Living with one testis, also known as monorchism, is a condition where an individual has only one testicle instead of the usual two. This can be the result of a congenital condition, injury, or surgical removal (orchiectomy). While having one testis may raise questions or concerns for some individuals, it is important to note that most people with one testis lead normal and healthy lives.

Physiologically, the remaining testis typically compensates for the absence of the other, continuing to produce hormones and sperm. In terms of fertility, individuals with one testis can still father children, although fertility may be slightly reduced. Emotional and psychological aspects may play a role in how someone copes with this condition, and open communication with healthcare professionals, support from friends and family, and self-acceptance are crucial in adapting to life with one testis. Regular check-ups with a urologist  recommended to monitor overall health and address any specific concerns related to this condition.

What is “monorchism” or living with one testis?

Monorchism or living with one testis is a medical condition characterized by the presence of only one testicle in the scrotum instead of the usual two. It can be congenital (present at birth) or acquired due to factors such as trauma, surgery, or disease. Monorchism can sometimes be associated with other conditions or abnormalities, and it may require medical evaluation and management depending on individual circumstances.

Causes

Living with one testis can result from various causes, including:

• Congenital Conditions: Some individuals are born with only one testicle, a condition known as monorchism. This can occur due to developmental issues during fetal development.
• Undescended Testicle (Cryptorchidism): In some cases, one or both testicles may not descend into the scrotum as expected during fetal development. If an undescended testicle is not corrected through surgery, it may result in the loss of the affected testicle.
• Testicular Torsion: This is a medical emergency where the spermatic cord that provides blood flow to the testicle becomes twisted. If not promptly treated, it can lead to the loss of the affected testicle.
• Testicular Trauma: Injury to the testicles, such as a severe blow or crushing, can result in the loss of one or both testicles.
• Testicular Cancer: In some cases, testicular cancer may necessitate the removal of one or both testicles through a surgical procedure called orchiectomy.
• Infections or Inflammatory Conditions: Severe infections or inflammatory conditions affecting the testicles may require surgical intervention, potentially leading to the removal of one testicle.

It’s important to note that while some causes are congenital or arise during development, others may be the result of medical conditions or emergencies that require prompt attention and intervention. Individuals facing these circumstances should consult with a urologist for appropriate diagnosis, treatment, and guidance on adapting to life with one testis.

Is it possible having a baby men who have one testis ?

Yes, it is generally possible for men with one testis to father children. The testicles produce sperm, and having one healthy testicle is often sufficient for normal sperm production and fertility. The remaining testis typically compensates for the absence of the other one by producing enough sperm to maintain fertility.

However, it’s important to note that fertility may be slightly reduced compared to men with both testicles. If someone with one testis is having difficulty conceiving with their partner, consulting a fertility specialist or reproductive endocrinologist can provide insights into potential solutions or interventions.

In any case, if you have concerns about fertility or family planning and you have only one testis, it’s advisable to seek guidance from a urologist who can provide personalized advice based on your specific situation.

Is it possible having a normal sexual life men who have one testis?

Yes, it is entirely possible for men with one testis to have a normal and healthy sexual life. The testicles play a role in producing hormones, including testosterone, and sperm for reproduction. When a man has one testis, the remaining one often compensates by producing sufficient hormones and sperm for normal sexual function and fertility.

In terms of sexual performance, having one testis is unlikely to have a significant impact. However, individual experiences may vary, and factors such as psychological well-being, overall health, and any underlying medical conditions can influence sexual function.

If someone has concerns about their sexual health or experiences any difficulties, it is advisable to consult with a urologist. Open communication with a doctor can address specific concerns, provide guidance on maintaining sexual health, and offer support as needed. Additionally, addressing any psychological or emotional aspects related to having one testis can contribute to a positive sexual experience and overall well-being.

Follow up

Men with one testis can lead normal, healthy lives, but there are a few considerations and precautions they may want to keep in mind:

• Regular Medical Check-ups: Schedule regular check-ups with a healthcare provider to monitor overall health, hormone levels, and any potential issues related to having one testis.
• Self-Exams: Perform regular self-examinations of the remaining testis for any changes in size, shape, or lumps. Early detection of any abnormalities can be crucial.
• Hormone Levels: While one healthy testis can often compensate for hormone production, it’s still advisable to monitor testosterone levels. If there are concerns about hormone imbalances, consult with a healthcare professional.
• Fertility Concerns: If planning to have children, individuals with one testis may want to consult with a fertility specialist if they encounter challenges. Fertility may be slightly reduced, but many men with one testis can still father children.
• Protective Measures: Take precautions to avoid injury to the remaining testis, as injury can have implications for fertility and overall health.
• Psychological Support: Adjusting to life with one testis may involve psychological and emotional considerations. Seeking support from friends, family, or a mental health professional can be beneficial.
• Testicular Prostheses: Some individuals may choose to use testicular prostheses for cosmetic reasons. Discussing this option with a healthcare provider can provide more information.
• Sexual Health: Maintain a healthy lifestyle, including regular exercise and a balanced diet, to support overall sexual health. If there are concerns about sexual function, consulting with a healthcare professional is recommended.

It’s important to emphasize that many men with one testis lead fulfilling lives without significant health issues. However, staying proactive about health and seeking medical advice when needed can contribute to overall well-being.

Symptoms

Men with one testis typically do not experience specific symptoms solely because of having one testicle. However, it’s important for them to be aware of any changes in their remaining testis and to monitor their overall health. Here are some general considerations:

• Regular Self-Examinations: Perform regular self-examinations of the remaining testis. Look for any changes in size, shape, or the presence of lumps. If there are noticeable changes, it’s crucial to consult a healthcare professional promptly.
• Pain or Discomfort: If there is persistent pain or discomfort in the remaining testis, it should be evaluated by a healthcare provider. Pain can be a sign of various conditions, including infection or injury.
• Hormonal Changes: While one healthy testis can often compensate for hormone production, any significant hormonal changes may warrant medical attention. Symptoms of hormonal imbalances can include changes in mood, energy levels, or sexual function.
• Fertility Issues: If there are concerns about fertility, such as difficulty conceiving, it’s advisable to consult with a fertility specialist. While many men with one testis can father children, fertility may be slightly reduced.
• Emotional Well-being: Adjusting to life with one testis may have emotional and psychological implications. If feelings of anxiety, depression, or body image concerns arise, seeking support from friends, family, or a psychiatrist can be beneficial.

Diagnosis

The diagnosis of men with one testis involves a combination of medical history, physical examination, and, if necessary, additional tests. Here are the typical steps involved in the diagnosis:

• Medical History: The healthcare provider will take a detailed medical history, including information about any previous surgeries, injuries, or medical conditions related to the testes.
• Physical Examination: A thorough physical examination will be conducted, focusing on the genital area. The healthcare provider will assess the remaining testis for size, shape, and any abnormalities.
• Self-Examination Teaching: If not already familiar, the healthcare provider may educate the individual on how to perform regular self-examinations of the remaining testis to monitor for any changes.
• Blood Tests: Blood tests may be conducted to measure hormone levels, particularly testosterone, to ensure that the remaining testis is producing an adequate amount.
• Imaging Studies: In some cases, imaging studies such as ultrasound may be recommended. Ultrasound can provide detailed images of the testes and surrounding structures, helping to identify any abnormalities.
• Fertility Assessment: If fertility is a concern, a semen analysis may be performed to evaluate the sperm count, motility, and morphology. This test can provide information about reproductive potential.
• Psychological Assessment: Considering the potential impact on mental health and well-being, healthcare providers may assess the individual’s emotional response to having one testis. Supportive counseling or therapy may be recommended if needed.
• Further Testing: Depending on the specific circumstances, additional tests or consultations with specialists may be recommended. For example, if there are symptoms of pain or discomfort, further investigation may be necessary to determine the cause.

It’s important for individuals with one testis to maintain regular check-ups with a urologist to monitor their overall health and address any concerns promptly. Early detection and intervention can be crucial in managing potential issues and ensuring the best possible outcomes.

Treatment

The treatment for men with one testis depends on the underlying cause, associated symptoms, and individual health factors. In many cases, having one testis does not require specific treatment beyond routine medical care and monitoring. Here are some aspects of the treatment and care for men with one testis:

• Regular Check-ups: Schedule regular check-ups with a healthcare provider to monitor overall health, hormonal levels, and the remaining testis. This is crucial for early detection of any potential issues.
• Self-Examinations: Perform regular self-examinations of the remaining testis to monitor for changes in size, shape, or the presence of lumps. Early detection of abnormalities can be vital.
• Hormone Replacement Therapy (if necessary): In some cases, hormonal imbalances may occur. If there is a deficiency in testosterone, hormone replacement therapy (HRT) may be considered. This involves the administration of testosterone to maintain hormonal balance.
• Fertility Considerations: If fertility is a concern, individuals may seek consultation with a fertility specialist. While many men with one testis can father children, fertility may be slightly reduced. Assisted reproductive technologies may be explored if needed.
• Management of Emotional and Psychological Aspects: Adjusting to life with one testis may have emotional and psychological implications. Seeking support from friends, family, or a mental health professional can be beneficial in addressing any concerns or anxieties.
• Protective Measures: Take precautions to avoid injury to the remaining testis, as trauma can have implications for fertility and overall health. Using protective gear during sports or activities with a risk of injury is advisable.
• Educational Resources: Healthcare providers may provide educational resources on living with one testis, including information on sexual health, fertility, and self-care.

It’s important to note that not every individual with one testis requires active treatment. In cases where one testis has been surgically removed due to conditions like testicular cancer or torsion, the remaining testis can often compensate for normal hormonal production and sperm production. However, each person’s situation is unique, and treatment plans should be tailored to individual needs. Regular communication with a urologist is essential for ongoing care and addressing any specific concerns.

Testicolar prosthesis

A testicular prosthesis is a silicone implant designed to replicate the appearance and feel of a natural testicle. It is an option for men who have undergone surgery to remove one or both testicles (orchiectomy) due to conditions such as testicular cancer or torsion, or for those born with only one testis.

Here are some key points regarding testicular prostheses:

• Cosmetic Restoration: The primary purpose of a testicular prosthesis is cosmetic restoration. It can help maintain a natural appearance in the scrotum, contributing to a sense of normalcy and self-esteem.
• Personal Choice: The decision to use a testicular prosthesis is a personal one. Some men may choose to have a prosthesis for aesthetic reasons, while others may opt not to undergo this procedure. It’s essential for individuals to make the decision that aligns with their comfort and preferences.
• Surgical Implantation: The implantation of a testicular prosthesis is a minor surgical procedure. It is typically done as an outpatient procedure under general or local anesthesia.
• Prosthesis Types: Testicular prostheses come in various shapes, sizes, and textures to match the natural appearance of the testicles. The choice of prosthesis is often based on individual preferences and the surgeon’s recommendations.
• Timing of Implantation: Testicular prostheses can be implanted at the same time as the orchiectomy (immediate implantation) or at a later date. The timing depends on individual circumstances and preferences.
• No Impact on Functionality: It’s important to note that a testicular prosthesis does not restore the functionality of the removed testicle. It is a cosmetic option and does not produce hormones or contribute to sperm production.
• Potential Complications: Like any surgical procedure, the implantation of a testicular prosthesis carries some risks, such as infection, bleeding, or implant displacement. However, complications are relatively rare.

Summary

Men who have one testis, also known as monorchism, may face various situations depending on the underlying cause. Regular medical check-ups, including hormonal, sexua functionality and fertility assessments, are essential for monitoring overall health and addressing any potential issues promptly.

Overall, with proper care, monitoring, and support, men with one testis can lead healthy, fulfilling lives. Regular communication with Urologist is key to addressing specific concerns and ensuring comprehensive care.

Prof. Dr. Emin ÖZBEK

Urologist

Istanbul- TURKEY