What are the treatment options for small retracted testicles?

Question

Hi doctor,

I am a 36-year-old male. I have somewhat small testicles. But what really bothered me is not their size, but that they often like to retract up inside. When that happens, the scrotum will level out with the rest of the skin, and it looks like I do not have any testicles. Cold temperatures, exercise, and sexual arousal all cause my testicles to retract.

I can either force them back out into my scrotum with my hand, or they will eventually do it on their own. I do not really pay attention, honestly.

My right side does experience some pain. My biggest concern that really bothers me is the cosmetic appearance of my testicles retracting. When I get sick with a fever, my testicles hang a little. I want every day to look like this. Is this something I can get treated for?

Please guide.

Answer 1

Hi,

Welcome to icliniq.com.

I read your query and understand your concerns.

This is actually a common concern, and you have explained it clearly. The position of your testicles is controlled by two muscles, the cremaster and dartos muscles.

In some men, the cremaster reflex is overactive, meaning the testicles can retract up into the groin, especially in response to cold, arousal, exercise, or stress. This can make the scrotum appear flat or empty at times, which is exactly what you are describing.

The reason your testicles hang lower when you have a fever is that warmth causes the muscles to relax. That is also why they tend to hang lower in warm environments or after a hot shower, which is closer to the appearance you prefer.

Management options include:

Keeping warm (e.g., hot showers), reducing stress, wearing looser underwear, and avoiding cold environments can help the testicles stay in a lower position more consistently.
Opt for supportive but not tight clothing, avoid sudden temperature changes, and minimize stress, as sympathetic nervous activity can increase retraction.
In cases where the issue is persistent, painful, or causes significant distress (including cosmetic concerns), a minor surgical procedure such as cremaster muscle release can be performed to reduce the overactive reflex.

So yes, if the appearance or sensation is bothersome to you, treatment is definitely possible. Many start with conservative approaches, and surgery is a safe, effective option if needed.

I hope this answers your query. Feel free to reach out anytime.

Thank you.

Answer 2

Hi,

Welcome back to icliniq.com.

Your diagnosis is retractile testes. Surgery is called cremaster muscle release, cremasteric muscle stripping, or sometimes orchiopexy with cremaster release.

Find a urologist with a men’s health focus near you. The goal is to weaken or cut the cremaster muscle so the testicle cannot retract into the groin.

I hope this answers your query. Feel free to reach out anytime.

Thank you.