We have seen and successfully treated so many couples married for several years without having sexual intercourse. This condition is called unconsummated marriage. The couple with longest duration I have seen is of 22 years.  Non consummation of marriage can occur due to several reasons. It is due to problems related to either husband, wife or both. Male problems such as erectile dysfunction, premature ejaculation, Sexual desire disorder, dyspareunia, phimosis, peyronie's disease and female problems such as absence of sexual desire, sexual arousal disorder, dyspareunia, sexual aversion disorder, vaginismus etc can cause non consummation of marriage. Other psychological problems such as adjustment problems, marital conflicts or dislike towards the partner also can lead to such conditions. How ever nothing to worry about it. With modern investigative and treatment modalities  we can identify the cause and treat it successfully.

It appears that you may have varicocele.

Varicocele causes progressive and duration dependent damage to the testis. As a result sperm motility will be reduced first followed by count. Over the years testis become atrophied and the production of male hormone (testosterone) will reduce. It will cause loss of sexual desire and erection. In other words you may develop an early andropause.

If there is a varicocele in an infertile man or in an unmarried man or a person who doesn’t have children, one must do microsurgical varicocelectomy. This is the latest scientific view and standard teaching on this matter. How ever in most of the places varicocele is usually operated using laparoscopic surgery or conventional surgery.

The most common complications of conventional varicocele operations are hydrocele, varicocele recurrence, and injury to testicular artery, spermatic cords etc. This may the reason why your Gynecologist advised against the surgery and advised for ICSI. A person having varicocele should undergo microsurgical varicocelectomy before going for IUI, IVF or ICSI to improve the sperm quality. It will reduce or nullify the adverse effect of ROS (reactive oxygen species) on the sperms. Presence of varicocele will reduce the percentage of success when going for artificial reproduction techniques.

In microsurgery the use of the operating microscope allows for reliable identification of spermatic cord, lymphatics, internal spermatic veins and venous collaterals, and the testicular artery or other arteries. So that chances for these complications are almost reduced to less than 1 percent. Repair of varicocele results in greater improvement in sperm motility and count.

Microsurgical varicocelectomy provides a safe and effective approach to varicocele repair with preservation of testicular function, improvements in semen quality, and improvements in pregnancy rates.

You may consult a reputed Andrologist/Urologist. If not satisfied please visit our hospital.

It appears that you are suffering from premature ejaculation. This may be due to various causes such as infection, inflammation, hypersensitivity, habituation or any other factors. First we have to find out the cause. Treatment may vary from medication to sex therapy or a combination of both based on the causes. To plan the treatment you need to undergo a clinical evaluation including physical examination and investigations. Based on the results it can be successfully treated.

Homosexuality is of two types. The first is ego syntonic in which the individual enjoy and it doesn't cause any mental stress to the person. Second type is ego dystonic in which the individual feels mental agony and distress about his own homosexual behaviour and hence wants to change it. No treatment is indicated for the first group. Ego dystonic homosexuality can be treated if the individual has a genuine motivation to change his behaviour.

Treatment is indicated only if the person has any discomfort or problem due to his own homosexual tendency or behaviour. The desire to change the orientation should not be due to other's (family, friends, religion etc) pressure. Treatment will be successful only if the person has a very genuine and consistent motivation to change his behavior. There is no medicine to change the sexual orientation. Treatment is psychological using techniques of sex therapy based on cognitive behavioural principles. Usually we don't take any homosexuals for treatment. But we have treated a few men with genuine motivation and they recovered.

Erectile dysfunction is treatable. Treatment varies from sex therapy, medicines or surgery. It can be planned only after appropriate investigations and physical examination. Without  this we are unable to give an opinion.

From our experience of treating thousands of patients with sexual problems from Kerala and outside it is found that 99% of men complaints of small penis got apprehension and doubt about the size of their sexual organ. It is only a concern, and not a fact. The size of flaccid penis is immaterial and it will keep on changing based on the atmospheric and body temperature. Most men worry about the size of the flaccid penis. The only published research study conducted in India on penile size is from Dr. Promodus Institute of Sexual & Marital Health which is published in the International Journal of Impotence Research (2007, 19,558-563). The mean erected length is found to be 13.01 cm with a SD of 1.62 cm.  The summary of this study is available at the Institute’s website (www.drpromodusinstitute.in) and the full paper is available in the internet at the journal’s site.

You need not worry about the penile size. You may consult a doctor who can examine your body and alleviate your apprehensions.

There is no medicine available or discovered so far to increase the penile size. Only surgical procedures are available which we are doing  at our Institute. You can see it from our web site also.  There are solutions for all problems.

If any of the partners is not satisfied we can assume that there is a problem. Inability to control the ejaculation may be due to several reasons. Sometimes this may be a habit. In some other cases such problems may be due to infection, inflammation, hypersensitivity, or any other factors. First we have to find out the cause. Treatment may vary from medication to sex therapy or a combination of both based on the causes. To plan the treatment you need to undergo a clinical evaluation including physical examination and investigations. Based on the results it can be successfully treated.

Erectile dysfunction is treatable. Treatment varies from sex therapy, medicines or surgery. It can be planned only after appropriate investigations and physical examination. Without  this we are unable to give an opinion.

Erectile dysfunction is treatable. Treatment varies from sex therapy, medicines or surgery. It can be planned only after appropriate investigations and physical examination. Without  this we are unable to give an opinion.