Question: My testicle bag keeps contracting. There is no pain, but it will not stop contracting day or night. I have seen 12 doctors and had one operation, but nothing helps. Could you give me some advice?
The scrotum in males is the sac that holds the testicles. The testicles must be kept at exactly the right temperature in order to produce sperm and hormones properly. This temperature is slightly lower than normal body temperature, and this is why the testicles are slung outside the body in the scrotum.
A muscle in the scrotum, called the detrusser, contracts to make the scrotum smaller, or relaxes to make it larger. In cold weather, the detrusser contracts, brings the testicles closer to the body, and thus keeps them warm. In hot weather, the reverse occurs, with the detrusser relaxing to allow the scrotum to sag, and the testicles to move away from the body and keep cool. I suspect that you are having spasms of the detrusser muscle, which are causing your scrotal contractions. These may be very difficult to stop, but a low dose of a muscle relaxant such as Valium may be tried.

Question: How effective are the operations to insert an inflatable prosthesis in the penis to overcome impotence in a 64 year old man?
This operation is the absolute last resort in the treatment of erectile failure in a man. It is necessary to start with investigations to find any cause of his impotence. These causes can be as diverse as diabetes, psychological problems, pituitary tumors, thyroid disease and alcoholism, as well as a host of less common problems.
Once a cause of impotence has been found, that should be dealt with, or if no specific cause can be found, other forms of treatment can be tried. Other treatments include using a simple vacuum tube that ‘sucks up’ the penis, and a rubber ring around the base of the penis then keeps it erect. Medications such as Viagra, and the injection into the penis known as Caverject, can also give a very effective erection in many impotent men. If all else fails and the man is keen to proceed, an operation to replace the internal organs of the penis with an inflatable balloon can be used. The overall results of this operation (which is quite expensive) are good, but as with all operations, there is always a small chance of failure or complications.
It is essential that all the pros and cons of such a procedure are discussed in detail with both a doctor who is not directly involved in the procedure (eg. your general practitioner) and the surgeon.

Question: I am a young man with a sensitive problem. I believe my penis is too small. Although I know this does not directly affect the function in sexual intercourse or reproduction, it has been an issue of embarrassment and self-image while growing up. Could you please advise me as to a treatment or technique that I could use to make my penis larger?
As you correctly state, a small penis has no effect upon your ability to father children, and continued reassurance on this point may help you gain confidence in your ‘manhood’.
The size of the penis varies from one person to another, in the same way that some people have big noses while others are small. There are no prizes for having the largest nose on the block, nor are there for the size of any other parts of your anatomy. The only people who will ever need to be aware of your problem are yourself and your wife or other sex partners.
The size of the penis does not determine whether a man is a good lover or not. Women appreciate the foreplay and fondling as much as the sex act itself, and if you can become skilled in the former, you will keep any woman happy. Even during intercourse, the most sensitive part of a woman’s sexual organs are the clitoris, which is at the outside entrance to the vagina, and the so-called ‘G spot’ which is just inside, and on the front wall of the vagina, at a point where even the shortest penis can give stimulation.
As a last resort, if you really do want to compete with others in size, there is a plastic surgery technique available. Do not underestimate your prowess; you will be able to satisfy the sexual appetite of any woman if you approach her in the right way.

Question: I am 58 and I have had a constant embarrassment because of an underdeveloped penis and testicles. As a result, I have never married or indulged in sexual intercourse. Do you know of anyone who can help me?
Small testicles and penis may function just as well as large ones, and may be merely a developmental problem, in the same way that some people are tall and others are short. At your age, hormonal treatments are not likely to be successful, but you should be examined by a general practitioner to ensure that your testicles are not developing any sort of tumor, and that the hormonal balance in your body is correct.
When seeing your GP, I would suggest that you ask for a referral to a psychiatrist. This is not because I think you are mad or crazy in any way, but a psychiatrist may be able to help improve your self-esteem, and cope with a problem that has obviously preyed on your mind for several decades. Provided your GP’s check up shows no problems, there is no reason why you should not enjoy normal sexual relations, because you are certainly not too old for that. There are many lonely, older women who would love to have a caring partner.
As a last resort, and one I would not recommend without psychiatric counseling, you could see a plastic surgeon to have penile and testicular implants inserted. This is a radical procedure, and not without its problems.