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Question: I have been unfertile probably since puberty but only found out after I was married at 20. The answer to Me has always been the fact that if you look at my scrotum and penis it appears at least 80% of the time as though I just stepped out of ice cold water. From what I've read the scrotum is supposed to keep the testes away from the body in order to produce fertile sperm. I have a normal size penis and yet when you look at me 80% of the time I look like an undeveloped boy. Of course this has been a source of embarrassment but when I am aroused, there is no evidence of it whatsoever. I also have inverted nipples most of the time which seems to indicate a lack of blood flow to the mucosa. No doctor has ever took me serious on this and I felt like a fool to bring it up. Have you ever heard of such a case? Years ago I was prescribed dibenzaline, and it changed the looks of my genatalia to normal but is no longer used as Flomax now takes its place and I am on that drug. I was put on Dibenzyline because the doctor determined back then that I had a spastic ureter in my bladder and it did help with urine flow. Sorry if this sounds stupid but I just NEVER had it addressed. Thank you so much for your time on this matter. Most sincerely XXXXXXX Mullett
I have had biopsies on both testes and back in the time when I was trying to have children doctors did everything then known to assess my problem and the final diagnosis was just spermajectic arrest. there was no live sperm in my seamen. I'm not talking about the usual changes in the scrotal sac, I am talking about the testicles going up inside and the sack not hanging down at all and the penis is completely shriveled to the point where there is The least possible amount of blood in it. I have seen enough naked genetenalia to know how they get when very cold. Believe me mine is not caused by the cold! Sometimes for no reason it looks perfectly normal and average where as most of the time like I said it resembles a very small child's. If testicles need to be kept at a certain temperature to produce lives sperm this is absolutely not happening with me and I was hoping you might shed some light on why. What makes the flow to that area very to such a great degree under the exact same temperature and conditions? Thank you
I have had biopsies on both testes and back in the time when I was trying to have children doctors did everything then known to assess my problem and the final diagnosis was just spermajectic arrest. there was no live sperm in my seamen. I'm not talking about the usual changes in the scrotal sac, I am talking about the testicles going up inside and the sack not hanging down at all and the penis is completely shriveled to the point where there is The least possible amount of blood in it. I have seen enough naked genetenalia to know how they get when very cold. Believe me mine is not caused by the cold! Sometimes for no reason it looks perfectly normal and average where as most of the time like I said it resembles a very small child's. If testicles need to be kept at a certain temperature to produce lives sperm this is absolutely not happening with me and I was hoping you might shed some light on why. What makes the flow to that area very to such a great degree under the exact same temperature and conditions? Thank you
Brief Answer:
Yes sir, I have read about such cases, may not be accurate though
Detailed Answer:
Hello Mr. XXXXXXX and welcome.
Thank you for writing to us.
I have gone through your query with diligence and would like you to know that I am here to help. I am sorry to hear about the insufficient amount of help you have received over time, and quite frankly speaking the knowledge and literature on such a presentation is very limited sir.
in response to your first question, yes sir I have read of such a case, but in all honesty have never encountered any such case. I do remember coming across quite some information during medical school in a subject called Human Physiology. I cannot argue with the diagnosis put forward as I am sure this was done by more than one doctor and after long and exhaustive investigations, but I do believe that the diagnosis was simply directed towards the lack of sperm in your semen and not completely directed towards the cause for it.
I do somehow believe the diagnosis should be something related to primary male hypogonadism. You may want to read more on the topic if you wish to do so, but I should again inform you that this diagnosis is very generalised and has numerous conditions categorised under it. The causes for primary male hypogonadism are numerous, and I shall go ahead and list them for you if this helps you sir. They are:
+Leydig cell aplasia
+Cryptorchidism
+Bilateral anorchia
+Noonan syndrome
+Klienfelter syndrome
+Chromosomal errors such as gonadal dysgenesis
+Kallmann syndrome
+Panhypopituitarism
+Prader-Will syndrome
+Isolated luteinizing hormone deficiency
and a few others.
I understand how the list can be long and all the conditions can be unheard of, but you can easily find information on the internet (only general) on each condition, or write back to me for any elaboration and I would be more than happy to help. Some of these conditions match your presentation of having a shrivelled penis most of the times (underdeveloped), almost absent scrotum and constantly descended testes. Poorly developed blood circulation and infertility.
Have your doctors ever considered a congenital endocrine condition (adrenal, or pituitary, thyroid, etc.)? Have you undergone any chromosomal investigations?
My sincere apologies if at all my response is too lengthy, it was just an attempt to try and fit in everything I remember from med school into my response. Please feel free to write back to me for any clarifications, or elaboration on any one point in my response, I would be more than happy to help.
Best wishes.
Yes sir, I have read about such cases, may not be accurate though
Detailed Answer:
Hello Mr. XXXXXXX and welcome.
Thank you for writing to us.
I have gone through your query with diligence and would like you to know that I am here to help. I am sorry to hear about the insufficient amount of help you have received over time, and quite frankly speaking the knowledge and literature on such a presentation is very limited sir.
in response to your first question, yes sir I have read of such a case, but in all honesty have never encountered any such case. I do remember coming across quite some information during medical school in a subject called Human Physiology. I cannot argue with the diagnosis put forward as I am sure this was done by more than one doctor and after long and exhaustive investigations, but I do believe that the diagnosis was simply directed towards the lack of sperm in your semen and not completely directed towards the cause for it.
I do somehow believe the diagnosis should be something related to primary male hypogonadism. You may want to read more on the topic if you wish to do so, but I should again inform you that this diagnosis is very generalised and has numerous conditions categorised under it. The causes for primary male hypogonadism are numerous, and I shall go ahead and list them for you if this helps you sir. They are:
+Leydig cell aplasia
+Cryptorchidism
+Bilateral anorchia
+Noonan syndrome
+Klienfelter syndrome
+Chromosomal errors such as gonadal dysgenesis
+Kallmann syndrome
+Panhypopituitarism
+Prader-Will syndrome
+Isolated luteinizing hormone deficiency
and a few others.
I understand how the list can be long and all the conditions can be unheard of, but you can easily find information on the internet (only general) on each condition, or write back to me for any elaboration and I would be more than happy to help. Some of these conditions match your presentation of having a shrivelled penis most of the times (underdeveloped), almost absent scrotum and constantly descended testes. Poorly developed blood circulation and infertility.
Have your doctors ever considered a congenital endocrine condition (adrenal, or pituitary, thyroid, etc.)? Have you undergone any chromosomal investigations?
My sincere apologies if at all my response is too lengthy, it was just an attempt to try and fit in everything I remember from med school into my response. Please feel free to write back to me for any clarifications, or elaboration on any one point in my response, I would be more than happy to help.
Best wishes.
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
Thank you Dr. Kahn and your reply was not too lengthy. As a matter of fact in my situation one can never seem to get enough information and I realize that's because everything isn't cut and dried and there are so many extenuating circumstances when it comes to the human body. What has always made it so difficult for me to understand what is that like I said sometimes my genitalia appears absolutely normal. The testes hang down a good distance and bloodflow is adequate.interestingly I did a lot of research based on some words in the previous doctors comment and the things you mentioned for me to investigate came up and I read of many of these syndromes.it made me realize that there are so many complex issues that are involved in the human reproduction system that are even unknown to science at this point and so I guess I should be happy that I have at least had a very normal and satisfying sex life with both my first wife of 18 years and my second while she was alive. Also in my more promiscuous days way back when I wasn't ashamed of my size because by the time she saw me I was a aroused. I guess all this has made me realize some have it so much worse and are not even able to have a normal sexual relations. Also that time man I was going through this trying to have children was starting 45 years ago and I guess they knew less about things then then they do now. The answer just seemed obvious to me but now I realize there's a lot more involved than I might have thought. Thank you again Dr. for your time and effort and resolving this question for me and you have done an excellent job! Most sincerely XXXXXXX Mullett
Brief Answer:
It was my pleasure entirely sir
Detailed Answer:
Hello once again Mr. XXXXXXX
I really appreciate your kind words and am really happy that you have faced normalcy for the most part of your memorable life. I honestly concur with you a 100%, medicine is developing and learning of so many more conditions, disorders, syndromes, and diseases that things keep getting worse for us as a species.
But with the limited information there is out there for so many conditions, I did try my best to provide you with as much knowledge as I had from my medical school days. Please forgive my shortcomings and I wish you loads of luck for many more beautiful memories to come.
God bless you,
Dr. Shoaib Khan.
It was my pleasure entirely sir
Detailed Answer:
Hello once again Mr. XXXXXXX
I really appreciate your kind words and am really happy that you have faced normalcy for the most part of your memorable life. I honestly concur with you a 100%, medicine is developing and learning of so many more conditions, disorders, syndromes, and diseases that things keep getting worse for us as a species.
But with the limited information there is out there for so many conditions, I did try my best to provide you with as much knowledge as I had from my medical school days. Please forgive my shortcomings and I wish you loads of luck for many more beautiful memories to come.
God bless you,
Dr. Shoaib Khan.
Note: Consult a Urologist online for consultation about prostate and bladder problems, sexual dysfunction, kidney stones, prostate enlargement, urinary incontinence, impotence and erectile dysfunction - Click here.
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
Answered by
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