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September 19, 2020

Discolored Semen and Sparkwave Therapy: Dr. Mistry Answers Listeners’ Questions on Prostatitis and Post-Prostatectomy ED With Peyronie’s

Speaker 1: 

Welcome back to the Armour men’s health hour with dr. Mystery and Donna Lee .

Speaker 2: 

Hello, and welcome back to the women’s health hour. I’m dr. Mystery , your host here with my cohost Donald Lee .

Speaker 3: 

Hello everybody. Welcome back.

Speaker 2: 

Welcome to our show. I’m a board certified urologist. My name is dr . Cindy mystery. That is my real name given to me by my parents.

Speaker 3: 

It was less money and he wears a cowboy hat. I do wear a coat . He proud of that hat on occasion at work, I will tell you

Speaker 2: 

Wearing boots and a hat makes you feel about six inches dollar does your penis. That’s right. If we just got a little bit, a little boots and lat for our genitals,

Speaker 3: 

That’s called a tennis shoes and a baseball cap.

Speaker 2: 

I think it would always feel better. This show is brought to you by our urology practice NAU urology specialists. We are a full service urology practice that treat conditions for both men and women. Although this show was really dedicated towards the health of men, it’s really intended to try to give men an opportunity to ask questions and to seek guidance on those more sensitive topics that we may not feel comfortable going to the doctor for, or have gotten treated somehow or in some fashion in the past, but are really unclear if that was the right way. There’s a study done for sexual dysfunction that shows that men and women will bring up the issue maybe once or twice with their doctor. But if they feel like they’re blown off or things are not done enough in the way that they , they feel most comfortable with, they won’t ask again. The show is an opportunity for people to be able to get another shot at it here , another perspective, and we really, really enjoy giving you the show .

Speaker 3: 

That’s right. And we have lots of questions to go over and we’ve got people waiting for a week or so

Speaker 2: 

Agents that are coming in to see us in the office are really amazing. And when they hear topics dealt with on the show, they come in more prepared. And I think that’s another big benefit of having the show is just people kind of hear what I’m about to tell them before they come in. A lot of them are surprised that Don and I really are exactly like this in person. So if you need a really uptight Dr. May keep looking, keep looking.

Speaker 3: 

Yeah, this, this shows given the opportunity to patients to really discuss these things without being scared, because I’ve had at least two people in the last seven days, call us and say , I didn’t want to talk about this, but I heard you talking about on the radio so openly, and I can just talk about it now. And they were just so open and it was really engaging and we made appointments and the feminine,

Speaker 2: 

Our clinic is seeing patients that’s been established since 2007 NAU urology specialist on it . Why don’t you tell them where we are?

Speaker 3: 

We are in round rock, North Austin, South Austin, and dripping Springs where they love dripping. And we can fix that. Um , our number is (512) 238-0762 . And our website is Armour men’s health.com. And you can send us a question to Armour men’s health@gmail.com

Speaker 2: 

A big thanks and shout out to our team here at KLBJ news radio, a five 90. We’re very lucky to have them as partner for this show and appreciate the , uh , free rerunning on Sunday.

Speaker 3: 

And congratulations to Daniel. One of our KLBJ guys, he got married. Congratulations. You’re going to need dr . Ministry Arabian 20, 30, more years for something I’m sure we have a really interesting question. Um, this patient is 75 years old and he’s been sexually inactive for many years recently. He said I masturbated for the first time in years and my ejaculate was Brown. I tried it again a few days later and got the same result. What does Brown semen mean ?

Speaker 2: 

That’s a great question. Discoloration of the semen is in our experience more likely to be from an infection of the prostate gland. Now it can be an old infection that has resolved or inflammation that is resolved or something active. I usually, I think of recurrent bright red blood in the semen to be more worrisome than a brownish or older kind of blood. If you’ve had a procedure done more likely like a prostate biopsy or a cystoscopy and have Brown semen , that’s not surprising at all. I could conceive of having something even after maybe maybe a colon or rectal surgery, but I think that’s pretty rare for most people. It’s just going to be an infection of the prostate or prostititus if it’s just, if your only symptom is discoloration of the Hewlett, we generally don’t do anything. You just clean the tubes out. That’s your only symptom clean the tubes out, just clean the tubes out. That’s right. Donna. It’s exactly what it means.

Speaker 3: 

In those words,

Speaker 2: 

A teenager at home don’t, you know what these words mean,

Speaker 3: 

Three teenagers at home. He has . I do know, but I was just wanting to make sure that’s right.

Speaker 2: 

So just getting rid of the ejaculate, I think is probably in your best interest, your spouse or your partner is not likely to contract anything or become ill from that discoloration and that singeing of the blood.

Speaker 3: 

He’s got a hand partner. Go ahead.

Speaker 2: 

The , sometimes it’s the most loving partner, honestly , never let you down. You can , uh , unless you have arthritis, I guess. Oh no, no. If you have a discoloration of your jacket, but you also have urinary symptoms like urgency frequency, lower back pain fever, incomplete bladder emptying, and that these symptoms have gotten worse. Then in that case, we almost always think that it’s justified to do a, an antibiotic course in our office. If you’re really worried about consistently discolored semen , we also do something called a semen culture. It’s easy as you just giving us a semen sample and we sending it for a routine tissue culture. So those are some options to think about , uh , with discolored semen .

Speaker 3: 

Well , I didn’t ever want to talk about that, but thank you. Uh , we have another question. This gentleman is 50 years old. He had a prostatectomy in 2008 with the DaVinci, which is something you’re familiar with after PT. I was able to get an erection and also used a pump for a while. At some point I developed Peyronie’s disease, which is our biggest topic, correct. I’m 99% sure. And have had issues getting an erection when I do, it’s just not a one and there’s a large curvature. My penis has also shrunk and yes, I’m 20 pounds overweight. I see ads for shockwave therapy and believe that I heard you all talk about it on the show that it does not work well. He wasn’t listening to this show, but then caught a guest doctor saying that it does work. Okay. I’m on testosterone shots weekly. My first count was three 50 a year ago now at 700.

Speaker 2: 

That’s great. So just because of brevity, I won’t really address the testosterone issue to really summarize what we’re talking about here. You have a history of prostate cancer. You had your prostate removed and he developed post prostatectomy impotence, which is common. It occurs in up to 70% in, even in patients that have nerve-sparing , they can still develop erectile. Dysfunction is one of the main things that people consider. When they’re talking about treatment, you’re able to get an erection using the pump or by yourself. And that’s awesome news, but now you develop curvature from Peyronie’s disease. So , um, I’m going to give you the textbook answer. And the textbook answer is having severe ed after prostatectomy, along with Peyronie’s usually means that getting an inflatable penile prosthesis is your best option. The reason is the right book answer is because when you put in the rigid silicone cylinders that fill up your penis, you can model M O D E L model the penis over the cylinders and straighten out Peyronie’s. This will give you back length. The cylinders will give you adequate girth. And the product itself gives you tremendous spontaneity, greater than 90% satisfaction. And people are, you know , very happy with getting it done. One of our partners here, dr. Christopher Yang is fellowship trained in prosthetic surgery. You’re going to get an amazing case with an amazing surgeon. So if you’re interested, that’s where to go. Now that’s a surgery and some people don’t want to go through surgery. And the idea of replacing the inner workings of your penis with a, with a prosthetic may not be something that appeals to you. So then we talk about how would we take out the prostatectomy, the fact that you had a prostate surgery out of the equation in just a person who has ed and, and peronas disease. Absolutely. We think that a shockwave or in our, in our office, we call it spark wave therapy, certainly has a real role in breaking down causing microtrauma of the tissue and then hap helping it remodel or reform into a more straight penis that is able to , uh, get erect. And so absolutely that may be an option that could also potentially salvage you some, some length as well. Um, that along with intracavernosal injections, which are injections of a small amount of fluid into the penis, that will give you a super rigid erection. That’s a great combo therapy. There’s also the value of doing something called Xiaflex injections, which is the enzyme that breaks down the peroneus plaque. So if I really had to put a real program together, it would be something on the order of Xiaflex injections for the peroneus disease, intracavernosal injections for getting robust erections and then , um, a consideration of spark wave or shockwave therapy to help regenerate that, that those erectile bodies to make them healthier. And so that your spontaneous erection or your pump driven erection is as much more,

Speaker 3: 

I think maybe he heard her say that it might not work for everybody, but it’s , we’ve gotten some incredible outcomes with the shockwave.

Speaker 2: 

Our, our, our, our spark wave therapy program here is very busy. Uh, it costs $2,000 for six treatments , uh, which is , uh, almost half of what, you know, the fly by night, you know, pop , pop , pop, pop, pop up clinics do. And what I try to inform patients, you know, even though sometimes in a medical clinic, we feel weird about asking people to pay for cash procedures, but they’re more than willing to go to somebody else that does it. Right ? And they don’t treat erectile dysfunction. All they do is shockwave. I mean , they’re not there to make your erections better. They’re there to give you shock .

Speaker 3: 

And they don’t know if it really is the best option. Cause that’s the only trick that they have.

Speaker 2: 

That’s the, that’s the one that that’s the , you’re a nail and they got a hammer. So , uh, but what we’re here to make sure that the right tools applied for the right problem. And we’d love to see you in the office. Donna, how do people get on ?

Speaker 3: 

You can catch us on our podcasts . They’re amazing and they’re everywhere and they’re free. Uh , anywhere you listen to podcasts and you can call five one two, two, three eight zero seven six two , send us your questions. We’ll get them answered. I’ll respond to them. It’s armor men’s health at Gmail.

Speaker 2: 

The armor men’s health hour is brought to you by urology specialists for questions, or to schedule an appointment, please call (512) 238-0762 or online at [inaudible] dot com.

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