Allan Schwartz, LCSW, Ph.D. was in private practice for more than thirty years. He is a Licensed Clinical Social Worker in the states
There are several male genital disorders that are not as well known and well written about as prostate gland and other issues. Yet, these conditions cause an enormous amount of worrying and anguish for the men who have them and their partners. In the following posting, two of these will be discussed.
Peyronies Disease and Cryptorchidism are very real conditions that are the source of anxiety and depression for the small percentage of men who suffer from these problems.
Peyronies disease is a connective tissue disorder that affects the penis when it is erect. Fibrous plaques develop that cause the erect penis to bend upward. Depending on the severity of the condition it can cause difficulties with sexual intercourse, pain on entry and a slightly shortened penis. The disease usually affects men between the ages of 40 and 60 but men who are younger and older can develop the disease. However, Peyronies is not contageous and afflicts only the individual who has it. If the condition becomes severe it can cause erectile dysfunction. There is no known cause for this deformity but it is hypothesized that trauma may be a contributing factor. The men with the disorder report no awareness of any trauma having occurred. At present, the only known treatment is surgery and that is not recommended unless the condition is severe.
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Men with the Peyronies become anxious and depressed with the result that they withdraw from sexual contact and avoid discussing the problem with either their partners or medical doctors. For this reason men with the condition are encouraged to talk openly and frankly with their wives or girl friends.
Psychotherapy is strongly recommended. Actually, sexual intercourse is possible for most of these men but feelings of shame about their appearance usually causes them to withdraw from sexual activity. Wives or girl friends can easily begin to think that their partner has lost interest in them because they are not attractive enough. Open and honest conversation can prevent these types of misunderstandings.
If someone is considering surgery it should be with a highly skilled urologist with a highly developed specialty in what is considered to be a very sensitive type of operation. In other words, this is not something a general urologist or surgeon should do.
Three percent of male infants are born with this condition which is one or both testicles being undescended into the protective sac called the scrotum. However, for two percent of these infants the testicle will spontaneously descend into the scrotum by six months of age. The percentage rates of infants born with this condition is much higher in those born prematurely.
There are a number of factors that may cause this condition but two of them are thought to be either genetic and or coffee drinking by the mother during pregnancy.
If the one or both testicles are undescended, the male risks infertility. Testicles produce the male reproductive cells known as sperm. In order to live and be viable, sperm need to be protected by normal body heat which is too high. The scrotum, external to the rest of the body, is the perfect environment for the sperm, preventing too much and too little heat. If the testicles remain undescended by age twelve or thirteen, when the onset of puberty begins, they will be unable to produce sperm. That is why surgery to lower the testicles is done around the age of six months. Probably the most common form of this disorder is a single testicle remaining undescended.
This condition can also cause a great deal of depression and anxiety because the affected men worry about their virility and reproductive capacity.
In actuality, an adult male with a single undescended testicle can produce children. The worry for these men are two-fold: 1) They feel self conscious about their appearance and 2) There is the very real danger that if the testicle is not surgically removed it can become cancerous. In the first case, it is possible to have an artificial testicle inserted into the scrotum so that the genitals appear normal. In the second case, it is strongly recommended that adult males have the undescended testicle removed. There is no reason why a man with a single functioning testicle should not be able to engage in sexual intercourse with full pleasure and impregnate his partner if they are planning to have children.
Parents with a male infant who is born with an undescended testicle should consult their pediatrician and, with that guidance and information, have the surgery to bring the testicle into the correct position.
In this condition as well as the first, psychotherapy is recommended in order to clarify misunderstandings.
Comments and questions are encouraged.
Allan N. Schwartz, PhD
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