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.