Small balls from Trt will it effect pump placement in my scrotum ?

The final frontier. Deciding when, if and how.



tomas1
Posts: 2081
Joined: Tue Jul 23, 2013 5:12 pm
Location: Tempe, AZ

Re: Small balls from Trt will it effect pump placement in my scrotum ?

Postby tomas1 » Wed Jun 25, 2025 4:36 pm

ElbowRoom wrote:I also have "little balls" from years of TRT use. I'm curious how that will affect pump placement and visibility. Dr. Hakky didn't mention it as a concern when he examined me and looked at my history, but I've added this to my list of questions to ask him the next time we talk. I'll let you folks know what he says.

My surgery is currently scheduled for October, so I have some time to find this out. It seems to me it depends on whether the scrotum contracts as the testicles atrophy, or stays the same size. If it keeps size that just means more space for a pump, if it contracts then it might make for a tight pump space and a very visible pump. "It is what it is" either way I suppose.


My balls shrunk and the scrotum stayed the same size.
Surgeon actually liked that, and the pump placement is perfect.
86 years
Inject testosterone weekly.
Implant on 1/22/19 by Dr Avila.
Scrotal, hor. incision just over 1"
18cm AMS 700 CX, 3.5cm RTE 100cc res
Gleason 6 prostate cancer. Monitoring it for now.
Update: On my last biopsies the cancer wasn't found.

Wooody
Posts: 114
Joined: Mon Jan 27, 2025 3:04 pm
Location: Bay Area, CA

Re: Small balls from Trt will it effect pump placement in my scrotum ?

Postby Wooody » Wed Jun 25, 2025 6:19 pm

tomas1 wrote:
ElbowRoom wrote:I also have "little balls" from years of TRT use. I'm curious how that will affect pump placement and visibility. Dr. Hakky didn't mention it as a concern when he examined me and looked at my history, but I've added this to my list of questions to ask him the next time we talk. I'll let you folks know what he says.

My surgery is currently scheduled for October, so I have some time to find this out. It seems to me it depends on whether the scrotum contracts as the testicles atrophy, or stays the same size. If it keeps size that just means more space for a pump, if it contracts then it might make for a tight pump space and a very visible pump. "It is what it is" either way I suppose.


My balls shrunk and the scrotum stayed the same size.
Surgeon actually liked that, and the pump placement is perfect.


This was my experience. I stopped HCG many months prior to my surgery and let 'em get small. Then a couple months post op, I started growing 'em back with HCG so that the pump wasn't so prominent in my sack compared to my balls. Absolutely zero problem for me operating the pump with larger balls.
Titan Classic 22cm + 1cm RTEs - 2/25 - Dr Karpman, Bay Area CA

strongagain
Posts: 622
Joined: Tue Aug 25, 2015 11:17 am

Re: Small balls from Trt will it effect pump placement in my scrotum ?

Postby strongagain » Thu Jun 26, 2025 10:43 am

This was my experience. I stopped HCG many months prior to my surgery and let 'em get small. Then a couple months post op, I started growing 'em back with HCG so that the pump wasn't so prominent in my sack compared to my balls. Absolutely zero problem for me operating the pump with larger balls.


Are you on TRT? I don‘t like my small balls at all. Coming Wednesday I have an appointment with my Uro, gonna ask him about HCG therapie. Are doctors reluctant when it comes to HCG? I wonder what he‘ll say, I fear he might say no… Does one get bald when being on both TRT and HCG?
Born in 1950, ED since 2007 (colon cancer)
08/2015 Titan Zero Degree 22 cm + 3 cm RTE
Dr. Leiber, Freiburg, Germany
6.7" x 5.7" - Very happy with implant.

Living in Freiburg, Germany and in Cape Town, South Africa

Wooody
Posts: 114
Joined: Mon Jan 27, 2025 3:04 pm
Location: Bay Area, CA

Re: Small balls from Trt will it effect pump placement in my scrotum ?

Postby Wooody » Thu Jun 26, 2025 2:14 pm

strongagain wrote:Are you on TRT? I don‘t like my small balls at all. Coming Wednesday I have an appointment with my Uro, gonna ask him about HCG therapie. Are doctors reluctant when it comes to HCG? I wonder what he‘ll say, I fear he might say no… Does one get bald when being on both TRT and HCG?


Yes. I've been on TRT for many years, and on and off of HCG as well. I can't speak for all Dr's but mine was fine with it. I have not had an issue with balding but that may be my genetics. I don't know.
Titan Classic 22cm + 1cm RTEs - 2/25 - Dr Karpman, Bay Area CA

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ElbowRoom
Posts: 379
Joined: Mon Mar 17, 2025 1:58 pm

Re: Small balls from Trt will it effect pump placement in my scrotum ?

Postby ElbowRoom » Thu Jun 26, 2025 2:20 pm

tomas1 wrote:My balls shrunk and the scrotum stayed the same size.
Surgeon actually liked that, and the pump placement is perfect.


Awesome, thank you.
58yo Coloplast Titan implant scheduled for 10/23/2025 with Dr. Hakky. Pre-op erect measurements:
8.5"L and 6.5"C

strongagain
Posts: 622
Joined: Tue Aug 25, 2015 11:17 am

Re: Small balls from Trt will it effect pump placement in my scrotum ?

Postby strongagain » Mon Jun 30, 2025 1:50 pm

I just came home from a consultation with the uro. I asked him about HCG. He almost got hysterical. Never ever would I give you a prescription for that. HCG is way too dangerous. Bodybuilders take it till the collapse due to heart failure. It‘s extremely expensive too. Forget about it, you‘ll never get it from me. …
Born in 1950, ED since 2007 (colon cancer)
08/2015 Titan Zero Degree 22 cm + 3 cm RTE
Dr. Leiber, Freiburg, Germany
6.7" x 5.7" - Very happy with implant.

Living in Freiburg, Germany and in Cape Town, South Africa

Wooody
Posts: 114
Joined: Mon Jan 27, 2025 3:04 pm
Location: Bay Area, CA

Re: Small balls from Trt will it effect pump placement in my scrotum ?

Postby Wooody » Mon Jun 30, 2025 4:57 pm

strongagain wrote:I just came home from a consultation with the uro. I asked him about HCG. He almost got hysterical. Never ever would I give you a prescription for that. HCG is way too dangerous. Bodybuilders take it till the collapse due to heart failure. It‘s extremely expensive too. Forget about it, you‘ll never get it from me. …


Wow, time for a new uro if I were you. My current and previous drs recommended and prescribed it for me no problem and have been using is safely for many years. And no, it's not expensive in my experience.

Here's what ChatGPT has to say on the subject when I asked it "Is hcg safe and effective for men to use with TRT to maintain testicular size and function?":

--------------------

Yes, HCG (human chorionic gonadotropin) is generally considered safe and effective for use in men undergoing testosterone replacement therapy (TRT), particularly for the purpose of maintaining testicular size and function, including fertility. Here's a breakdown:

-- Why HCG Is Used with TRT
TRT increases testosterone levels, but it suppresses the hypothalamic-pituitary-gonadal (HPG) axis, reducing or shutting down LH (luteinizing hormone) and FSH (follicle-stimulating hormone) production. This leads to:

Testicular atrophy (shrinkage)
Decreased sperm production (infertility)
HCG mimics LH, stimulating the Leydig cells in the testes to continue producing testosterone and supporting spermatogenesis.

-- Evidence of Effectiveness
Clinical studies and real-world use support that HCG:

Preserves testicular volume during TRT
Helps maintain intratesticular testosterone, necessary for sperm production
Is often used in fertility preservation strategies in men on TRT
Can restore fertility in some cases, even after TRT has suppressed natural function

-- Safety and Side Effects
Generally well tolerated, but possible side effects include:

Increased estrogen levels (HCG can upregulate aromatase)
Gynecomastia (breast tissue growth) due to estrogen
Acne, mood swings, or fluid retention
Testicular pain (rare)
In men susceptible to estrogenic side effects, aromatase inhibitors (like anastrozole) may be co-prescribed.

-- Typical Protocol
There’s no one-size-fits-all, but common regimens include:

250–500 IU of HCG 2–3 times per week, alongside TRT Administered subcutaneously or intramuscularly

Higher doses (≥1000 IU) are usually reserved for fertility treatment or HPTA restart protocols and come with higher risk of side effects.

-- When to Use HCG with TRT
Men who want to preserve fertility
Men concerned about testicular shrinkage
Men planning future cessation of TRT and want to maintain some testicular function

If fertility is not a concern, and testicular atrophy isn’t bothersome, HCG may not be necessary for every TRT patient.
Titan Classic 22cm + 1cm RTEs - 2/25 - Dr Karpman, Bay Area CA

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Kodixx
Posts: 432
Joined: Wed Jan 08, 2025 5:32 pm

Re: Small balls from Trt will it effect pump placement in my scrotum ?

Postby Kodixx » Tue Jul 01, 2025 12:07 pm

I've considered using HCG, without TRT, to achieve a moderate increase in T. For anyone who does that or has tried that, any advice ?

- Chuck
Feb 2025 - 58 yo, 38 with greatest wife ever
AMS CX, Tenacio, Dr Broghammer (excellent) - pre-op L:7", post-op @ 5 mo L: 6.75" G: 5.5"
2 wks pain, cycling-sex-lifting @ 7 wks, only minor discomfort @ 10 wks, felt like 'new normal' @ 16 wks

NewGuy2025
Posts: 36
Joined: Sat Feb 08, 2025 11:16 am

Re: Small balls from Trt will it effect pump placement in my scrotum ?

Postby NewGuy2025 » Wed Jul 09, 2025 10:48 am

strongagain wrote:I just came home from a consultation with the uro. I asked him about HCG. He almost got hysterical. Never ever would I give you a prescription for that. HCG is way too dangerous. Bodybuilders take it till the collapse due to heart failure. It‘s extremely expensive too. Forget about it, you‘ll never get it from me. …


lol, sorry to say that, but your doctor has no idea what he is talking about. It seems he mixed up HCG with HGH. Only one different letter, but a huge difference in what it is. For HGH everything he said is valid. So i believe he mixed it up.
41 years old, Rigicon Infla 10X 18cm + 2 RTE (2cm & 1,5cm) - 21,5 cm total - by Dr. Sean Park & Prof. Osmonov @UKSH Lübeck / Germany

My journey + cycling-documentation: viewtopic.php?f=6&t=2656

NewGuy2025
Posts: 36
Joined: Sat Feb 08, 2025 11:16 am

Re: Small balls from Trt will it effect pump placement in my scrotum ?

Postby NewGuy2025 » Wed Jul 09, 2025 10:52 am

Kodixx wrote:I've considered using HCG, without TRT, to achieve a moderate increase in T. For anyone who does that or has tried that, any advice ?

- Chuck


Some men do it, but it´s not really recommended because HCG does metabolize a lot more to estrogen than Testosteron and also there are reports of desensitization of testicles. Thats why protocols usually have a break of HCG for a few weeks every 6-8 weeks.
41 years old, Rigicon Infla 10X 18cm + 2 RTE (2cm & 1,5cm) - 21,5 cm total - by Dr. Sean Park & Prof. Osmonov @UKSH Lübeck / Germany

My journey + cycling-documentation: viewtopic.php?f=6&t=2656


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