Virility and fertility

Second Opinion/ Dr Yatish Agarwal

I am a 25-year-old male. My left testis was removed at 11 years of age because of a developmental anomaly. The testis had not descended into the scrotum. Now I am getting married and worry that this would hamper my sexual prowess and fertility. I am not also sure if my penile size is adequate. Do I need to go for any tests? Would any medication or exercise be of use?

—NK

Dr Avneet Singh Chawla, surgical specialist, Vardhman Mahavir Medical College & Safdarjung Hospital, says you must stop being anxious. A solitary testis is sufficient to make a man virile and allow him to produce sperms in necessary numbers to make a marriage fertile. Usually, man produces as much as three times the number of sperms required for conception, and even if you halve it, there is no ground for worry.

The male potency and penile size also has no direct relationship to the number of testis. You could, however, opt for a cosmetic procedure to get an artificial testis implanted into the empty side of the scrotum to give it a normal appearance and feel.

Excess Fluoride

My 27-year-old sister suffers from osteoporosis and skeletal fluorosis. She has marked stiffness in her neck and hip joints and is bent at the hip. She can walk freely, but because of the stiffness cannot move her neck and hip backward. Despite being under treatment for two years, there is no sign of improvement in her joint function. Can you suggest a remedy?

—Santosh Kumar

To combat osteoporosis, she needs good amounts of calcium (1000 mg/day) and vitamin D. At the same time, it would be a good idea to check why she has developed osteoporosis at such a young age. Lab tests to measure serum levels of calcium, phosphorus, alkaline phosphatase, parathyroid hormone and kidney function may offer some useful clues.

There is also an immediate need to check the water you drink. If it has high fluoride content, you must find a healthier alternative. Further deterioration could compromise your sister’s spinal canal and lead to painful neurological symptoms. The other family members also need to be vigilant against the threat.

Pseudo Cyst

I am suffering from pancreatitis complicated by a pseudo-pancreatic cyst. Despite much treatment, the abdominal pain has not eased. Please advise.

—KR

Dr S.K. Jain, senior gastroenterologist, Sita Ram Bhartia Institute, says you have not quite described the nature of your pain.

The treatment of the pseudo-cyst depends upon its duration, location and size. If the cyst is larger than 8 cm or does not show any signs of improvement, it must be drained. There are several ways and techniques to do this. A cyst which is located next to the gut or is in communication with the pancreatic duct can be drained simply through endoscopy.

This procedure enjoys a success rate of over 85 per cent. However, if the cyst is not accessible through an endoscope, it can be drained effectively with the help of laparoscopic or open abdominal surgery.