Dear Dr. G,

I need your help.

I am 23-years-old and confess to having an embarrassing problem.

I only have one testicle, but it has never really bothered me as I never paid much attention to it.

Until now, that is.

I met this girl in university and the relationship is getting serious. No, we have not started having sex yet, but my girlfriend has noticed that I keep my genitalia “under wraps” so she does not find out about my condition.

To be honest, I am very anxious and concerned my congenital malformation will compromise my sex life.

What are the potential effects of my condition? Are men with one testicle more likely to have less potency and erectile rigidity? Is their ejaculate less fertile?

Anyway, since nature has only granted me one testicle, what can I do to improve my sexual performance?

And by the way, what happened to my other testicle?


Undescended testicle or cryptorchidism, is a testicle that did not move into its rightful position in the scrotal sac.

The movement of the testicles into the scrotum usually occurs in the final stages of gestation, hence an undescended testicle is more common amongst boys born prematurely. The testicles are supposed to be pulled by gubernaculum through a passageway in the groin (inguinal canal) and dropped into the scrotum. Of course, such processes can be ceased or interrupted along the way, resulting in cryptorchidism.

The exact cause of undescended testicles are unknown. Maternal exposure to excessive alcohol, female hormones, genetic causes and the poorly developed testes may be responsible for it.

The vast majority of boys with undescended testicles have the correction done in their childhood. Such an operation requires careful manipulation of the testicle into the scrotum with stitches to fix it in place. Early intervention below the age of one appears to diminish risk of complications such as cancer and infertility.

Treatment of adult men with undescended testicles is dependent on the location of the testicles. The “missing” testicle can almost always be located by an MRI scan of the abdomen and pelvis. In most adults with undescended testicles, the testicle is usually poorly-developed or abnormal. Orchidectomy or the removal of the testicle is normally appropriate to prevent cancer.

Despite the misfortunate of the testicle lost along the way, most men with undescended testicles have normal sexual libido, erectile rigidity and ejaculatory ability. Any compromise in sexual function is usually psychological in origin.

When these men overcome confidence issues and accept the fact that the lack of one crown jewel has no impact on their ability, the one-sided empty sac is a mere “inconvenience”, rather than an “impedance”.

Martin Luther King famously said, “faith is taking the first step even when you don’t see the whole staircase.” Josh should build up the courage to see a doctor and locate that missing testicle. Once you have find it, it may require relocation or even removal. Even in the event of losing the testicle became necessary; don’t be despair, as “confidence in love is taking the first step even you don’t feel the whole scrotum”.

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