Scrotox, no result?

Question

Is it possible for Scrotox to fail to “drop the testes” even by any amount? I’ve had 100 units done twice. First time no results whatsoever. Second time, Scrotal sweating is reduced but no change (not even the slightest bit) to how the testes hang. Is it possible the cremasteric and Dartos muscles are not determining how high my tested hang (quite high)?

Randal Haworth, MD, FACS · Answer

Scrotox, the use of botulinum toxin injections in the scrotum, is primarily aimed at reducing scrotal sweating rather than altering the position or hanging of the testes. The effects of Scrotox on the cremasteric and Dartos muscles, which are responsible for testicular positioning, are generally limited. It is unlikely that Scrotox injections alone would significantly impact how the testes hang or their position.

If you have concerns about the position of your testes, it would be best to consult with a urologist or a qualified healthcare professional who specializes in male reproductive health. They will be able to provide a more comprehensive evaluation and offer appropriate guidance or treatment options tailored to your specific needs.

Best of luck !

Mahmood Siddique, DO · Answer

Scrotox, or Botox for the scrotum, is sometimes used with the aim of relaxing the cremaster and dartos muscles to reduce tightness and allow the testes to hang lower. However, the effects of Scrotox can vary significantly from person to person, and while reduced sweating is often a reliable result, lowering of the testes is less predictable.
Here are a few things to consider:
Anatomy and Muscle Response: The positioning of the testes can be influenced by various factors, including anatomy, muscle response, and baseline tightness of the scrotal skin. In some individuals, the cremasteric reflex (which lifts the testes in response to temperature changes or touch) remains active even after Botox, limiting the degree of relaxation.
Dosing and Placement: Though 100 units is a considerable dose, outcomes can also depend on precise placement and individual response to Botox. Some individuals may require adjustments in dosing or even a different approach to achieve noticeable results.
Alternative Approaches: If Scrotox alone does not achieve your desired results, consulting with a specialist experienced in male aesthetic procedures could provide further insights. Some patients benefit from additional or alternative treatments that specifically target scrotal tightening or muscle overactivity.
Gradual Results: If it's only been a few weeks, remember that Botox can sometimes take a few weeks to show its full effect, though a noticeable drop usually happens sooner if it's going to occur.
I recommend discussing these possibilities with your provider to tailor the treatment more specifically to your goals. Best wishes for your next steps.

Joshua T Halka, MD · Answer

Hello,
If you had botox injected into your scrotum it likely only affected the dartos muscle of the scrotum which isn't as much of a determinate of the testicle position as the cremasteric muscles. Unless the injection of the cremasterics were done under ultrasound guidance I can't see them being well targeted. The cremasteric muscles surround your spermatic cord and become part of the internal oblique muscle in the groin region, someone may be able to inject the cremasterics near the internal oblique to better target them, but ultrasound guidance may also help.
Dr. Halka

Mary C. DuPont, MD, FPMRS, FACS · Answer

Injection of Botox into the scrotal skin is used as a treatment for scrotal hyperhidrosis, diminishing the sweating of the scrotum. 
The cremasteric muscle is responsible for the elevation of the testes in response to stimuli such as cold or touch. If Botox were to be injected into the cremasteric muscle, it could lead to a temporary paralysis of the muscle, resulting in the relaxation of the muscle, thus allowing the testes to hang longer.

Barry Kusman, MD, FACS (retired) · Answer

Hello,
In our opinion scrotox would only be used for sweating in this area and not for management of an undescended testicle. Usually, surgery may be required. I would see a Urologist or general surgeon with this condition.

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