Phone: 512-238-0762

Fax: 512-341-7370

August 29, 2020

The Mistry Vasectomy: Dr. Mistry Describes the Two Types of Vasectomies He Performs and the Vasectomy Reversal

Speaker 1: 

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

Dr. Mistry: 

Hello, and welcome back to the Armor Men’s Health Hour. I’m Dr. Mistry, as always with my host, Donna Lee.

Donna Lee: 

Hello, I got the giggles all of a sudden. So happy to be back.

Dr. Mistry: 

For those of you that listen to the show, you may recall that Donna Lee is in fact a comedienne, a professional comedienne.

Donna Lee: 

Seventh funniest mom in America, per Nick at Night.

Dr. Mistry: 

She and I have a running gag that one day I’m going to come up with a whole comedy set.

Donna Lee: 

You wish.

Dr. Mistry: 

Okay. Are you ready for my first one?

Donna Lee: 

I guess.

Dr. Mistry: 

Okay. Here it is. Ready. “What is the difference between a man and a woman?”

Donna Lee: 

You know I don’t like this joke.

Dr. Mistry: 

“There’s a vas deferens!”

Donna Lee: 

Gosh. Can I just tell you, I didn’t know what a vas deferens was until I started working for you three years ago?

Dr. Mistry: 

That’s a really good, nerdy, eighth grade biology joke.

Donna Lee: 

If you know what a vas deferens is. Now we have to tell the listeners what a vas deferens is. What is a vas deferens?

Dr. Mistry: 

Sure. So the vas deferens is the tube that connects the testicles to the prostate and that’s where sperm is transported so that we can make babies.

Donna Lee: 

Okay. So tell the joke again.

Dr. Mistry: 

Okay. “What’s the difference between a man and a woman?”

Donna Lee: 

What is the difference between a man and a woman?

Dr. Mistry: 

“There’s a vas deferens!”

Donna Lee: 

What?!

Dr. Mistry: 

You get it because it’s like a vast difference.

Donna Lee: 

That’s so funny. Geez, that joke.

Dr. Mistry: 

Man. I’m going to kill. I I’m so gonna kill on comedy night.

Donna Lee: 

That’s the one joke you have going on tour?

Dr. Mistry: 

I don’t know, doing a lot more material then.

Donna Lee: 

Hey, funny tidbit. When I opened for DL Hughley at the improv in Houston, we had seven shows. So I went out and then his guys feature went and then I also featured for him at some point, I always made $600 and he made like $30,000 for the weekend.

Dr. Mistry: 

Nice.

Donna Lee: 

Talk about that big difference.

Dr. Mistry: 

There’s a vas deferens in money there. I thought we talked the segment about the two different surgeries that we do for the vas deferens. This month, I was confronted with a patient who had a very enlarged vas deferens, and it was very thickened…

Donna Lee: 

Is that equivalent to a large penis?

Dr. Mistry: 

No, it is not. This is the one that you don’t want to have. It was very tender and painful to, calcified, vas deferens. And it’s one that resulted, we think from a trauma that the patient experience and has now led to infertility and chronic pain. So we’re going to remove the whole vas deferens. You know what that surgery is called?

Donna Lee: 

The vas deferens-ectomy?

Dr. Mistry: 

Believe it or not, it’s just called a vas-ectomy, but that’s going to be a much bigger, much more involved procedure than we would usually associate with a vasectomy.

Donna Lee: 

I like mine better, the vas deferens-ectomy.

Dr. Mistry: 

I thought we’d just kind of review, especially during these times, for those of you, if you’re at home from work and you’re able to recuperate, you may be interested in having a vasectomy during this during this time. The vasectomy is a very commonly well tolerated procedure. It takes about 20 minutes. We do it here in the office

Donna Lee: 

And you have great music that plays in the background.

Dr. Mistry: 

Well, if you like eighties, new wave alternative, because that’s pretty much all that’s going to play. And the reason that you can tolerate the music is because we do offer IV sedation…

Donna Lee: 

You’ll be high as a kite!

Dr. Mistry: 

…using intravenous Midazolam, which wears off pretty quick. Most patients are able to walk out of here, even though they’re pretty loopy, sleepy, or really funny.

Donna Lee: 

They’re always smiling, every time.

Dr. Mistry: 

It’s a lot of fun [inaudible]…we’re thinking about hiring a new marketing company, and we talked about marketing for 20 minutes during his vasectomy. And then when I called him to make an appointment, he goes, “Who’s this?”

Donna Lee: 

What are we talking about?

Dr. Mistry: 

What did we talk about?

Donna Lee: 

That is so funny.

Dr. Mistry: 

So that’s another running joke we say about people when they, when they go back to write reviews about the vasectomy, they say, “Well, don’t remember it, but everything went well!”

Donna Lee: 

That’s right. Not getting my wife pregnant.

Dr. Mistry: 

One of the reasons that we started the IV sedative here in the clinic during the vasectomies is because it allows us to do something called a single visit vasectomy, which means that you can come in, get your consultation for the vasectomy and get your procedure in the same day, which is extremely convenient. It makes it more likely that you’re going to go through with the procedure because you only have to come and wait in the waiting room and wait for me, and, you know, do all that stuff one time.

Donna Lee: 

Other offices, you have to go in three times, at least.

Dr. Mistry: 

One, two or three times, two or three times. It becomes inconvenient when people are already kind of nervous about the procedure. And so we try to eliminate that one barrier by doing it. Another real benefit from the vasectomy, the IV sedation is that you don’t remember it getting done. And early on in my practice, I had this theory that when you’re getting worked on down below, that’s already kind of a anxiety provoking experience, and if you can remember the pulling or the tugging or the sharpness of any kind of instrument, I bet you kind of makes you like have some anxiety.

Donna Lee: 

That sounds like a one-star Yelp review to me.

Dr. Mistry: 

Yeah, like a PTSD kind of experience. And I think a lot of men were having discomfort after their vasectomy, just because of that experience of having gone through it. As a result of that, we have much higher rates of actually completing the vasectomy because the anatomy is a lot easier to deal with. And we have a lot less people complaining of pain and discomfort afterwards. So that’s really great. So the IV sedation really puts us in a different category. We use a single incision, [inaudible] vas deferens…

Donna Lee: 

That’s why it’s called the Mistry vasectomy!

Dr. Mistry: 

Is a mystery, you don’t even remember having it. We used to have a jock strap with a question mark. That was our quote unquote “t-shirt” because nobody’s gonna wear their vasectomy t-shirt, but you may wear your vasectomy underwear.

Donna Lee: 

That’s funny. We need to reimplement that for sure.

Dr. Mistry: 

Yeah, the joker. Anyway it was the Mistry vasectomy because, you know…

Donna Lee: 

You can check this out too, on our website, austinvasectomy.com and Dr. Mistry goes into detail about the Mistry vasectomy.

Dr. Mistry: 

You would almost think that I love this. I should do it for a living.

Donna Lee: 

And get paid for it?

Dr. Mistry: 

And get paid for it. But we do something else here, too, and that’s the vasectomy reversal. We do quite a few vasectomy reversals as part of our male fertility offerings here. The vasectomy reversal is done on some estimates on about 10% of patients that have a vasectomy rethink that decision.

Donna Lee: 

Wow, 10%.

Dr. Mistry: 

You know, you never know.

Donna Lee: 

Not always the guy, the 60 year old with the hot 20 year old, just sometimes?

Dr. Mistry: 

When I was in training, that’s what, that’s what it used to be. It used to be that down in Houston, that the couple would fly in from out of town, he would come into the hospital because of a vasectomy reversal and she would go to the Galleria to go shopping. And, but what’s interesting is second wives are older than they used to be.

Donna Lee: 

Oh really?

Dr. Mistry: 

They sure are. Sure are.

Donna Lee: 

They’re late 20’s now?

Dr. Mistry: 

And so if you’re thinking about getting a vasectomy reversal, but your second spouse happens to be 38 or 42, it may be wiser terms of the chance of getting a baby to, instead of do a reversal of the vasectomy to do an extraction, which we can do right from the testical or epididymis, and then go through IVF. We have some wonderful IVF partners that we use. And so that’s one of the important considerations that we ask men to go through before they make a decision on becoming dads again, is what would be the most likely way for it to happen? And there are a number of reasons men want to have a vasectomy reversal. There’s a remarriage, which is probably number one, there’s just rethinking family size as economic situations change, and then of course the most tragic is loss of a child. And it’s an unfortunate tragedy that we deal with probably, you know…

Donna Lee: 

More than we should.

Dr. Mistry: 

…yeah, three to six times a year, we have a couple come in with a tragic loss of a child. The vasectomy reversal is, is a way for, you know, for that family to find, you know, some happiness out of a tragedy. You can get a vasectomy reversal in the office, in some places you can go down there or someplace that will do it in the office. I think it’s much, much more comfortable to get it done under general anesthesia because it takes, you know, an hour and a half to do it. And you’ve got to sit still for an hour and a half. And somebody working on your stuff. I mean, we do most of ours in the operating room. The price for a vasectomy is around $6,000 vasectomy reversal. That is about $6,000. It is not covered by insurance. And for an additional $500, we’ll do something else, which is that at the time of your reversal, we will collect sperm that you can cryo-preserve, and you’re not going to get, you’re not going to find that opportunity virtually anywhere. It adds about half an hour to the case. It requires me to examine the sperm under a microscope to make sure there’s moving sperm. It gets sent to a cryo preservation facility just for a little bit of extra money. You have that confidence that even if the vasectomy reversal doesn’t work, then you have sperm that’s in the freezer that you could use for IVF or some other assisted reproductive kind of thing.

Donna Lee: 

And how well does that work? I’ve never really thought about it.

Dr. Mistry: 

The reversal? Well, you know, a lot of people think of the reversals like just a plumbing job, like you just took a tube and you’re just, and you’re just kind of occluding it and you just have to take that occlusion out and put it back together. But that, you know, the reproductive anatomy is really a living, breathing, evolving system. So when you occlude the vas deferens with a vasectomy, the sperm backs up into the testicle and there can be damaged done to the epididymis and testicle that doesn’t allow the vasectomy reversal to work. So the numbers I usually quote is if you’ve had a vasectomy in the last two years or less, the reversal rates about 90%, if it’s less than seven years, the reversal rate is somewhere between 75% and 85%. But if it’s, you know, 15 years or older, that number can drop to as low as 35%. So that the time since your vasectomy could have a big impact on success, as well as the, any pain or complications you may have had.

Donna Lee: 

Good to know. You know, we had the guy in his sixties who wanted his vasectomy reversal 30 years ago.

Dr. Mistry: 

It wouldn’t make me happier.

Donna Lee: 

I tried to get him to come in.

Dr. Mistry: 

It couldn’t make me happier. So let’s, let’s hope we can get him in. And, that was probably the longest, most boring joke that I’ve told.

Donna Lee: 

He also didn’t have a girlfriend though.

Dr. Mistry: 

Oh, he didn’t?

Donna Lee: 

No, or a wife.

Dr. Mistry: 

He was just getting ready for it.

Donna Lee: 

He’s 65, he’s ready!

Dr. Mistry: 

Good for him.

Donna Lee: 

That’s funny, oh my goodness. Well, you can reach us during the week at (512) 238-0762. Listen to our podcasts wherever you listen to podcasts, so you can relive all of this magic again. And our website is armormenshealth.com. Send us your questions!

Speaker 2: 

The Armor Men’s Health Hour will be right back. If you have questions for Dr. Mistry, email him at armormenshealth@gmail.com.

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