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Since there is a slightly higher incidence of developmental dysplasia of the hip in children with muscular torticollis, the hips need to be evaluated X-ray Evaluation • Xrays of the cervical spine in congenital muscular torticollis will reveal rotation of C1-C2 related to the torticollis position • Early treatment includes stretching exercises. A high-pitched “click” at full abduction is not a positive but is probably due to fascia lata slipping over the greater trochanter Diagnosis/Treatment • If diagnosis of hip instability is made in the first few months of life, generally closed reduction and use of a Pavlik harness or hip spica cast to maintain reduction with greater than 90° flexion and moderate abduction for three to four months usually produces good results • If diagnosis is not made until walking age, surgery may be needed THE NECK Congenital Torticollis or “wry neck” • Physical sign of an underlying problem usually due to muscular fibrosis, the presence of a hemivertebra, or atlantoaxial rotary subluxation. Appointments can be made either as an in-office consultation or a virtual phone consultation. Dermal fillers offer great sensitivity and control to increase the circumference of the penis. However, we recommend patients abstain from sexual activities for about three days. 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Diminished testicular size and compromised fertility during testosterone replacement therapy occur because of the down-regulation of gonadotropins.308 The administration of exogenous testosterone as a means of male contraception is under study.309 In these men, azoospermia usually results within approximately 10 weeks of beginning therapy. Prostate cancer is well known to be, in the majority of cases, an androgen sensitive disease, and prostate cancer has been treated in patterns designed to lower testosterone levels.270 Androgen replacement therapy is an absolute contraindication. At the same time, many studies271–273 have failed to show significant exacerbation of voiding symptoms attributable to benign prostatic hyperplasia during testosterone supplementation, and complications such as urinary retention have not occurred at higher rates than in controls receiving placebo nor has there been any difference in the urine flow rates, postvoiding residual urine volumes, and prostate voiding symptoms with patients receiving treatment in these studies. While the development of the penis and testes eventually subsides, sperm production continues. Its most apparent influence occurs during puberty, when it accounts for the development of the penis and testes, the deepening of a boy's voice, and the production of sperm, alongside other secondary sex characteristics. This production is why the testes are part of both the reproductive and endocrine systems. 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