Rezum for BPH: Dr. Mistry and Donna Lee on the Many Benefits of “Shockwave” Treatment

Speaker 1: 

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

Dr. Mistry: 

Welcome back. I’m Dr. Mistry, your host, here with my cohost, Donna Lee.

Donna Lee: 

Hello everybody. We’re sounding exceptionally smooth today.

Dr. Mistry: 

That’s right. It’s really, hearing myself through a microphone through earphones, that’s 99% of why I do this show.

Donna Lee: 

It really is.

Dr. Mistry: 

We really appreciate all of the feedback and the questions that we’ve gotten. Some of my patients still don’t know we have a radio show. I was doing a vasectomy the other day. He looked up at our ad for the show that’s in that place in the room and he goes, “Oh wait, you’re the guy on the radio.” I’m like, “Yes. I don’t think I could have a more unique name.”

Donna Lee: 

Or something that people misspell.

Dr. Mistry: 

That’s right, and maybe we need to do a better job of advertising our show on the to our own patients, maybe.

Donna Lee: 

Or maybe spell your name correctly.

Dr. Mistry: 

Maybe we’ll do both.

Donna Lee: 

Maybe I’ll fix it on the website.

Dr. Mistry: 

Yeah, we should do that. Well, we really appreciate all the feedback that we get from you guys. It’s really what keeps us going. If you have any number of urologic conditions, we have previous episodes that you can listen to via podcast, wherever your podcasts are.

Donna Lee: 

We’re podcastable.

Dr. Mistry: 

We’re podcasted.

Donna Lee: 

You can find us. Just search for the Armor Men’s Health Hour anywhere you listen to podcasts.

Dr. Mistry: 

And you know, we’re just kind of a mom and pop shop over here.

Donna Lee: 

We really are.

Dr. Mistry: 

We’re still trying to put this stuff together. So sometimes it does take a few extra days to get the latest episodes up there. Sometimes they’re up there without a title. We’ll get to it.

Donna Lee: 

It takes a village. We have a small tiny village of people working on this.

Dr. Mistry: 

It does, it does take us some time. But we really appreciate all the feedback and the questions. And I thought we’d go through some questions now.

Donna Lee: 

And back to the podcast, if you search the Armor Men’s Health Hour and specific things like erectile dysfunction or Peyronie’s or testosterone, our podcast will pop right up for you. We had, you know, I had an interesting call this week, Dr. Mistry. I had a patient call about shockwave therapy and he knew exactly what he wanted and he was pricing, he was like calling around to different clinics and pricing. So I told him about our pricing. It’s 6 treatments for $2,000 for the shockwave treatment. And he had heard it called as something else, so he wasn’t familiar with the word shockwave. So we went into great detail that it’s just pulsing. So why aren’t we going to call it penis pulsing treatment?

Dr. Mistry: 

I don’t know. We were still working on the [inaudible].

Donna Lee: 

I think we should.

Dr. Mistry: 

Exactly. So, those are, they may get confused about why there was even any question of the name. It’s because the technology that is used to exert this physiologic wave of energy into the penis actually derives from the same technology that we use to break up stones. And so when you tell somebody who has a kidney stone that they’re going to get the shockwave therapy, they know kind of what that means. And even though the, and the official term is extra-corporeal shockwave lithotripsy. So that’s where the, that’s where that shockwave comes into play. So if you’re using that same technology on the corporal bodies of the penis, which are the erectile bodies of the penis, it helps to elicit a regenerative response and in some men, in many men, it results in an improvement in native erections and perhaps either you can start using the pill again if it wasn’t, if it stopped working, or you don’t need the pill at all, which is ultimately the goal that we’re trying to achieve with these patients.

Donna Lee: 

Right.

Dr. Mistry: 

Our pricing for it is, as you mentioned, $2,000 for 6 treatments, which is the standard treatment protocol that we’ve adopted here. Each treatment takes about 20 minutes. I wouldn’t be surprised if this treatment with us is less expensive than other people.

Donna Lee: 

Right. He called other clinics and he was, I could tell he was trying to not sound surprised, but he was super excited, and he wanted to become a patient immediately, so that was a nice benefit, and we’re happy to help.

Dr. Mistry: 

You know, there are some clinics out there where that’s all they do. And I think that if I had to pick, if I, if I had to pay rent and pay for commercials and hire a physician to do something, I’d probably have to charge a whole bunch if the only thing I sold was one tool, right?

Donna Lee: 

That’s true.

Dr. Mistry: 

You wouldn’t go to a hardware store that only treats…

Donna Lee: 

Has nails?

Dr. Mistry: 

…only has, you know, just hammers because unless you…

Donna Lee: 

Hammers are us.

Dr. Mistry: 

…because if you just, if you need a wrench that day…So the point is that you should go to a clinic that treats erectile dysfunction. You shouldn’t go to a clinic that just does something, or just does shockwave, because they’re going to convince you that that’s the treatment for no matter what problem you have.

Donna Lee: 

Right. Your ear hurts? We’re going to shock your penis.

Dr. Mistry: 

You’re a terrible doctor. So, but that’s the advice I’d give to both that patient, that call, which we really appreciate, and anyone else. If it doesn’t work, you certainly don’t want to get sold another 6 pack of treatments that didn’t work that first time. Right? So you want to be able to move up or down the algorithmic ladder for erectile dysfunction, and you want to figure out if it’s part of something bigger–low testosterone or some problem with your neurologic system.

Donna Lee: 

Or your marriage stinks?

Dr. Mistry: 

No. But if it does, we also have a counselor.

Donna Lee: 

Counselor on site!

Dr. Mistry: 

We have a counselor on staff. It’s important that those of you seeking for treatment for something, don’t necessarily just seek out what you think necessarily in your mind is going to be the solution. Because the reason that we have specialty expertise is to help guide you. And I think that there’s another question that gets to the same thing.

Donna Lee: 

Yes, we do have another question. This came from a patient the other day: “Dr. Mistry (spelled correctly: M-I-S-T-R-Y.) What do you think about the procedure Rezum?” And when I read that, I thought, “Oh boy, does he have an opinion!” Because that’s one of his, that’s one of your tools in your tool chest.

Dr. Mistry: 

That’s right. For those of you that don’t know, a Rezum is a relatively new, specialized way of taking care of BPH or enlarged prostate. It’s actually really cool. It uses the concept of using hot steam. Well, I guess I don’t have to say hot steam. I mean almost by definition, steam is the same temperature.

Donna Lee: 

Is there cold steam?

Dr. Mistry: 

But it’s just steam that is used to kill prostate tissue. It has the benefit of being done in the office with minimal need for anesthetics. It can be done in minutes. The whole procedure takes like five minutes and can actually, actually result in the reduction of the size of the prostate. In our clinic we have multiple different tools that we use for BPH, including specialty products or procedures like Urolift or Rezum or microwave therapy. These are some names. We also do laser enucleation, we do Greenlight laser, and of course the standard vaporization or resection of the prostate. And so we have a lot of tools. So if you’re going to someone who really touts themselves as like the expert in a particular technology, don’t be surprised if that’s what they’re going to find out is that is the tool that’s right for you. Because, if I tried to make a name for myself of just being a Rezum doctor, then everybody would get a Rezum, and there wouldn’t be kind of a personalized approach to each prostate.

Donna Lee: 

Right. And we get a lot of people asking by email, they’ll say, “You’re the first doctor that’s talked about more than just one thing. Why is my doctor only talking about this one procedure? Why aren’t there more out there?”

Dr. Mistry: 

I don’t know. You know, I think that, you know, you get comfortable with how you train and, but we’re very intelligent, you know, surgeons, we can learn different techniques and get comfortable with them and provide effective care. So when it comes to the Rezum, we do think it’s a, I think it’s a very, very effective way of treating an enlarged prostate. I would say that as a caveat in my own personal practice, if you have a lot of irritative urinary symptoms like urgency and frequency, if those are the main symptoms you’re having, then the Rezum can make those a little worse for a little bit of time. But, ultimately they will get better. But if your main symptoms are slow flow, dribbling after you finished peeing, hesitancy, which means that it takes a little while to get the flow started, or you’re getting recurrent urinary tract infections because your bladder isn’t emptying, then Rezume is a great option there because you’re actually reducing the size of the prostate and moving some of that, and opening up that channel. The Urolift procedure is another procedure that we do sometimes in the office a lot of times in the operating room and that uses kind of clips or a type of, it’s called a prosthetic stent to kind of open up the urethra right where the prostate is squeezing it. And for some patients those are not appropriate procedures. Sometimes anatomically it may not be the right one. Symptomatically, may not be the right one. Or your prostate is just, we’re just too big for those procedures. So, the Rezume is covered by insurance, and it’s something that is easily tolerated and highly effective. And I put it right below for most of my patients any kind of procedure to remove part of the prostate, like a transurethral resection of the prostate in terms of effectiveness. So for the right patient, Rezume is the right thing. But understanding how to use that procedure and how it applies to you, I think you need to make sure that your provider is someone that’s presented you multiple different options for treatment and you need to feel comfortable that they’re not just selling you the one tool that they happen to have in their belt.

Donna Lee: 

Right. Well that’s a very thorough answer about Rezume. I know the patients seem to be pretty happy afterwards.

Dr. Mistry: 

That’s right.

Donna Lee: 

It must be that steam. That warm, engaging steam.

Dr. Mistry: 

Come in for a spot for your prostate.

Donna Lee: 

Well, we’ll stop there. You can reach us during the week at (512) 238-0762. Our email address again is armormenshealth@gmail.com or you can go to the website and submit your email there, armormenshealth.com. You can also see Dr. Mistry, M-I-S-T-R-Y, and his very handsome face there. We’re in Round Rock, North Austin, South Austin, and Dripping Springs. And again, send us those questions. We’ll answer them anonymously on air and I will respond to them to let you know that we received the question armormenshealth@gmail.com. We’ll be right back.

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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.