan his family after marriage. They also need to be told about sexual hygiene and have all doubts cleared about sex. In case the prospective groom happens to have sexually transmitted disease, particularly HIV, for which at present there is no "cure", the very proposal of marriage has to be carefully discussed and considered. Some other aspects of advantages of having a "Premarital Medical Horoscope" will be discussed in our future newsletters. Be healthy; be well informed and be proactive, Dr. M.Mohan Rao, MBBS, MS, FICS, MCH,
Additional Comments (July, 2009)
|
|
In the last Newsletter on Medical Horoscope, we discussed in a general way, various aspects of such a proposal. In this Newsletter, let us see few examples where a premarital medical check up and counselling would have averted problems after marriage. 