Phone: 512-238-0762

Fax: 512-341-7370

August 8, 2020

Is Your FLP (Funny Looking Penis) Peyonie’s Disease? Dr. Mistry and Donna Lee Talk Causes and Treatments

Speaker 1: 

Welcome back 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, a board certified urologist, here with my certifiable co-host.

Donna Lee: 

Certifiable. I’m going to start calling you Mr. Worldwide.

Dr. Mistry: 

Mr. Worldwide!

Donna Lee: 

But not the pit bull version, like the men’s health version, since there’s so many listeners in other parts of the world.

Dr. Mistry: 

As far as we know, we’re the most awarded men’s health show on the, in the world…as far as we know.

Donna Lee: 

My old junior high school awards are right in front of us with my label maker that I brought along.

Dr. Mistry: 

That’s right.

Donna Lee: 

It says “Ding-a-ling and Yum Yums Awards 2020.”

Dr. Mistry: 

That’s right. People often ask me why I became a urologist and you know what I say? Because of the jokes.

Donna Lee: 

That’s what I tell people in interviews when they interview with us and they think that it’s so funny. They’re like, really?

Dr. Mistry: 

Well, when I was in medical school, we had, you know, obviously the choice of anything in the world to do. And so I really liked surgery. I think my dad wanted to become a heart surgeon, and I kind of wanted to be a brain surgeon.

Donna Lee: 

Really?

Dr. Mistry: 

And I said, “You know what the real heart and brain of the body is?”

Donna Lee: 

The penis.

Dr. Mistry: 

That’s right. And so I was like, you know, I might as well just go straight to the source and work on that which is the most important. And I went to a grand rounds, which is kind of the weekly thing that doctors do when they’re training to learn about new cases, and the chairman of the department, Tim Boone, I’ll never forget, he made a joke about how big his member was in front of everybody, and nobody even found it weird. It was just a normal part of the urology. And you’ll go to urology conferences and people will talk about that kind of stuff all the time. So you’re all just tend to be a good humored, very smart, incredibly handsome group of doctors. What, you don’t think so?

Donna Lee: 

What’s funny is when you do mention a large member around the office, it’s not a bunch of doctors, it’s a bunch of our employees. The looks are like, “Oh, Dr. Mistry’s talking about penis again!”

Dr. Mistry: 

And our last week’s show, we talked about making your member larger with Dr. Dellinger and penile enhancement. So it was a fascinating talk. And although it’s something that I think some people think about, but they’re maybe a little too embarrassed to even bring up. If you’re worried about whether things are normal down below, if you think that you may have an FLP, which you’ll just have to put the letters together for yourself, and…

Donna Lee: 

I think we have to tell him it’s a funny looking penis, because somebody asked me once, what is FLP?

Dr. Mistry: 

Okay, well, there you go. If you think, if you want a second opinion on how things look down there, it’s definitely the kind of thing that we want to do. And if you have questions, please email them to us. And if you have jokes, email them to us. Donna Lee, I think people will start sending us jokes.

Donna Lee: 

Oddly, we have the cutest little jokes. As a professional comedienne, we cannot, we’re not taking credit for these jokes. These are actual jokes that are already out in the world. So just FYI for any comedians who are listening and think I’m a terrible comedian for saying somebody else’s joke. This patient sent in: “A 91 year old man is at the urologist, and he was told he would need a semen, feces, and urine sample. So the elderly gentleman starts removing his pants and the urologist says, “What are you doing?” The gentlemen said, “Here. I’ll just give you my underwear because it contains everything you need.”

Dr. Mistry: 

That’s pretty good. It’s pretty good.

Donna Lee: 

Oh, these guys. Anyway, so we do have some questions.

Dr. Mistry: 

Let’s go for it.

Donna Lee: 

The questions again, send them to armormenshealth@gmail.com or visit our website, armormenshealth.com. This particular one kind of a local guy who says “Dr. Mistry, I’m 62 years old, I believe I have PD,” which is Peyronie’s disease. He said, “My penis is bent and has shrunk. Can y’all help And what is the cost? I’m listening on 590AM and live in Bastrop.”

Dr. Mistry: 

That’s a great question. Peyronie’s disease probably is one of the most commonly asked issues here on this show. When the company that makes a product called Xiaflex, which is a treatment for Peyronie’s disease came out, they had these incredible numbers of the millions of men in the United States that suffered from the condition, and I just didn’t even believe it. But now I know it, now I believe.

Donna Lee: 

Because of the show?

Dr. Mistry: 

Yeah. I mean, and we encourage you to look through the podcasts of previous episodes, but I’m going to go through our little Peyronie’s disease spiel here. Peyronie’s disease classically presents as a curvature of the penis. And that curvature going to be up, down, left, right…often associated with a shortening of the penis. It causes men to have a lot of anxiety when it comes to intercourse, because either they can’t have intercourse if the curvature is too big or too severe. It can cause pain for your partner if the angle is just not appropriate. It can cause pain to you. It can lead to really lack of enjoyment of intercourse. And I will say that Peyronie’s disease is one of the things that causes men, the most grief when I’m talking to them, and you can really see how it’s affected them. It does cause shortening and there are treatments. And fortunately insurance covers a lot of these treatments. What you’re going to feel on the physical exam is often a nodule or a plaque underneath very deep on the penis. A lot of men can’t feel it themselves, but some can. So if you feel like you can feel it, if you can feel a nodule associated with the curvature, then that’s definitely the kind of thing that we can help you with in terms of making it, making the curvature less severe and improving pain if necessary. So some of the treatments that we offer within our program, we offer what are called intralesional injections. We can do that with either a medication called verapamil or a medication called Xiaflex. Xiaflex is the FDA approved treatment that uses a kind of an enzyme that breaks down scar and allows it to open up. The injection itself is not really that painful. It is covered by insurance and works well for mild curvatures. Then there’s surgical interventions. So there are surgical interventions that fix the curve, but don’t fix the shortness, and there are surgical corrections that fix the curve and maintain length, but then you risk having some sensory deficit or some numbness at the head of the penis. This last week, I saw many patients with Peyronie’s disease, several that had a curvature that was so severe they couldn’t have intercourse anymore, maybe a 90 degree or greater curvature, almost like when they’re having an erection, that penis head is pointing back at the body. Those types of patients, the real fix that we try to do for them is to make sure that we maintain the length. They are going to suffer some degree of at least temporary penile numbness while those nerves that we have to move out of the way heal. The vast majority of our patients get their sensation back. I don’t have any, in fact that reported longterm penile insensitivity. But there are surgical corrections. There’s corrections in terms of intralesional injections. There is not oral therapy that works, but there are…

Donna Lee: 

Sorry, sorry.

Dr. Mistry: 

It’s the one time oral therapy didn’t do anything.

Donna Lee: 

I almost said something inappropriate. Go ahead.

Dr. Mistry: 

And then there’s the use of penile stretching devices. So we use something called a vacuum erection device, and then a number of treatments that you can even get online, which are that they look like contraptions from medieval times to kind of put the head of the penis like in a vice and stretch it, which we use often. But when you see one of these things…

Donna Lee: 

You run? Forget it, I like my Peyronie’s disease!

Dr. Mistry: 

Yes. And, if you’re just trying to self-treat your Peyronie’s at home off things off the internet, we’d encourage you to come in and get some professional advice. And that’s what we’re here for.

Donna Lee: 

Why is the word disease associated with it?

Dr. Mistry: 

I think that it’s because the real underlying condition is the positing of scar tissue along the erectile body. And this, this type of scar deposition is not unique to the penis. There’s a condition in the hand called Dupuytren’s contracture, where scar is deposited along the tendons of the hand, and it causes the hand to become kind of like a claw-like. Oh, there’s an overlap between men who have Dupuytren’s contracture and men that have Peyronie’s disease. So clearly there’s some kind of abnormal scar healing responses going on. We have many theories on why Peyronie’s disease develops. One of the most commonly cited theories is that of microtrauma. So the idea is that perhaps, as men are getting less and less rigid erections, as they’re getting older or their testosterone is getting lower, they’re getting less rigid erections, and so when they’re having sex, their penis is actually bending in abnormal directions a little bit every time. And so that little microtrauma every time then leads to abnormal scar deposition. But Peyronie’s disease can develop so rapidly. We have had patients that will call us that day. They will call us, they’ll say “I woke up this morning and everything was fine yesterday. And today my penis is bent.” And so it can happen overnight, automatically happened to people. And so if that is don’t, and people are confused about what happened. I mean, something that they trust was going to work just fine, all of a sudden it’s betraying them overnight. And a lot of men associated with a severe penile trauma, like a breaking of the penis, which by the way, we have seen a major uptick in our practice. So guys, please take it easy. I don’t know what it is. I don’t know what it is. We’re getting two or three a week now. Oh, my, we would see only one a month before.

Speaker 2: 

I don’t know what’s going on. Ladies. Come down on everybody. We’re guys. We don’t judge them.

Speaker 1: 

I mean, it’s been it’s it’s, it’s, it’s really something. I think one of our partners that dr. Yang had had three in the last two weeks, just him. Wow. Crazy. Okay. Everybody needs to take a choice to take it easy, but Peroni’s disease is not always associated with a severe P&L trauma like that. There can be a, and there can be people that have absolutely no risk factors at all and have it. So it’s not something you did, but it’s something that we can help you fix.

Speaker 2: 

Like, I always say another reason not to. Yeah.

Speaker 1: 

Wow. That is not what you should say.

Speaker 2: 

I started saying that you’d sit terrible. It’s a thing now for me, it is a terrible motto. I love you, Michael.

Speaker 1: 

Well, Michael, why don’t you tell Michael how to get ahold of him?

Speaker 2: 

Michael. Call (512) 238-0762. Michael sent the email to all women’s health@gmail.com and Michael visit our website at armor men’s health.com. Listen to the podcast. Michael dr. Mystery wants to hear from you email questions to Armour men’s health@gmail.com. We’ll be right back with the Armour men’s health hour.

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