El Chapo Guzman
'El Chapo' shakes hands with Sean Penn. Rolling Stone/Reuters

The 57-year-old gangster was given a testicular implant in a Tijuana hospital to increase blood circulation, according to reports in Mexico. Sexual performance drugs and injectable testosterone were found in Joaquin El Chapo Guzman's Sinaloa mountain hideout when he was recaptured on 8 January.

The procedure — which usually requires general anaesthesia — could not have been performed in the mountains of Sinaloa, where he was hiding, Mexican journalist Carlos Loret told the news website SinEmbargo. The operation is recommended for those who suffer from erectile dysfunction.

Juvenal Perez, a urologist who examined El Chapo said he recognised the scars on the gangster's lower abdomen as probably caused by the implantation of a penile prosthesis. "I saw the scars on the back, hips and reproductive system," Perez, a member of the Mexican Academy of Urology told Reforma newspaper. This procedure, which costs around MXN350,000 (£13,500, $19,100, €17,560), involves implanting a bubble-shaped pump in the scrotum.

Carlos Loret de Mola was the first journalist to enter the house where Guzman was hiding. Mola reported seeing a pharmacy prescription for "more than 4,000 pesos in medicines to improve sexual performance". He also found four DVDs of La Reina del Sur, the TV series starring Kate del Castillo who plays a drug trafficking boss.

El Chapo is believed to have fathered 18 children with seven women.

The operation is believed to have been performed before the drug lord met up with actor Sean Penn. Hollywood star Penn said it was a "myth" that the meeting played a vital part in the recapture of El Chapo. "The government were humiliated that someone found him before they did," he told CBS's 60 Minutes.

When quizzed if officials wanted him "put at risk", the actor replied that he did. Penn, who was writing about drug policy for Rolling Stone magazine said: "The discussion about this article ignores its purpose – to contribute to discussion about the War on Drugs. My article failed."