Phone: 512-238-0762

Fax: 512-341-7370

March 7, 2020

Dr. Mistry Answers Questions On Post-Prostatectomy ED, NAU Urology’s Erectile Rehabilitation Program, Intercavernosal Therapy, and Penile Prostheses

Donna Lee: 

The Armor Men’s Health Hour is brought to you by Urology Specialists. For questions during the week, call us at (512) 238-0762 or visit our website at armormenshealth.com. The Armor Men’s Health Hour is a show dedicated to providing information on a variety of medical topics, some of which may include sensitive subject material about penises. All cases discussed have been done with the permission of the people involved and their penises.

Speaker 2: 

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

Dr. Mistry: 

Hello and welcome to the Armor Men’s Health Hour. I’m Dr. Mistry, your host, here with my cohost as always, Donna Lee.

Donna Lee: 

Hello, happy radio-land, and podcast-land out there.

Dr. Mistry: 

Hello everyone. I’m Dr. Mistry. That’s “Mistry.” That was a recommendation from one of our listeners, that I spell the name and make sure you know that I’m a real person, not just to some gimmicky actor.

Donna Lee: 

He thought that it was “Mystery,” like the mystery novel and that you were being cute.

Dr. Mistry: 

Kinda like Dr. Strange maybe?

Donna Lee: 

Yeah, that would be more appropriate.

Dr. Mistry: 

I’m a board certified urologist. I have been practicing urology here in Austin since 2007. Our practice is called NAU Urology Specialists. We treat a variety of men’s health conditions as well as general urologic conditions, and are really happy to be part of the community.

Donna Lee: 

That’s right. We’re all over the place, too. We’re very busy.

Dr. Mistry: 

And Donna, you are our practice manager and the queen bee around here.

Donna Lee: 

I try. I do need my tiara though, please. And maybe a bee suit, bee outfit. We’re all over the place. We’re in Round Rock, North Austin, South Austin and in Dripping Springs, Texas, the beautiful Dripping Springs. I do want to go back to your name, which is super awesome. The gentleman that sent the email and that we keep everybody anonymous. He said that he thought it was “Mystery,” like the mystery novel–“M-Y-S-T-E-R-Y,” which led him to think it was some sort of joke and not to be taken seriously. And then he said, “I came to realize that is not the case.” So thank God.

Dr. Mistry: 

Good.

Donna Lee: 

He said, “I suggest you guys just spell your name more often,” so…

Dr. Mistry: 

Well there you go.

Donna Lee: 

So it’s “M-I-S-T-R-Y,” if you want to Google Dr. Mistry.

Dr. Mistry: 

We really appreciate you joining us today. We try to provide information on topics that are specifically relative to men’s health, but also that may kind of involvement in general. So that’s why sometimes, we will talk about topics that both include health impacts on men and women, and we love your questions. You know, questions suggest a very high degree of engagement with our show. And it’s one of the things that drives us to do it.

Donna Lee: 

And then KLBJ said that we’re doing a great job.

Dr. Mistry: 

Good.

Donna Lee: 

So we’re still keeping our jobs.

Dr. Mistry: 

And if you’re listening on podcast, please send your questions through that, too. Our podcast is absolutely blowing up. You can find it wherever you find your podcasts.

Donna Lee: 

We have like hundreds and hundreds of downloads a week.

Dr. Mistry: 

Yes.

Donna Lee: 

It’s crazy.

Dr. Mistry: 

Yes, I’m becoming a podcast model.

Donna Lee: 

You can tell me, you can say “I told you so,” because I was like, “Oh, we’ll just get 20 or 30 a week.” We got several hundred in the last few weeks.

Dr. Mistry: 

And we’re just really about answering your question. So speaking of questions, Donna Lee, let’s do it.

Donna Lee: 

The first one is from just a few days ago, “Dr. Mistry, I had my prostate removed 7 years ago at age 62 due to cancer. I have been unable to achieve an erection ever since. Would the new ultrasound treatments help someone like me? And if so, does Medicare pay for it?”

Dr. Mistry: 

That’s a great question. Really leads to several different components. The first thing I’m going to talk about is what is the role that shockwave plays in erectile dysfunction? So using kind of the colloquial term “shockwave” I think kind of can be scary to some people.

Donna Lee: 

And it doesn’t actually shock.

Dr. Mistry: 

No, it doesn’t shock anybody.

Donna Lee: 

Other companies are using other names that sound less shocking.

Dr. Mistry: 

That’s right. Linear compression therapy and other kinds of therapies. But I would just tell you that it’s a small amount or small intensity of energy that’s directed right towards the erectile bodies of the penis leading to a regenerative effect. It causes micro-damage that leads to the body wanting to fix that area. You get rejuvenation of nerves and blood vessels as well as the health of just the sheath that is holding the blood that makes a good erection. It’s great for mild to moderate erectile dysfunction. I think if anyone is trying to sell you shockwave and you have severe erectile dysfunction where you’re not able to get any erections, I think that you’re likely to be a little disappointed by that. Certainly if someone is trying to do anything to your penis and they’re not a urologist, I would definitely, definitely take a step back. And I know that sounds silly, but…

Donna Lee: 

No, it’s a good point.

Dr. Mistry: 

You know, use of shockwave therapy can be done by anyone. There are plastic surgeons out there doing it. There’s med spas doing it. You don’t want to just go to someone for your erectile health that just happened to be able to buy a machine. So, we would encourage you to come see us and get a really comprehensive evaluation and we have the lowest price, most effective, low intensity shockwave therapy on the market. The second part of this question is probably a little deeper, and that is what do you do with post prostatectomy impotence? For those of you that don’t know, the prostate is located in the pelvis, underneath the bladder. And surrounding the prostate are the nerves that help maintain nervous outflow to the penis and erectile bodies. And when they get cut, oftentimes during a radical prostatectomy for prostate cancer, those nerve impulses don’t get transmitted to the penis, and so getting an erection like you remember getting it where you think about something and that nerve impulse gets transmitted around those nerves to the penis and then causes blood flow to increase, then you get an erection…that’s not going to happen anymore. What we usually advise our patients if it hasn’t come back in a year–because it can can come back–but if it hasn’t come back in a year, it’s not likely to work or come back on its own. Some patients in our practice, we use something called an erectile rehabilitation program where we use the combined use of a vacuum erection device as well as a daily Tadalafil, as well as some other supplements to try to maintain the health of your erections and penis. But if that doesn’t work, then when you got to go to the next step. Now the good news is the blood supply to the penis and erections are still intact. So if we can just give you either pills or injections or sometimes intraurethral creams to help promote that blood flow into the penis, we can help you obtain an erection that feels normal and you can have a normal orgasm, and no ejaculate, but an orgasm. However, if those don’t work or those won’t appeal to you, the inflatable penile prosthesis is a wonderful option, especially if you’re concerned about money. The inflatable penile prosthesis is a 3-piece, completely internally inserted device, where you actually will have a little pump that you’ll pump up. It’ll transfer fluid into these cylinders that’ll give you a full rigid erection as long as your penis is with great girth, wonderful sexual satisfaction–in fact, satisfaction rates are over 90%.

Donna Lee: 

Where’s the pump?

Dr. Mistry: 

The pump is in the scrotum. It’s almost like a third ball, but it’s easily concealable. Nobody will know that you have this thing in you.

Donna Lee: 

Oh, that was my next question. How do you hide it from the ladies?

Dr. Mistry: 

…the ladies.

Donna Lee: 

This is my third ball.

Dr. Mistry: 

My third ball. I mean, you’re lucky if she’s exploring you down there that much, honestly. You know that Donna Lee. Do you even know how many testicals you husband has?

Donna Lee: 

No, he’s got at least one.

Dr. Mistry: 

And so, the use of that inflatable penile prosthesis is one associated with a high degree of satisfaction, covered by Medicare covered by most commercial insurances, and covered by the VA.

Donna Lee: 

Right? That’s amazing.

Dr. Mistry: 

So if you’re a VA patient and you want to use your, you know, benefits that allow you to see a doctor soon, you know, encourage your VA provider to have a referral to our clinic. It’s covered by the VA, it’s covered by Medicare, covered by Tri-Care and just…

Donna Lee: 

You can’t get your breasts augmented, but you can get your penis augmented.

Dr. Mistry: 

Well as long as you know…

Donna Lee: 

…covered by insurance.

Dr. Mistry: 

…as long as men are in charge of the government right now…

Donna Lee: 

Hey, there it is.

Dr. Mistry: 

…we’re going to have to make sure we’re taken care of. You know exactly how it is now. All right. Do we have time for another question?

Donna Lee: 

A quick one, along the same lines? But we had another patient who I’m actually working with to get them an appointment, but, “I’m 65 years old and have ED. I’m seeking outside help. VA is causing me a lot of frustration.” So I thought, I feel so bad for this guy because we have a ton of VA patients who are super frustrated.

Dr. Mistry: 

That’s right.

Donna Lee: 

So we will see the VA patients.

Dr. Mistry: 

Absolutely. And so, you know, within the confines of the VA system, you really have a couple of options that you can do. One is testosterone therapy to make sure that that level is normal, which can help a lot of the pills work. Then the pills, which are often covered by the VA, but if not, we can usually get you the pills for something around $30 a month. And a testosterone therapy is pretty inexpensive too, somewhere in the 30 to $40 a month range. But the next that we can provide is something called intracavernosal therapy, where it’s an injection of medicine that will allow the blood vessels that bring arterial blood into the penis to expand and give you a full rigid erection that can last for an hour.

Donna Lee: 

That’s an injection into the penis.

Dr. Mistry: 

That’s correct.

Donna Lee: 

With a teeny tiny needle.

Dr. Mistry: 

Tiny, tiny needle, which seems offputting to those of you that wouldn’t even consider it. The needle is painless. The experience is widely, enjoyed by patients. And the medicine probably costs something around $8 a dose. And, if you are interested, if pills aren’t working for you, you’re not interested in the penile prosthesis yet, that intracavernosal injection is certainly a program that we can, we would be happy to put you on, do a trial here and get you sorted out. But then if you’re in the VA and you’re 65 and you’re interested in having 10 more years of great sex life, I think the penile prosthesis is a wonderful option. And you know what we have here? We have a super power here in our practice. Dr. Christopher Yang, my partner, spent an entire year doing nothing but penile prosthesis.

Donna Lee: 

Right? Wow.

Dr. Mistry: 

So you’re not going to get a better trained…

Donna Lee: 

That’s true.

Dr. Mistry: 

…and more dedicated practitioner for that purpose.

Donna Lee: 

He’s the man. As are you.

Dr. Mistry: 

So thanks for those 2 questions, somewhat related. They’re good. Donna Lee, why don’t you tell people how to get ahold of us?

Donna Lee: 

You can call us during the week at (512) 238-0762. We should really get a timer. What do you think? The time just runs away and we’re almost done with the segment. One. Our website is armormenshealth.com. That’s armormenshealth.com, so you can see Dr. Mistry’s handsome face and my super cute face. And you can send us emails to armormenshealth@gmail.com. Again, that’s armormenshealth@gmail.com I will respond to every one of them personally, and then I let Dr. Mistry know.

Dr. Mistry: 

And don’t forget the podcast!

Donna Lee: 

Don’t forget the podcast, wherever you listen to podcasts. We’ll be right back.

: 

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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