25 Mar Talking Everything Scrotums
The Penis Podcast Episode 8 | Follow on Spotify | Follow on Apple iTunes
DR JAYSON: Hi everybody, its Dr Jayson here and I’m here with my fellow Dick doctor, Dr Gav. This is the Penis Show reminding you that confidence changes everything, and today we’re talking about scrotums, Botox, scrotal enhancement and scrotal pain. Welcome, Doctor Gav.
DR GAV: Thank you, good to see you Dr Jayson, as always. And yeah, looking forward to talking more about the scrotum today and this topic which is an interesting one as there’s definitely a lot to discuss. So we’ll try and fit as much as possible in a short period of time, I guess.
DR JAYSON: So have you ever come across that Saturday Night Live skit with talking about Scrotox?
DR GAV: No I haven’t, but I think now I desperately want to see it.
DR JAYSON: You want to see it? funny. Find a link for it and we’ll put it down below! But honestly look, when people first started talking about Scrotox, I thought it was a joke too, and it shows you how there’s always more to learn. So why would somebody want to inject Botox (muscle relaxing injection) into their scrotum?
DR GAV: Well, that’s a great question, Dr Jayson. A number of reasons that I guess. Firstly for aesthetic purposes. There are guys out there who aesthetically think it’s not as pleasing to have a very tight and wrinkly scrotum, as simple as that. They believe that it would look much nicer if it was wrinkle free and relaxed.
DR JAYSON: Almost anything would make it look nicer wouldn’t it? It’s almost like the archetypal insult we say, that you look like a scrotum.
DR GAV: That would be one major reason and you know, that’s something that genuinely concerns some guys who are actually looking for genuine solutions. So, of course, one of the main treatments would be using some kind of wrinkle relaxer to relax the scrotum and give that smooth appearance.
DR JAYSON: So a muscle relaxing injection? what muscle are we injecting if we’re injecting into somebody’s scrotum?
DR GAV: So for purely aesthetic reason of the external part of the scrotum, it’s a very superficial muscle surrounding the scrotum, which is called the dartos, I guess people refer to it as and it’s really quite superficial, just under the skin. It’s what’s surrounds the scrotum and causes that tightening and wrinkling of the superficial skin itself.
DR JAYSON: Yeah. It’s as you say intimately bound to that deep surface of the skin and wrinkles it up quite significantly, giving it that Scrotal texture to it and so when we’re doing this treatment, it’s relatively easy to tell where we need to inject and where not to, because you can see that wrinkly nature to it. When you come up close to where the scrotum is attaching to the lower abdomen it goes smooth again as you don’t have that dartos muscle there. But yes, you can inject it there, you might have to put some numbing cream first because it’s a lot of needles and yes, and then possibly smooth it out. And of course, there are some guys who not only want the skin to be smoothed out, but also want it to hang lower as well.
DR GAV: So that might involve a different muscle, which is responsible for retracting the testicles themselves, as well as treating at the same time, the dartos and the outside.
DR JAYSON: So this is where we find another link to one of those videos of those kung fu masters getting kicked in the groin and not just feeling over because the testicles, which means it comes from inside your body, like with women and their ovaries being an internal organ, when guys it’s actually come to hang outside of the body because in most mammals (spermatogenesis) the creation of sperm is better at a slightly lower temperature, like thirty five degrees instead of thirty seven degrees (our core temperature) and that’s why testicles hang out in the breeze. You wouldn’t think it’s something that’s vital for reproduction.
DR GAV: No, so hence why they may have the ability from an evolutionary perspective to retract again, very significantly.
DR JAYSON: Yeah that’s why when a boy is born, one of the things that’s checked is seeing if the testicles have descended, which are then grabbed and given a stretch. It’s quite a strange thing watching your son get that! But yes, they can then also retract and if you’re trained, you can learn to retract your testicles right back up into your abdomen! It’s also a reason why men tend to get more inguinal hernias in this region from the weakening caused as a result of that tract of the testicle coming through the abdominal walls. So with this, it can actually track all the way down into the scrotum itself, we’ve got this muscle that retracts and so just like we can with the muscle relaxant injections elsewhere, we can also inject it into a frown and decrease it into this Cremaster muscle and allow the testicles to hang lower. My experience is that, it’s the guys who already tend to hang somewhat low, who’s Cremaster has been relaxed are now swinging who really like that! They like them to hang him way down low. Also guys who seem to naturally have very tight scrotums and testicles close to the body, even when they’re injected, it’s hard to get the same hang and swing in them. That’s been my experience, what about yourself?
DR GAV: Yes, definitely a similar experience and it’s strange, having injected wrinkle relaxer into other areas of the body and seeing it work incredibly effectively. In fact, there’s no chance of being able to frown (forehead), after wrinkle relaxer, if you use the right dose. But in the case of the scrotum and the Cremaster muscles, it seems to be a more different kind of muscle that has a reflex mechanism to it. It may get them to hang lower in certain situations, but they still have the ability to retract, which is not really the same in other areas of the body. But overall, they say when they’re warm and relaxed, it hangs lower and it is a better feeling, especially if this has caused them some pain in the past. But in the really cold situations where they tend to retract more, they still have the ability to a little bit, maybe a little bit disappointing that it’s not always that relaxed.
DR JAYSON: Yeah, well, you mentioned something actually really important there! That scrotal pain! Sometimes we’ll have guys who come to us purely for this reason! Usually they’ve seen their GP or a urologist and that’s definitely my preference, that they’ve seen a urologist and been checked out and found that there’s nothing else that we need to be worrying about because it’s just as important as women doing their breast checks, men should do scrotal checks.
DR GAV: Especially if there’s something causing them pain.
DR JAYSON: Yeah, when did you last do your testicular check, Dr Gav?
DR GAV: Definitely haven’t been to see another Doctor for checking it out.
DR JAYSON: I got to admit, I probably don’t check my scrotum myself, but maybe I should make a commitment that I’ll get it done because if it’s done early, testicular tumours are often treatable in the early stages. And unlike something that’s growing on your kidney or liver, which you can’t really get in and feel, this is something could feel by yourself. So most guys wouldn’t know that you’re supposed to check your own testicles, so this is a thing and there are good health reasons behind doing it. But, assuming that you’ve been checked out and there’s no cause found for the pain, it is what is often termed idiopathic pain. It means that the doctors are idiots and they can’t find the cause of it.
It does make sense. But yes, basically, we can’t find the cause.
DR JAYSON: So yeah, so in fact most commonly we can’t find the cause of this of this pain. So it’s been attributed to a number of things and sometimes it’s put down to this tension. In fact, guys will often describe it as a tension or tightness, or squeezing of it. And these guys usually do tend to have a very tight scrotum. They don’t come in usually with the usual dangly sort of testicles that usually seen. And so I think it seems reasonable. There have been a number of studies that have looked at injecting the muscle relaxing injections (the same thing that we used to frown lines and crow’s feet) into both the Dartos (the superficial skin muscle) and then deeper into the Cremaster and with only moderate success. However, if you’re someone who’s had success with the treatment, well, then that’s great! One of the difficulties with the treatment is the Cremaster injection is that it’s a little bit deeper in and the muscle there, also has the sabbatic cords (responsible for bringing the semen from the testicles into the penis), there’s actually this network of veins that go around it as well, and I think part of the reason might be why the injections don’t always work in the Cremaster is that instead of having all the botulinum toxin to relax and stay in the muscle, it tends to get into one of these veins and then washed off into the bloodstream which then disappears, not having any effect anywhere. They also are relatively expensive sort of procedures (botulinum toxin), especially when you can’t guarantee one hundred percent it’s going to work. And we’re using relatively big doses, so now the question is, should we be using bigger doses to get the effect? But I’ve certainly had a number of guys who have found it to be worthwhile and I think you’re saying that you had the same experience?
DR GAV: Yeah, definitely, even if it’s not 100 percent effective all the time, and the relief created is 50 percent of the time compared to before, that’s still a big improvement. I’ve always found it very interesting that it has the ability still to retract after a high doses of botulinum toxin.
DR JAYSON: Yeah. And the difficulty sometimes that I guess that people face is that even they’ve been to their GP or urologists they receive shrugged shoulders and replies saying they don’t know why it is so tough. So to at least have an alternative and get some level of relief, which is something. And one of the other theories is that it’s a vascular sort of pressure and there have been a number of articles also talking about decreasing pressure in that area, but starts to get really tricky. And again, it’s not a surgery I think that’s necessarily widely available. But just when I was doing research on it, I found there had been a number of publications, I just don’t know anybody in Australia even who specifically does that kind of that kind of surgery here.
DR GAV: One other interesting thing I’ll mention about this procedure is a number of patients who believe it may be a side effect of some medications. Certainly there are some out there that may cause some type of contractional muscle.
DR JAYSON: One that springs to mind that a patient was telling me about was his ADHD medication.
DR GAV: Was going to mention that exactly. And there’s a little bit of a trend saying a few with this same issue believe that they get pain from the tight contraction of the muscle probably from medication they’ve been on for a long period of time.
DR JAYSON: Yeah and the problem is they need that medication to function and then, yeah it’s giving them pain and it’s another reason for them not to be on that medication.
DR GAV: Ok well-
DR GAV: So I guess that’s something we commonly treat and see guys asking questions about- the aesthetic concerns of the scrotum, relaxing the muscle, making it look smoother, and then the guys who have pain because of that contraction. There’s also people who may want to enhance the scrotum and make it larger.
DR JAYSON: Yes, I wasn’t sure we’re going to get to that right now. So, yes, there’s obviously some guys like having that big bulge in their pants, and there have certainly been a number of things injected into scrotums over the years. And in fact, there also exists a kink where saline is injected for enjoyment, which is just sterile water stretching the scrotum up. But no, what we’re talking about here is a longer term augmentation of the scrotum. Previously guys have injected or had injected silicone, but which is a permanent filler into that area. And the amazing thing is that for the majority of them, it didn’t immediately get infected and drop off, something that would worry the hell out of me! Guys, whatever you do, don’t get silicone injected into you, it might be good for a day, a week, 10 years, but it can go very wrong. So silicone. Definitely not in favour of it. But we can inject the similar sort of fillers that we inject for CALIBRE procedure, that hyaluronic acid gel filler that’s completely safe. There are different kinds of fillers. There’s firmer and softer fillers. The good thing with the firmer fillers is, they tend to last longer and when that’s injected into the shaft of the penis to augment it, it’s going to last a long time which is great. Whereas when you inject a really firm filler into the scrotum, it can actually feel like a third testicle, which is not necessarily the desired effect, even though it augments the volume. It takes a lot of volume to create that increase in size. You put 10 mils into a scrotum and it virtually disappears, so 20 mils in and you start to get some noticeable increase in size. But yeah, it’s an area that can swallow up a lot of product, so to speak.
DR GAV: Sure.
DR JAYSON: So yeah, I get the occasional person who will come in requesting this sort of thing and I think for the majority of guys, it can be the cost that perhaps prevents them from going ahead with it, making it a less common procedure. Here in Australia, of course, fillers are quite expensive and when you’re injecting 30 miles in, it becomes an expensive procedure. When you compare it to somebody having, say, one mil just injected in their lips, 30 mils in a scrotum, is a lot.. And then, there have been surgical options as well including silicon options, ones that actually sort of fit like a cup onto the testicle itself and can add an increase in in size. The downsides of that, goes against the very purpose of the scrotum hanging out for the temperature as you now have insulating silicone that heats you up, which may result in a viably low sperm count and if you’re wanting to produce children, then that’s not an ideal. The other is that it also hides half/ two thirds of the surface of the testicle. And if you were to get one of those testicular lumps on your testicle, then you wouldn’t be able to feel it. Personally the idea of having a solid silicon cap on a testicle, doesn’t really appeal to me generally, I don’t favour that as an option for scrotal enhancement.
DR GAV: Mm hmm. All right well, there’s what’s not to do and things that can be quite dangerous, really especially in mentioning at the very beginning there, the silicone injections that can have fatal consequences. I know I’ve seen a few programs on television about some really sad cases. So yes, there are some things you really should be avoiding especially in the non-medical setting. But there are things that we talked about today that can be done and that we’ve had some results with, so if you have any more questions regarding the scrotum, feel free to post and comment below and we’ll try our best to get back to you.
DR JAYSON: Great. OK, well, I’ll look forward to talking to you again soon, Dr Gav.
DR GAV: You to Dr Jayson, great to be here as always and don’t forget guys, confidence changes everything.