Everyone knows that penis size is one of men’s biggest concerns and that some men will do almost anything to try and increase the length and girth of their member, from “natural male enhancement,” to vacuum pumps, to experimental surgeries and fat injections. However, what you may not know is that some men are more concerned about the size of their scrotum, which has resulted in a new and growing practice known as scrotal inflation (sometimes referred to as scrotal infusion). All I can say is don't try this at home, or anywhere else for that matter.

Scrotal inflation involves the injection of saline solution into the scrotal sac in order to temporarily increase its size. And, yes, you have to be willing to stick a needle into your scrotum to make this happen, so this practice obviously isn’t for everyone. The amount of fluid injected varies, and some guys appear to take it to a rather extreme level. For instance, in a 2003 case study of this practice, a man had injected 900 ml of fluid into himself [1]. To put that in perspective, that would be the equivalent of filling your scrotum with a little more than two and a half cans of Coca-Cola. Believe it or not, that’s nothing compared to a 2006 case study of a man who filled his sac with 2.5 liters of fluid (the equivalent of about 7 cans of Coke) [2]!

After this procedure, the resulting appearance of the scrotum looks kind of like a water balloon and, I am quite certain, would make it nearly impossible to wear skinny jeans (check out Figure 2 from one of the case reports here, but be warned that it may not be safe for work and you may find it emotionally traumatizing). That fluid will ultimately be absorbed by the body, but it may take a couple of days to return to normal size. However, the swelling does not always resolve itself and may become quite painful.

An even rarer variant of scrotal inflation involves filling the scrotum with air instead of liquid. I have (fortunately) only seen one case report of this and it involved a man’s scrotum being inflated by his wife through a drinking straw [3]. I will spare you the rest of the details, but needless to say, this wasn’t their best idea.

So is this activity really just about increasing scrotal size? For some, it definitely is. For others, however, inflation may have a fetish quality to it whereby the injection itself or the physical sensations caused by a distended scrotum are a source of sexual arousal.

Any way you look at it, scrotal inflation is a potentially dangerous practice. Risks include permanent infertility (if the testicle itself is injected), “scrotal emphysema” (in which air gets trapped in the tissue beneath the skin, resulting in the skin making a “crackling” sound when touched), and some potentially fatal complications, including embolisms and gangrene [2] Thus, no matter what you read or hear online about scrotal inflation being perfectly safe and harmless, don’t believe it.

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[1] Summers, J. A. (2003). A complication of an unusual sexual practice. Southern Medical Journal, 96, 716-717.

[2] Yoganathan, K. G., & Blackwell, A. L. (2006). Unusual cause of acute scrotal cellulitis in an HIV positive man. Sexually Transmitted Infections, 82, 187-188.

[3] Bush, G., & Nixon, R. K. (1969). Scrotal inflation: A new cause for subcutaneous, mediastinal and retroperitoneal emphysema. Henry Ford Hospital Medical Journal, 17, 225–226.

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