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October 10, 2020

Fecal Incontinence: Dr. Mistry Talks Treatment Options For Men and Women Experiencing Leakage or Urgency

Speaker 1: 

Welcome back to the Armour men’s health hour with dr. Mystery and Donnelley I’m desperate mystery . Your host here’s all was with my cohost, the effervescent of brilliant and person learning new words all the time on camera .

Speaker 2: 

Brilliant. What is it ? Does a brilliant mean lovely and thoughtful.

Speaker 1: 

If you know what these words mean, and I use them wrong, please not come up .

Speaker 2: 

Booleans I am a Boolean today.

Speaker 1: 

Donna is our practice manager at our urology practice. I’m a board certified urologist. Uh, I started, I started our practice NAU urology specialists in 2007, and we have grown to a magnificent great . We are the second largest, second largest urology group in Austin by default. But yes we are. That’s right. You know , as a general rule, we can’t say certain things in our office. We can never say semi-rigid we can never say re you know, smaller rejuvenation. That’s right. It’s gotta be, we gotta use the terms that talk about growth and ,

Speaker 2: 

And girth. You know, we got a lot of questions about that time. Dr. Dellinger was on talking about girth and fillers.

Speaker 1: 

We are doing so much penile enhancement and so much penile enhancement work. It is absolutely incredible for those of you that are looking for information on growth enhancement or any other kind of genital reconstructive work that you’d like to see done. We have amazing partners. I do a lot of the work along with a number of plastic surgeons in town. Dr. Dellinger is a great partner of ours at lesion and plastic surgery. And , uh , you know, especially if it’s a topic that had been bothering you and you don’t know who to talk to. I mean, it’s a , it’s a wonderful opportunity to talk to us.

Speaker 2: 

And I think there was some confusion because we talk about girth and length, and those are two different things. So I hope the guy knows that about his own PP .

Speaker 1: 

Well that’s okay. Well, we can talk to him .

Speaker 2: 

We can do both through dr. Yourself.

Speaker 1: 

That’s right. We’ll , we’ll, we’ll do our best to make, make your dreams come true. Uh, you know, this is a sensitive subject for a lot of guys. They’re like, I don’t know why I care. And then there are other guys that are like, well, my wife told me that the other guy was bigger. The old boy,

Speaker 2: 

I remember a story about that. Didn’t know why I say I’ve had bigger. So he went right out and got bigger. It’s going to cost me money. I just run from it.

Speaker 1: 

No . And so we’re here to help make those , uh, those kinds of , uh , which is of yours , at least be addressed, if not completely, you know , to your expectation

Speaker 2: 

Disney world for sex, we’re here to make your wishes come true.

Speaker 1: 

The most of the most common things that we do are in relation to men’s health is really to help optimize your function, whether it be urinary function, sexual function, hormonal function, how you’re feeling general fatigue. We want to make sure that we’re helping with your weight loss goals. And we do so many things that people wouldn’t necessarily associate with a traditional urologist office. And that’s because we are not a traditional urologist office. We are here to take care of you from the top of your head, to the bottom of your toes, in terms of making sure that you’re getting the right consultants that are helping to take care of you, the right medical test to help diagnose you. And then of course, you know, treat your kidney stones, treat your prostate cancer, treat your bladder cancer, put your bladder stones or fix your hormones, or for any of the number of reasons that people refer to us.

Speaker 2: 

Oh gosh. And we get so many referrals from all these amazing primary care physicians in town.

Speaker 1: 

That’s right. I mean , our relationship with your primary care doctor is really important. We also see a number of patients that have a previous urologist. I would say that probably half of the patients that I see as new patient consultations have been with another urologist and come to seek us out for second opinions or kind of a upgrade in their care. And that’s what you get with us when you’re big enough to be able to provide more services, but small enough to treat you like a person.

Speaker 2: 

And they’re probably just dig your name, mystery

Speaker 1: 

Dr. Mystery. It’s a real name. That’s right . We are seeing patients in a safe, socially distance and fully masked way here at a number of our offices all throughout town. And we’d love to see you. We are taking a new patient visits via telemedicine. And if it’s really a second opinion you’re looking for and putting hands on you and examining you may not be a critical part of that consultation than a telemedicine appointment is a wonderful way to get somebody to review your records. It’s covered by insurance. You know, I’ll give you kind of exactly the kind of treatment that I would give anyone who was a patient of mine primarily. I mean, you really get exactly in-person or on the phone where you’re getting on the radio, which, you know, hopefully you’ll like,

Speaker 2: 

I think so. I think I know we have a lot of patients who call because they listened to the show. So we appreciate that.

Speaker 1: 

Donna, why don’t you tell people how to get ahold of us and we’re off?

Speaker 2: 

Yep . You can call us during the week (512) 238-0762. You can Google us. Dr . Mysteries, a website is Armour men’s health.com. Well , our website, I guess, and you can send us questions to Armour men’s health@gmail.com. I’ll respond to all of them. We’ll send you free podcasts . If you don’t catch the show on the weekend on Saturday or Sunday on KLBJ and we have more questions, dr. Mystery. Awesome. Well hit us . This one kind of, I was a little worried, but when this wife Synthes in, so her husband’s a patient of hers . She says dr . Mystery, my husband has been in your program for a few months. Now he has refused to tell the doctor about his incontinence and says he doesn’t want to, or need to. I’m concerned he doesn’t have insurance. And she goes on about paying his office visits. I guess she’s paying his bills. He can’t keep a job because he can’t stop going to the bathroom all day. Basically he has to shower and change clothes to go back to work. That’s upsetting. She said, this has been going on since the nineties. He has a, he has had his gallbladder removed within the last few years. So that adds to the problem. She said, listening to your program, it seems there is a medication or therapy he can do to fix the pooping problem. Oh, it’s a pooping problem. Since he won’t tell the doctor and is just taking injections every week, it doesn’t seem to be helping his other problems. He has no intention of telling the doctor about this issue at our clinic. She wants to know what she should do. Well, what a great question. So he’s probably embarrassed.

Speaker 1: 

So, you know, when you, when you look at the question and I apologize if I don’t address exactly what was addressed or intended here, but what I’m going to talk to you about is something called fecal incontinence. So it sounds like that this, this listeners husband could be experiencing leakage of stool throughout the day unexpectedly. So that fecal urgency can be either just like urinary urgency or low loss or incontinence can be from either urgency or sphincteric dysfunction, where it just kind of comes out when you cough and sneeze. So can to leakage from the rectum or anus for fecal soilage. When it comes to fecal solos in a man, we get very concerned about underlying neurologic disease. You know, we recently had a patient who had a , uh, called an anal fissure or an anal abscess that had to be lanced on anal fistula had to be lanced that caused damage to their external sphincter that caused them to have a leakage. And there are fixes. You can actually do slings, just like you do slings for the bladder. You can do slings for the rectum. We have amazing colorectal surgeon partners that help with that. There are, there’s a big dietary component to helping with fecal incontinence as well. And men , particularly in women, fecal incontinence is often due to the same type of pelvic floor prolapse or pelvic floor Oregon’s falling that causes the bladder to fall or the uterus to fall, or any of those things that happened to women, especially if they’ve given birth to multiple children, that incontinence is due to just kind of a weakness of those, of those tissues in a man. We worry a little bit more about , uh , neurologic issues. And when it comes to diet, we really want to make sure that they’re on a diet that promotes really good quality, you know, fully formed stools. So not greasy hamburger diet. Well, I mean, if your gut can’t take a greasy hamburger, all of that greasy hamburgers ,

Speaker 2: 

That was pretty good diet . What about Indian ?

Speaker 1: 

You know what, that’s enough about you ? You know, I guess you’ve got a double wrap your underwear, you’re going to have to do that kind of stuff, but really it’s identifying foods that are not good for you when it comes to holding solid stools. And so our integrative nutritionist Shefali Ruvolo , who’s a physician assistant will work with you to give you advice on supplements on additives, to your food that can bulk up and make it a more high residue diets that you are able to get more fully formed stools without getting constipated. That’s great, making sure that the flora in your guts appropriate so that your , your colon is breaking down the, you know , materials in your stool properly, making sure that your, your small bowel and things aren’t, aren’t working. So where the gallbladder thing comes into it is that sometimes when the gallbladder comes out, the bile that’s supposed to be released by it doesn’t, it causes a more kind of greasy stool to come out. And so that can be effected or that can be adjusted diet without dietary.

Speaker 2: 

Where’s the gallbladder, what is the Galway or no ,

Speaker 1: 

It’s right under the liver and it functions in our digestive tract. Gotcha. And so then you have, what do you do with people with fecal urgency? There are medicines that can help decrease fecal urgency. And there’s also a neuromodulation, you know, how we use that Axonics to help people with bladder incontinence, right ? That these are like little leads put into the nerves that go to the bladder that act like a pacemaker for the bladder to kind of calm it down, right ? The same thing put in a slightly different place can be used for fecal urgency incontinence. So I know a lot of these things sound like they cost a lot of money. Pelvic floor physical therapy is another thing that we offer that will really help fecal incontinence, both in men and women and it’s topic. Nobody likes to talk about, right . I agree. It’s a , for many patients and embarrassing topic, but,

Speaker 2: 

But there’s a fixed maybe for sure.

Speaker 1: 

There’s definitely like steps that can be made to help make you feel better and feel more confident. And even if nobody can smell anything, you feel like you’re , you know, something, you feel like very uncomfortable in public when you’ve kind of staying in your pants. And , uh, we would love to be there as a resource to help make , um, you know, that part of your life much better. And sounds like for this particular person in, I could feel like fixing this issue is going to help their life improve

Speaker 2: 

And yeah . Help his wife not be angry. Cause she was not happy about paying.

Speaker 1: 

Well, trying to wake you up and make your wife happy all the time. It was really a goal that sometimes,

Speaker 2: 

Oh , my people get ahold of us. How do people ask questions? Send us your questions. We’ll answer them right here on air anonymously, Armour men’s health@gmail.com or you can call us during the week (512) 238-0762. And thank you so much for these amazing questions. Thanks back to the day , the armor men’s health hour. We’ll be right back. If you have questions for dr. Mystery, email him at Armour men’s health, ed gmail.com

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