Are you hanging low?

WARNING: There are graphic pictures in this blog.

I will be completely honest, I was asked about a surgical procedure this weekend that I didn't know existed; I should have known it existed, but seeing as I am not a man and I don't think about these things, why would I know about scrotum reduction surgery?  It seems like you can get everything else nipped and tucked, so why not your scrotum!  I also had no idea how much the average man worries about this issue.

Why does my scrotum hang?
To make it simple, there is a muscle completely responsible for your scrotum to tighten and loosen up (the testicles need to be about 2 degrees colder than the body so that your sperm can swim, live, and be merry.) Your scrotum helps to regulate that by moving them closer to your body when they are super cold (think jumping into the cold ocean) and when they are getting toasty (after a long hot shower.....or run.)  The lovely muscle in charge? The cremaster muscle.  It is a two sided muscle that runs from the internal obliques, to under the testicles.  Unfortunately, just like any other muscle, and with that constant pull of gravity, it can lose muscle tone with age, and just start to droop. It's a bummer, but it's part of the aging process.  It seems that there are no true "medical" issues that arise from this issue, but it is more of an aesthetic issue, although I hear a lot of complaints about inner thigh irritation, skin " sticking" to thighs, etc causing a lot of discomfort .... and quite honestly, awkward situations.

What can I do to prevent it?
The good news for all you men out there, you can do Kegel exercises (I have blogged extensively already, so click the link and check it out if you are interested) but hey help to keep that cremaster muscle in shape; like yoga for your scrotum. Just bear with me, dig deep, and get through it!  If kegels don't work, and you feel like they are really causing you discomfort and you just don't dog staring at a sagging scrotum sack, there are surgical options: scrotal reduction.

What's the deal with scrotal reduction?
Really, all that happens is that the excess skin of the scrotum is cut off (surgically they say the skin is "excised" but all that means is they remove it by cutting it off).  It is a relatively minor surgery, and is usually one day surgery, meaning that you have the procedure (30 minutes to an hour), recover from anesthesia, and go home later that day.  The recovery period is usually 4-5 days, because the more you rest the area and allow it to heal, the better the results will be from the surgery; but immediately after the surgery you will have bruising, swelling, and some small scars (all of which will fade/go away over time).   But of course, like any surgery, there are risks associated with it, like bleeding, infection, poor wound healing (it can re-open), and chronic pain (from nerve damage). If the muscle is damaged in any way during surgery, it may create an issue with muscle mobility which can lead to sterility or decreased viability of sperm (they may be too hot or too cold in the scrotum- apparently sperm is very finicky!)  And, if you have any chronic medical conditions, it may make anesthesia more difficult for you, so you will have to be pre-screened and possibly get a letter from your Primary HCP stating that you are fit for surgery.  Most insurance will not cover this surgery, it is considered cosmetic, so be ready for a hefty bill (It can cost $850-2000 depending on who you go to, their experience, etc.)

If you are having changes due to age, or you feel like you are having problems with your scrotum, it is worth it to go talk to your HCP and see if this is right for you. If you have the means, are prepared for the complications versus what you deal with day to day, this may be beneficial for you and your lifestyle.....but try the kegels first, won't you??

Yours in Good Health
B