Phone: 512-238-0762

Fax: 512-341-7370

August 22, 2020

Pelvic Pain, No Gain: Dr. Mistry Answers a Listener’s Questions About Pelvic, Testicular, and Bladder Pain

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, here with my cohost Donna Lee.

Donna Lee: 

That’s right. Hello. I’m also a pseudo radio producer in my spare time.

Dr. Mistry: 

That’s right. You’re doing a great job producing the show. Nice job.

Donna Lee: 

Except for Daniel. Daniel does all the work.

Dr. Mistry: 

He does all the work. And Donna Lee is our practice manager. I’m Dr. Mistry, a board certified urologist. This show is brought to you by NAU Urology Specialists, the practice that we started in 2007 in Round Rock, but now we’re worldwide.

Donna Lee: 

You are Mr. Worldwide because all the podcast listeners are mostly here, but there’s so many in Europe and all sorts of other countries. And we’re shocked.

Dr. Mistry: 

We had to remind somebody that we were actually on the radio first though.

Donna Lee: 

Oh yeah. He was like, “What? You’re a podcast.”

Dr. Mistry: 

That’s right. I tried to explain to him that being on the radio is a lot harder because you have to put out content every week. And unlike some podcasts are sitting as underwear somewhere. You’re saying I’m too bored today.

Donna Lee: 

Can you imagine doing a podcast about just your feelings and camping?

Dr. Mistry: 

Apparently 110 million from Spotify will make that really enjoyable.

Donna Lee: 

That’s true.

Dr. Mistry: 

That’s right.

Donna Lee: 

I hope Joe Rogan hears this, please.

Dr. Mistry: 

Please, Joe Rogan–listen to our podcast.

Donna Lee: 

I’m waiting for him.

Dr. Mistry: 

This is a men’s health show. We talk about a number of men’s health topics. They range from things that are specifically urological, like erectile dysfunction, prostate cancer, kidney stones. We even talked about a number of women’s topics at times, including hormone therapy, urinary incontinence in women, because the men have to deal with it in some way.

Donna Lee: 

Oh–that was mean. But we could change it to the Armor Wellness Hour in the future. What do you think that’ll attract the womens?

Dr. Mistry: 

No marketing ideas on the air, lady.

Donna Lee: 

We need to bring in more womens.

Dr. Mistry: 

But we also talk about things that may affect you outside of urology, including if you search our podcast history, we have Tripp Buckley talking about reflux disease. He’s one of the city’s most amazing practitioners for that. We have Dr. Tyler Goldberg talking about advanced orthopedic surgery, including hip surgery and knee surgery. We have just an amazing cast of characters that have been on this show, and really thank them for their support and as well as the number of primary care doctors that have talked about primary care support.

Donna Lee: 

Right? My favorite segments are the Dr. Aisha White, a plastic surgeon, and Dr. Wang–Dr. Wang’s first name?

Dr. Mistry: 

Diana Wang.

Donna Lee: 

Diana Wang, and they are featured on the “That’s What She Said” segments, because that’s what she said.

Dr. Mistry: 

So if you have questions, it’s really what helps us drive this show and our interest in continuing to produce it. You know what one of my favorite things talk about, Donna Lee?

Donna Lee: 

Penises?

Dr. Mistry: 

No. You’re the office manager here, but you don’t have medical training.

Donna Lee: 

No.

Dr. Mistry: 

So I always like to you, what are some interesting things that you, that you wonder about sometimes when you’re walking around.

Donna Lee: 

Oh, putting me on the spot.

Dr. Mistry: 

And like most men, we can’t find that spot very often.

Donna Lee: 

No you can’t. And I understand that joke. You know what’s fascinating to me, I just told some of the staff members is a little, probably awkward and weird, but when I first started with you, I was walking down the hall and this smell hit me so hard that I was blown away and had to walk backwards and go back around the other side of the clinic. And I found out it was an infected semen. What is that?

Dr. Mistry: 

That’s a great question. So…

Donna Lee: 

I’d never heard of that until I started with you.

Dr. Mistry: 

It’s a great question because it overlaps with many different of the, of the subjects that we deal with. Getting a bacterial infection of the semen means that it probably has to come from either the testicle, the epididymis, or the prostate. And that’s the kind of, the biological lineage of where your sperm comes from. So sperm is made in the testicle, it matures in the epididymis, it travels up the vas deferens up to the prostate where it mixes with seminal fluid and then is, in the course of ejaculation, is then emitted out of your body. Usually infected semen is, comes from the prostate. It’s one of the most common ways that we find and diagnose prostatitis is we do a semen culture where somebody brings in a semen sample and we send it for examination on a plate that looks for bacteria growth. That’s probably what you smelled. It was probably a really bad prostatitis.

Donna Lee: 

Bless his heart.

Dr. Mistry: 

Oh, bless his heart.

Donna Lee: 

Dustin was checking and he can’t smell anything. He’s like, “I don’t smell it.” The rest of us passed out and then we had to revive each other and we went back to work.

Dr. Mistry: 

If you do this enough as a doctor, then the urologic smells and odors don’t bother you. It reminds me of a funny thing of how I feel a surgeon knows what kind of surgeon he’s going to be.

Donna Lee: 

Really?

Dr. Mistry: 

That’s right. So, you know, you know, you’re going to be a surgeon when you walk into that first day of medical school lunch, and you only are allowed to sit at certain tables, you know.

Donna Lee: 

Like high school?

Dr. Mistry: 

That’s just like high school. And so the nerdy ones become neurologists. You know…

Donna Lee: 

They’re pretty ones become dermatologists.

Dr. Mistry: 

The jocks become orthopedists. And then, you know, the funny cut ups become urologists. But then you go and decide to become a surgeon, and then it comes down to what fluid you can tolerate.

Donna Lee: 

Stop it.

Dr. Mistry: 

That’s right.

Donna Lee: 

Really?

Dr. Mistry: 

So I could never tolerate phlegm. And so I decided not to become an ENT. I couldn’t do it. Those days, walking through the halls as a medical student at the VA hearing…

Donna Lee: 

Hearing all the hawking?

Dr. Mistry: 

….and the spitting into the cup, I was like, “I could never do that.” And then if you can’t handle poop, you can’t be a general surgeon. I was like, “I could bathe in urine. It’s fine. It’s sterile.” You know what I’m saying?

Donna Lee: 

There’s all sorts of websites for that.

Dr. Mistry: 

I’m a urologist…Oh boy. So I could become a urologist.

Donna Lee: 

My husband had a friend who had a girlfriend and he was an older and she was older and she kept hinting to him, she kept saying, “You know, there’s no taste in urine.”

Dr. Mistry: 

Oh, gross. Can we please edit that part out? So, Donna Lee, what’s another question you got for me?

Donna Lee: 

Oh, a bunch of amazing questions. You can send them to armormenshealth@gmail.com, armormenshealth@gmail.com. We will get those questions answered, I’ll respond. “Dr. Mystery, I have constant pain from the bladder through the prostate and into my testicles. What would be the next step?”

Dr. Mistry: 

That’s a great question. The ball pain issue and the pelvic pain issue is usually a bane to the existence of many urologists, because they’re so hard to diagnose, but we’ve taken a real algorithmic approach to it. It’s either an infection or inflammation or a musculoskeletal or a neurologic response. I mean, we try to categorize that way. If it’s short lived and it just started, then an infection is usually something that we strongly consider. If it’s something that’s inflammatory, usually the inflammatory thing in your body, like irritable bowel syndrome, or this thing will come and go in six week increments, there’ll be some kind of dietary component to it. So if those are things that we pick up on, then we think it’s inflammatory. If you also have other musculoskeletal issues or neurologic issues like previous back surgery or back pain or disc issues, or if you have pelvic floor weakness, evidenced by urinary incontinence or urinary urgency, then that pain can be due to that. Now that’s not including all the anatomic issues: kidney stones, bladder stones, different types of even cancers diagnosed, although that’s not very common, fortunately. But our evaluation for somebody with bladder pain that goes to the prostate to the testicles is really gonna focus on infection, inflammation, and neuromuscular type issues. We often will prescribe pelvic floor physical therapy, medicines like amatryptolene that work on the nervous system or muscle relaxants. These are the kinds of approaches that we’ll take in the office. And I think that we’ve had exceptional success in helping people deal with chronic pelvic pain, which requires more than just a pain medicine doctor or just a gynecologist or just a, you know, a traditional urologist. We really pride ourselves in being able to provide that more holistic type care. We have a functional nutritionist who’s a PA on our staff. We have a pelvic floor physical therapist on our staff. We can manage hormonally what’s going on with you, from an infectious standpoint what’s happening with you. And if you have a chronic pelvic pain condition, don’t live with it. Even if nobody has kind of been able to, you know, figure out what’s going on. And if you’re out there and you have a condition like that, and somebody put you on three or four or five rounds of antibiotics–Hey, it’s not, it’s not an infection. Guess what? And we need to look for a different cause.

Donna Lee: 

Think about all the people at the pain clinic who have that sort of pain. I never thought about that.

Dr. Mistry: 

That’s right. And you know, pain, pain management is tough. But if you’re not a urologist, then you may not know about the things that that we do. And so a combo therapy is probably in your best interest. So if you’re out there and suffering and you want a second opinion, then Donna Lee, how do they get ahold of us?

Donna Lee: 

You can reach us by telephone (512) 238-0762. You can send us an email to armormenshealth@gmail.com. You can visit armormenshealth.com and we will have a brand new, beautiful website for you. Dr. Mistry, we’re podcastable, like everywhere.

Dr. Mistry: 

We are worldwide.

Donna Lee: 

We are Mr. Worldwide. You can hear our podcasts wherever you listen to podcasts for free. They’re amazing and informative. You can Google Armor Men’s Health and then Google whatever urology topic you’re searching for, like Peyronie’s disease, funny looking penis…what do you think prostate, anything? And our podcast will pop right up. And you can listen to us in Russia and Germany, apparently, Asia. So find us where you can. And again, send us questions to armormenshealth@gmail.com. We’ll answer them all anonymously. And I wanted to give Shannon a shout out. She helps us figure all this stuff out. So thank you Shannon, for all you do. We appreciate it. And you too, Daniel and Kelly, everybody have a wonderful day. Take care of your body parts and come see us.

Dr. Mistry: 

Very good.

Donna Lee: 

Bye!

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 armormenshealth.com.

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