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July 4, 2020

Prostatitis Problems: Dr. Mistry Talks Chronic Prostatitis Causes and Treatments

Speaker 1: 

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

Dr. Mistry: 

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

Donna Lee: 

Yes. And I go by Dr. Donna, now.

Dr. Mistry: 

You do not go by Dr. Donna.

Donna Lee: 

But a patient called me that.

Dr. Mistry: 

No, that’s illegal.

Donna Lee: 

Well, I’m going to put it in quotes, and it’ll be fine.

Dr. Mistry: 

We’re not doing that. There’s no quotes on the radio.

Donna Lee: 

They can’t see my air bunnies?

Dr. Mistry: 

That’s right. We both have faces for radio. Welcome to the show. I’m a board certified urologist. This is a men’s health show, and we are brought to you by NAU Urology Specialists. We have been in practice since 2007. We have four physician practitioners. We have four physician assistant and nurse practitioners. We have a pelvic floor physical therapist. We have a sex therapist. We have sleep apnea testing. What I think is one of the most comprehensive urologic type medical practice you’re going to find in the world.

Donna Lee: 

That’s right. And we are although the second largest in Austin, we do try harder and we are cuter on the weekends, with the pushup bras…for you.

Dr. Mistry: 

For me? Oh my Lord. Anyway, I think what she means is that, you know, when you’re looking for a doctor, you want somebody that’s still looking to impress you and do a great job for you. That’s right. You know, that really brings up a very interesting point, which is that, and I say this on the show all the time, although all the doctors that I come across are exceptionally well-trained, especially those that went to Baylor.

Donna Lee: 

There it is. Took 47 seconds.

Dr. Mistry: 

You’re still going to be limited in terms of the advice that you’re going to get based upon where they trained, how they trained. I’m such a big believer in the second opinion, and this idea that if you have a medical condition that you find to be complex, then there’s many multiple options for treatment, then sometimes it’s a good idea to get more than one opinion because there’s some surgeons out there and some physicians out there that only do things a certain way and have certain biases. And you as their patient are then subject to those biases. And I think that that getting a second opinion or doing research on your own and finding out and seeking out and taking control of your own healthcare is something that we think is very important for our patients. And in fact, we have patients that come to us from all over the state and even some from out of the state to get treatments for their prostate cancer, to get treatments for their chronic prostititis, to get advanced stone chemistry work, because we take all of those things so seriously. We have an amazing nutrition program here. So if you have been diagnosed with a urologic cancer, if you have irritative urinary issues, even irritative bowel issues, if you think that you’re complex and you don’t want to just keep taking pills and want to learn how you can get a functional nutrition kind of approach to what’s going on with you, these are things that we do because the whole body is connected. You know what I’m saying? The hip bone connects to the kneebone.

Donna Lee: 

I love that song.

Dr. Mistry: 

I don’t think I know any of the other words.

Donna Lee: 

I don’t know the words.

Dr. Mistry: 

After the pelvis, I get confused about anatomy.

Donna Lee: 

I don’t think we ever get to the toe bone in that song.

Dr. Mistry: 

Well, this is a show that’s dedicated to the issues of men’s health. You know, men’s health affects younger men, affects older men, you know, men, men, men, men, men.

Donna Lee: 

And it affects women.

Dr. Mistry: 

That’s right. And an affects…

Donna Lee: 

The women in the household has to deal with your BS.

Dr. Mistry: 

That’s right. Speaking of women, you know, the very first woman in our lives is our mother. You’re right. And we get mothers that come in with their sons for problems all the time. And I think it’s maybe because the mom is worried that the son’s not going to be able to communicate or be as forthcoming with the doctor and we enjoy it. You know, moms, if your son is 22, maybe step out when I do the genital exam.

Donna Lee: 

No, we did have an older man come the other day come with his mother. That was fun. She was in charge and 78 years old. So that was fun.

Dr. Mistry: 

I mean, there’s some patterns that are hard to break. But if you’re a worried mom out there and you have questions about your boy and you want to ask us a question, how do people get ahold of us?

Donna Lee: 

You can call us during the week (512) 238-0762, but more easily for you, you can email us at armormenshealth@gmail.com or send a question through our website, which is armormenshealth.com. And we actually did have a mother reach out about her son.

Dr. Mistry: 

Let me hear that question.

Donna Lee: 

The question is for you, of course. “Dr. Mistry, heard your show for the first time today, when you offered to answer a question, I thought I’d ask. My son is 23 years old. Short version, he had prostatitis the first time when he was 17, has had it a couple more times has had various issues. He’s having issues urinating. He did do pelvic floor therapy for a bit, still tells me he often has prostate pain.” She put it in quotes, “still leaks, and he just deals with it. I’m encouraging him to see someone again, seems like there could be longterm issues he’s not considering. That is my real question–longterm effects or something he’s not thinking about.”

Dr. Mistry: 

That’s what kids do, right? I mean, especially the younger people in their early twenties that think they’re bulletproof and don’t worry about future things. Going through that, prostatitis is generally considered a condition, often brought on by bacteria, at least initially, in which a man can have urinary frequency, urgency pain with urination, they can have back pain and pain above their pubic bone. Now, usually that first episode does respond to antibiotics. In our office, we generally will put you on a two to three week course of antibiotics. We may get a semen culture or a particular culture of the fluid from the prostate. We’ll also put you on probiotics and then make sure that there’s nothing anatomically that’s going to get you to continue to have that same condition over and over again. Some people develop an atypical inflammatory response of the prostate that leads to a condition called chronic prostatitis. And that term actually takes many different forms. It can become chronic pelvic pain syndrome, interstitial cystitis, chronic prostatitis…People have different terms or different words for it, but in general, what it means is that you get intermittent episodes or flares of bothersome urinary complaints that cause leakage in some cases, like it sounds like in this gentleman, that you can also cause a burning. It can cause discomfort when sitting it can cause pain after a ejaculation, and for a lot of guys, can really make your life quite miserable. I think it’s frustrating because most, I would say many urologists do not like to take care of this condition. It’s frustrating for us. There’s nothing anatomic that I can cut out. There’s nothing to do in a way.

Donna Lee: 

Right? And you can’t make a young man do what he’s supposed to do.

Dr. Mistry: 

Maybe, maybe, but you know, a lot of times these guys are really motivated. So they really need to go to a person who really cares about finding out what could be going on. And because there could be five or six things going on, you really have to be patient by going through the process. For sure, although it sounds weird, nutrition and stress management are very important components of dealing with intermittent chronic prostatitis.

Donna Lee: 

I bet he hadn’t thought of that yet.

Dr. Mistry: 

When it comes to whether it’s a biomechanical or muscular issue or something really with the prostate, I ask one question and that is a question that his mom probably doesn’t ask–it is, does it feel worse or better after you ejaculate?

Donna Lee: 

Oh yeah. Mom wouldn’t ask that.

Dr. Mistry: 

Mom doesn’t ask that. Okay? So if it feels worse after he ejaculates, then it’s in my mind, I think it’s a muscular issue. And if it feels better or no change with ejaculation, then it’s probably a prostate or something up in the bladder issue. And so that’s how I use a simple question to distinguish where I think the problem is. So let’s say the problem is muscular and the mom said he already did pelvic floor physical therapy. Well, I don’t know what they did or how they did it, or how long he stuck with it or whether he stuck with the, with the exercises. I tell you, I have kids like that, and I tell him to go clean the room, I got to tell him 15 times. I’m sure that if you went and did the pelvic floor physical therapy, but had a homework regimen, you know, maybe he didn’t stick to it. You know?

Donna Lee: 

Yeah, I can’t imagine he’s 23. It’s tough.

Dr. Mistry: 

That’s right. So it’s just a different way and a different mindset of thinking about how we deal with these kinds of chronic conditions in younger people. And especially if he has flares, meaning where he has like several days of discomfort and then it goes away for several months, then maybe he just kind of feels like he’ll just live with it. So then what you think about is what does he live with every day? If he has shy bladder where he can’t pee in public, or he feels like he has to sit to pee, or he has leakage with his dribbling after he finishes peeing, he may have that all the time, and only the flare sometimes. What we would add is to this is usually some medication to help his pelvic floor relax. We would really make sure that there’s nothing anatomically going on with his prostate. And then we would really strongly push an urge, a monitored stress management and nutrition program that I think is going to be a dramatic improvement. And I wouldn’t be surprised if this young man also had some bowel issues and some other things that are all very much connected because you know, the hip bone is connected to the knee bone. So the pelvic floor is connected to the prostate, it’ss connected to the bladder. And so if you are out there suffering from a chronic prostatitis or something of that nature, it doesn’t matter whether you’re 23 or 63 or 83, we would love to see you and give you our advice and our take on that very debilitating and very annoying condition.

Donna Lee: 

Wow. What an incredible answer. There was a lot to talk about.

Dr. Mistry: 

Every question is just a package that I love to unpack.

Donna Lee: 

Isn’t it like a little Christmas gift for you?

Dr. Mistry: 

Because it’s an opportunity to showcase why I think that our practice is different, why our approach is different and why you can’t be dismissive of virtually any case, any condition, or any patient.

Donna Lee: 

And any age. We had a lovely man in his eighties, came in and wanted to know how he can have more rigid erections. So, good for him.

Dr. Mistry: 

He’s, right, he’s our new favorite guy.

Donna Lee: 

Yeah. I love that guy.

Dr. Mistry: 

I love it. The octogenarian who’s trying to have sex is my favorite patient. So you get in here, you know…

Donna Lee: 

Come on in!

Dr. Mistry: 

…and we’ll make your nineties better than your seventies.

Donna Lee: 

Wow. There’s a T-shirt. Oh my heavens. Well, you can call us during the week at (512) 238-0762. What we learned today is penis people’s problems, but we can fix them.

Dr. Mistry: 

That is not what we learned.

Donna Lee: 

Our email addresses are armormenshealth@gmail.com and our website is armormenshealth.com. You can see our smiling faces there and send in an inquiry through that email or through that website as well. Thank you so much for listening and thanks for the question. And listen to the podcast!

Speaker 2: 

Dr. Mistry wants to hear from you! Email questions to armormenshealth ed gmail.com. We’ll be right back with the armor men’s health hour.

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