Phone: 512-238-0762

Fax: 512-341-7370

March 7, 2020

Dr. Mistry and Donna Lee Talk About Foreskin, the Buried Penis, and Testosterone Replacement Pellets

Speaker 1: 

Welcome back to the Armor Men’s Health Hour with Dr. Mistry and Donna Lee.

Dr. Mistry: 

Hello and welcome back to the Armor Men’s Health Hour. I’m Dr. Mistry, your host here with my cohost, the award winning and super funny, Donna Lee.

Donna Lee: 

Hi. I am award-winning. Well, I brought their award from home, but still.

Dr. Mistry: 

That’s right. I like how on our commercial you announced that we’ve been nominated for the world’s best men’s health show in the world.

Donna Lee: 

Most interesting men’s wellness show in the entire world.

Dr. Mistry: 

Nominated by you yourself.

Donna Lee: 

You know what if I believe that, who’s to say it’s not true?

Dr. Mistry: 

You know, I’ve known of a couple other men’s health and wellness shows over the years. A good friend of mine in Houston had one for many years and I listened to it and I, I do think that our content is really good. The feedback we’ve been getting from listeners has been spectacular.

Donna Lee: 

Did he have a cohost?

Dr. Mistry: 

No, he didn’t have a cohost, just by himself. And I want you guys to know that it really is a pleasure for me to do it. We talk about things that aren’t just related to the practice of urology or our practice itself. Really, we see this as a vehicle to educate the listener about a number of topics. We’ve had people talk about hernias and reflux disease and cancer treatment and orthopedic issues and all sorts of things. Really, because we want to really, as much as we can in a very thoughtful way, demonstrate to you guys that if you have a urologic issue, we’re going to give you the same thoughtfulness, consideration, and extensive workup that we treat all medical topics. Patients aren’t just a number for us. We see new patients all the time. We would be happy and proud to take care of your men’s health needs as well as your specific urologic needs. And when we talk about men’s health, what we’re really talking about is testosterone, vasectomy, erectile dysfunction, prostate problems, kidney stones, kind of between the belly button and the knees, in terms of men’s health, you know. You like that?

Donna Lee: 

I do. I like that you said belly button. It’s not…

Dr. Mistry: 

Umbilicus.

Donna Lee: 

I’ve never heard you say “belly button” before. Thank you.

Dr. Mistry: 

Donna Lee, why don’t you tell people about our practice?

Donna Lee: 

We are located in Austin, Texas and surrounding areas. So if you’re not in Austin and you’re listening to the podcast, you can still reach out to us during the week at (512) 238-0762 if you have a question. But even better, if you email us that question, we will answer your question on the podcast or the radio anonymously, of course, at armormenshealth@gmail.com. That’s armormenshealth@gmail.com. And I am always shocked at how many emails we’re getting now. We just get more and more every week, so thank you for the people listening.

Dr. Mistry: 

We do. We do. We’re really happy with the amount of engagement. I know a lot of people are listening to this show in the car and so for people to like remember the website or the email and then go all the way home. Please don’t email your question while driving.

Donna Lee: 

Well you can if you do audio texting, I suppose. But I always get super excited when 3 or 4 or 5 days has gone by from the show and we get an email, because I’m like that person remembered us, and they have a question.

Dr. Mistry: 

That’s awesome. So let’s get to a couple of those questions now.

Donna Lee: 

Speaking of questions, a more recent question that came in: “Dr. Mistry, I have stenosis of my foreskin and I’m unable to un-sheath my penis. I have no problems with erections or climaxing. I had a dorsal vent performed about 10 years ago with no success. I’ve been told I do not have enough foreskin left to work with this. Is this something you might be interested in helping? Also why this falls to a urologist and not a plastic surgeon?” Well, had a little twist at the end of that one.

Dr. Mistry: 

I like that. Well, number 1, if you care about it that much and it’s your penis, please keep it in the hands of a urologist. That being said, this, this question could mean several things. So I’m just going to answer it the simplest way first, and then kind of add some twists. Okay, so the first thing I will say is that if you are uncircumcised, and the skin that lives over the head of your penis does not come back easily, that can predispose you to the development of cancer, recurrent infections of the head of the penis and very poor hygiene. It can lead to recurrent urinary tract infections and in some cases even cause pain during intercourse. The simplest solution to that is a circumcision, but if the questioner says that he doesn’t have enough foreskin to work with, that makes me think he has something else, and I’ll go through that in just a moment. But let’s just say a standard patient with what we call phimosis is where the skin that goes over the head, the very end of it becomes a very tight ring and cannot be pulled back. We actually see that as a presenting symptom for diabetes. And I would tell you that if you are like a 40 year old man and you’re starting to have penile foreskin problems, I would venture to guess that you probably have an 80% chance of having an undiagnosed diabetes or prediabetes-type condition.

Donna Lee: 

I never thought of that.

Dr. Mistry: 

The easiest thing to do for that kind of patient is called a dorsal slit. Sounds like what that listener had. And if the dorsal slit didn’t work then it was probably too small of a dorsal slit and a repeat one is certainly an option, but a circumcision is going to take care of that in most, most cases. Now, if you are, and the circumcision is going to be removing that whole skin, sewing it up, we really pride ourselves in a really a really good, you know, aesthetically very pleasing look. It does temporarily change some of the sensations you have down there and can potentially impact kind of sensations during intercourse. But for most people, it’s a godsend improvement over where they were. If, however you are being told that you have too little for skin, this could be a condition called “buried penis,” and buried penis is when, it usually happens in men who are overweight and they have a lot of skin or fat down in the mons kind of around the penis. And what’s happening is the penis is getting kind of pushed into the skin and then the skin, the remainder of the skin is coming over the head and then causing stenosis. When that happens, it’s associated with another condition called lichen sclerosis or also a condition called BXO, Balanitis Xerotica Obliterans.

Donna Lee: 

Bless you.

Dr. Mistry: 

It’s wonderful. And that can actually be associated with urethral stricture disease and a number of other things. And that we do fix with a plastic surgeon. So that is the kind of thing where we go and remove a big fat pad from around the, uh, the base of the penis. We have to then take all that skin down and oftentimes skin graft the skin. It is, it sounds worse than it ends up being. You end up having your penis again, which is nice. And we regain a lot of length and it’s a pretty intense kind of thing.

Donna Lee: 

We need to have a plastic surgeon on to talk about this with you.

Dr. Mistry: 

We will and we have some awesome plastic surgeon partners that are going to do a great job. And so if you have a buried penis or you have foreskin problems like this, it could be simple or it could be complex, and it’s exactly the kind of thing that, you know, excites us here to help take care of.

Donna Lee: 

Right? And that was an excellent answer. And I don’t give you the questions beforehand. So it’s like a little game that we play every week.

Dr. Mistry: 

It is a little game, isn’t it?

Donna Lee: 

I have another good one that’s pertinent to this station because we hear so many commercials on air, but, “I’m a 52 year old man. I’m trying to get back what I lost, Dr. Mistry.” I imagine he’s talking about, you know, that… I went to a well known hormone replacement clinic…”

Dr. Mistry: 

His keys.

Donna Lee: 

His keys. Exactly…”I went to a well known hormone replacement clinic in town. I’m spending about $800 a month for testosterone pellets. I feel great, but what are my options when it comes to pellet therapy? And do you treat women?”

Dr. Mistry: 

That’s a great question. I assume you asking if you treat women because you want us to treat your wife. And so, hormone clinics are something that really cater to a particular kind of clientele.

Donna Lee: 

The busy guy.

Dr. Mistry: 

And uh, I think a real valuable resource in the community to spread some information. For us, we are a men’s health clinic and we’re going to treat more than just giving you testosterone. To answer this caller’s question simply, our pellet therapy, which I would say rivals anyone’s, is about $100 a month. So it’s much, much less expensive. You will have to have pellets placed about every 6 months and any intermediate therapy you might need in the meanwhile would be covered just for that same amount of money. We’re also going to make sure that your estrogen is taken care of, that you don’t get too high estrogen, your blood count’s taken care of. Some patients who are on testosterone therapy can have a worsening of their obstructive sleep apnea. So that’s something that we’re going to be carefully checking and monitoring. We’re going to be making sure that you’re getting the impact you want. If you’re looking to start testosterone because you want more energy, we’re going to make sure that we’re doing things, whether it be testosterone or not, to give you more energy. If you’re doing it for erectile dysfunction or for cognitive issues or for any number of things including weight, we want to make sure that our therapy and your goals are being met because if you’re just a one trick pony, if no matter what you have wrong with you, the clinic only offers one kind of therapy, then…

Donna Lee: 

Yeah, you have to go to urologist.

Dr. Mistry: 

…you may not be getting exactly what you want and not all urologists are the same. You know, you’re not going to be able to go to any urologist and get high level testosterone therapy. But I know that every single one of our providers is going to provide exceptional therapy. You’re going to have nutritional counseling, and we’re going to make sure that you don’t have any other urologic issues as well that could interfere with your therapy.

Donna Lee: 

So super comprehensive. We’re not just doing the one thing.

Dr. Mistry: 

We’re doing what I think is right because I have to sleep at night and I want to make sure that every patient that leaves us is well taken care of and I can feel real confident with that with our providers and with you as the head of this little…

Donna Lee: 

Empire. Can you say little empire together?

Dr. Mistry: 

You’re trying. We’re the second biggest urology group in town, that means we try harder.

Donna Lee: 

That’s right. We’re a little prettier. Pushed up our boobs just a little bit higher.

Dr. Mistry: 

And we do treat women for pellet therapy, that was the second part of the question.

Donna Lee: 

That’s right, I’m one of our patients, and I feel amazing.

Dr. Mistry: 

That’s right. So Donna Lee, why don’t you to tell people how to get ahold of us?

Donna Lee: 

You can call all of us or ask for me if you want, (512) 238-0762. We are in Round Rock, Austin, South Austin, and Dripping Springs. And please email those questions, we’ll answer them every time and we’re super excited to receive them. Armormenshealth@gmail.com, armormenshealth@gmail.com. And our website is armormenshealth.com. Thanks, Dr. Mistry.

Dr. Mistry: 

Thank you.

: 

Dr. Mistry wants to hear from you. Email questions to armormenshealth@gmail.com. We’ll be right back with the Armor Men’s Health Hour.

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