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Have one testicle lower than other and penis got larger. Should I go for surgery?

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Practicing since : 1995
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My son says he needs an operation because since he was young, one of his testicles was lower than the other. Now, he is 31, and his scrotum is sagging and his penis has gotten much longer -- 11 inches (!) -- over the last 20 years as a conseqence. It is now getting in the way of work, exercise, etc. He never told us because of his personal embarassment, so I suppose the situation kept getting worse. 1. What is the name of his medical issue, as well as the solution and possible cost? 2. What is the recovery time. 3. Is this a major operation requiring hospitalization? 4. What are his options, and is it life-threatening. 5. Lastly, please give me an idea of what the medical procedure entails. Much thanks. XXXXXXX
Posted Sat, 30 Mar 2013 in Men's Health
Answered by Dr. V. Sasanka 14 hours later
It is highly likely that the problem is with the testis that is higher than it's opposite partner which is lower in the scrotum. Nature has intended that the testes remain low in the scrotum, and sometimes some men are born with a testis which has not reached the designated area low in the testis, and has remained higher up in the groin from where it should have come down.
Such a testis ideally should have been operated upon in a young age to bring it lower down, but it is never too late, and I guess the surgery that your mentioned might have been this - orchidopexy for 'cryptorchidism' meaning 'hidden testis'- where an operation is done to mobilize the testis from the groin area, and fix it to the scrotal skin so that it does not move up again.
As a surgery, this should be fairly straightforward, and it should not entail hospitalization for more than a day or two. There is no threat to life due to the surgery under normal circumstances. Cost of the surgery would vary from place to place, and I should imagine that a teaching hospital attached to a university could probably be much cheaper than a private hospital.
All this is discussion is assuming that the procedure is indeed for bringing down a testis which is high up. I do not recollect myself or any other urologist I know for that matter, ever requiring to operate on anyone to take their testis up to prevent sagging of scrotum.
I would not be worried about the long size of his penis. It has no relation to his testes or scrotum. Some people would say he is naturally gifted, and it would be ideal to leave it at that, and focus on measures to avoid embarrassment, as for example, when he is wearing swimming trunks.
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Follow-up: Have one testicle lower than other and penis got larger. Should I go for surgery? 12 hours later
Dr. Sasanka,
Thank you for a most informative answer. You are saying that the problem was a testicle that remained high, rather than the one that was lower. The only inconsistency that appears to me is that he claims that his penis continued to lengthen when his scrotum continued to drop (droop). Thus, in the last ten years or so, he says his penis got longer -- associated with the droop of his testes, even though the opposite might be true. Is what he says possible, because his body should have matured -- i.e. stopped growing -- after age 20 or so? The last time I recall seeing his penis was when he was about 10 years old, and it appeared normal. Could there have been a burst of growth in the next 10 years? This is the only explanation I can think of if you say that the penis size is not associated with the problem with his scrotum.
Perhaps the issue is, in addition to the testicle that has not "dropped," that he actually wants to shorten his penis, and does not want to tell us due to potential embarassment. Is there an operation that does this? I would think the risks would outweigh the benefits due to the complexity of the blood vessels in the penis, but I would greatly appreciate your opinion. That is, the cost, recovery time, and feasibility, and other details you can think of.
As a further note, my wife is a small woman and is 4' 8." I am Asian and do not have a large penis -- about 5", so I am surprised how he can end up with an 11" penis.
Thank you again for your advice. Let me know if this is a separate medical question and requires an additional payment. XXXXXXX
Answered by Dr. V. Sasanka 9 hours later
As I said earlier, I do not recollect ever having heard of a surgery for reducing the size of the penis. I think it is inherently an extremely difficult task, and the physiology of penis would make it difficult for the penis to resume normal function as earlier after such a procedure. I am certain the testes remaining high or low will not cause a long penis ( If anything, people with a defective testis might have smaller penis in view of poor production of a hormone called Testosterone which is required for growth of the phallus in young adults).
I sincerely suggest that you speak to your son in detail about this, and make sure he understands all the consequences of going under the knife. If required, you can also consult the doctor who recommended this surgery which I think will clarify a lot of issues.
Hope I have been able to help.
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