Is it possible to stay sexually active with one testicle?

Question

Hello doctor,

I am 31 years old. I recall that since I was about 11, one of my testicles has always been positioned higher up in my scrotum. When I look down at my genitals, I cannot see my right testicle, but my left one is clearly visible and starts from the same position next to my penis. I understand that one testicle is usually higher than the other, but this seems abnormal. It also feels stuck in place. Why is this happening?

Please help.

Answer 1

Hello,

Welcome to icliniq.com.

I have reviewed all the data you provided (attachments removed to protect the patient's identity). Normally, the right testicle is positioned slightly higher than the left, but in your case, it is positioned a bit higher than usual. During development, the testes form inside the abdomen and then descend into the scrotum. Sometimes, this descent can be arrested at any point. Proper descent is important because the testes cannot produce sperm at higher temperatures inside the abdomen, which is why they remain outside.

You appear to have mild cryptorchidism (an undescended testis). Have you had this condition since childhood, or is it of recent origin? If the testicle is positioned very high up, meaning it is not in the scrotum, surgery may be required to bring it down. However, in your case, I do not think surgery is necessary. If you have not experienced any problems and this condition has been present since a young age, there is no need to worry. But if it has developed recently or if you are experiencing any issues, I recommend consulting a urologist. An ultrasound scan may also be necessary.

I hope this helps you.

Answer 2

Hello,

Welcome back to icliniq.com.

I agree that cryptorchidism is a concern. Although it may have been asymptomatic until now, there are some known issues associated with it, such as hernia, torsion, and an increased risk of malignancy. The likelihood of developing testicular cancer in cases of undescended testes is a known complication. While the incidence of testicular malignancy in the general population is one in 100,000, it is one in 1,000 to one in 1,500 in patients with cryptorchidism.

Therefore, we may need to consider removing the undescended testis. Have you completed your family? Please consult a urologist so they can examine you and discuss the next steps in management.

I hope this helps you.

Answer 3

Hello,

Welcome back to icliniq.com.

Normally, one testis is sufficient for parenthood and sperm production. However, I am sorry to say that there is a small risk (5 to 10 percent) of developing malignancy even in a normal testis. According to some studies, close follow-up is recommended. Varicocele is a condition involving the pampiniform plexus of veins in the spermatic cord and is associated with infertility. This condition may require surgical ligation of the veins on the right side.

Regarding parenthood, even with azoospermia (low sperm count), newer technologies like IVF (in vitro fertilization) and ICSI (intracytoplasmic sperm injection) can help. With these techniques, even a single sperm is sufficient to fertilize an oocyte and form a zygote, which can then be implanted in your female partner to achieve pregnancy. I recommend getting a semen analysis to assess your sperm count. It is important to consult a good urologist now to address all your concerns.

I hope this helps you.

Thank you.