Phone: 512-238-0762

Fax: 512-341-7370

April 11, 2020

When Your Penis Throws You a “Curve” Ball: Dr. Mistry and Donna Lee Discuss Treatments for Peyronie’s Disease

Donna Lee: 

The Armor Men’s Health Hour is brought to you by Urology Specialists. For questions during the week, call us at (512) 238-0762 or visit our website at armormenshealth.com. The Armor Men’s Health Hour is a show dedicated to providing information on a variety of medical topics, some of which may include sensitive subject material about penises. All cases discussed have been done with the permission of the people involved and their penises.

Speaker 1: 

Welcome 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 as always with my bubbly and ever-competent cohost, Donna Lee.

Donna Lee: 

Oh, I thought you were going to say effervescent, effervescent.

Dr. Mistry: 

Ever-competent.

Donna Lee: 

I like it, it’s a new word. So we’re so far away from each other because it’s 2020 and we’re dealing with the Coronavirus.

Dr. Mistry: 

That’s right in the hopes of delivering some normalcy to our listeners as well as to ourselves, we are happy and very privileged to be able to provide you a show that gives you some in-depth information on men’s health issues. I am a board certified urologist and this show is brought to you by NAU Urology Specialists, the second largest urology group in town.

Donna Lee: 

You know what I always say: “If you’re a second largest, that means you’re second…”

Dr. Mistry: 

You just try a little harder?

Donna Lee: 

“Try a little harder, you’re a little prettier on Saturday nights.”

Dr. Mistry: 

That’s right. You know, some of our listeners think you’re the bad influence on the show.

Donna Lee: 

I was going to bring that up. We had somebody called the clinic and I just happened to answer that particular phone call because I was helping with phones since we’re having staff, you know, work from home and trying to manage all of that. But he suggested you have to reign me in every show because I’m the dirtier one.

Dr. Mistry: 

That’s right.

Donna Lee: 

And If you know any of us…

Dr. Mistry: 

I couldn’t agree more.

Donna Lee: 

…like our staff and family members, if you know us at all, that’s a very funny statement.

Dr. Mistry: 

Yes it is. Because you’re the comedienne.

Donna Lee: 

Well and I’m your HR director, so I feel like…

Dr. Mistry: 

That’s right. You’ve got to reign us in.

Donna Lee: 

…I’ve got to reign you in all the time.

Dr. Mistry: 

Interestingly, that patient is a real close patient of ours, been a patient for many years…

Donna Lee: 

Very nice.

Dr. Mistry: 

…treated many different things. So I think he’s more on my side than yours.

Donna Lee: 

When he told me that you have to reign me in quite a bit during the show I was like, “Oh boy, hadn’t thought of that, but thank you.” But thanks for listening.

Dr. Mistry: 

Well, we’ll see what kind of trouble we’ll get in today.

Donna Lee: 

Right?

Dr. Mistry: 

Donna Lee, why don’t you tell people how to get ahold of us and about our practice?

Donna Lee: 

That’s right. You can call us during the week at (512) 238-0762. I’ll do my best to not tell you a dirty joke. If you call, you can ask for me. Several people have called and asked for me, and we have a chit chat about the show! Our locations are Round Rock. That’s your main location, Dr. Mistry. It’s 13 years ago now. We’re in North Austin, South Austin, and we’re in a lovely little spot in Dripping Springs. Our website to visit is armormenshealth.com, but send your questions–all your amazing questions that we’ll answer anonymously every single week–to armormenshealth@gmail.com.

Dr. Mistry: 

And if you have a pressing urologic issue, we are still seeing patients for urgent issues in the office. We are limiting ourselves to just about 4 or 6 in a half day to keep the waiting room empty and to keep the rooms nice and sterile. But if you have an issue that you would like to talk to us via telemedicine, that’s a great option for you. You can get some questions answered. Second opinions can be dealt with that way. And although, you know, the aspect of putting hands on you and doing a physical exam may be somewhat impaired with that strategy, I think that the patients that I’ve treated personally and our practice has treated through telemedicine, I think those visits have gone very well.

Donna Lee: 

They have, and they’ve kept us pretty busy. I think everybody who’s in medical right now in Austin is pretty busy. So if you’re listening to this, like you said, if you’re listening to this podcast 10 years from now, we did not just have a practice where we saw people or visited with people over the phone.

Dr. Mistry: 

That’s right.

Donna Lee: 

This is temporary.

Dr. Mistry: 

And if it’s a thousand years from now, and you’re alien invaders, then it probably won’t make any sense anyway.

Donna Lee: 

Hey, speaking of podcasts, we have a ton of podcast downloads.

Dr. Mistry: 

Yes, we hit 5,000!

Donna Lee: 

5,000! I’m super impressed with both of us. I don’t know how to access those. I’m just kidding. You can access our podcasts anywhere that you listen to podcasts. Oh, you can also hear our show on the KLBJ website, newsradioklbj.com.

Dr. Mistry: 

Well, awesome. Well let’s get to some questions.

Donna Lee: 

You know, we had a few questions that came in. I realized that I think most of our questions, I feel like a majority, like 60% of our questions are about Peyronie’s.

Dr. Mistry: 

I agree.

Donna Lee: 

So we had a brand new listener that just reached out with a very simple question last week that said, do you treat Peyronie’s disease?

Dr. Mistry: 

Absolutely. For those of you listening to the show, Peyronie’s disease most classically is a condition that results in a curvature of the penis. You know, I never really believed the marketing from the marketing companies about Peyronie’s disease, about how common it is and how embarrassed patients are to speak about it. But now I’m a believer. I think that it’s a very commonly silently experienced condition. It initially results in pain with an erection, often associated with nodules along the penile shaft and a curvature. The curvature, actually those are a little easier to deal with, especially if there’s a nodule that that is involved. The more difficult type of presentation can create what’s called an hourglass deformity where there’s almost a thin part, a thinner part of the penile shaft, but still, we have treatments for that.

Donna Lee: 

It’s not always caused by trauma, correct?

Dr. Mistry: 

No, that’s correct. It’s, it can be, it was felt to be brought on by some type of penile trauma, like a penile fracture. But now we think that it’s more of a micro-trauma. Maybe as men are aging and their erections are getting softer, they’re just getting a little bit more trauma to the penis during intercourse. Most men cannot identify a specific event. And what’s even more troubling is that the curvature can appear overnight. You could wake up completely befuddled by what just happened to your main man down there.

Donna Lee: 

Wow. I bet that’s psychologically challenging.

Dr. Mistry: 

Oh yes.

Donna Lee: 

I can’t imagine.

Dr. Mistry: 

I think that this week we had a younger man who we’re treating for Peyronie’s under the age of 30, and it’s even more off-putting for someone who’s seeking out new sexual partners, you know, may have already some issues with, you know, how they’re performing. And then to have a penile deformity like that can be very off-putting. I thought I’d share some data today. This is old data about whether or not low intensity, extra-corporeal shockwave therapy is something that would work for men with Peyronie’s disease.

Donna Lee: 

It’s something we handle.

Dr. Mistry: 

Yes, we do.

Donna Lee: 

A magical machine that we have.

Dr. Mistry: 

You’re going to hear a lot of ads on the radio and a lot of ads on your social media feeds about the potential of using low intensity energy that’s directed via ultrasound to the penis. In general, most urologists are not using this to treat Peyronie’s disease, but there is some data to suggest that the use of this technology may work. This particular study is from 2015. It’s a study out of Korea that showed that the use of this type of ultrasound directed technology had somewhere between a 33% and 60% effectiveness in treating the degree of curvature, plaque hardness, and penile pain. It is something that is offered to our patients who have troubling Peyronie’s disease, especially if they’re reticent to try any of the other treatments that we have. If you are suffering from Peyronie’s disease, we have a whole litany of previous talks on the various treatments. But, you know, a summary of them can include the use of various injections that can be used to break down the plaque that causes the curvature. We use routinely a vacuum erection device as well as a penile straightening device that requires daily use to help kind of open up or stretch the penis and hopefully bend things back into the normal location. If those don’t work, we have surgeries that can be used to correct the erection in terms of the curvature, and a multitude of different things that can be done to help restore your function. One of the biggest things that we do is we do put a lot of men on a daily Cialis, so that whenever they’re having intercourse, they have very rigid erection even if it is curved. Because if you have a softening erection and it’s curved, it’s going to make the curvature even wors and create more microtrauma. There’s also a huge overlap between Peyronie’s disease and low testosterone. Some studies suggest an 80% overlap between the two. When you do come and see us, our evaluation may include a penile Doppler study so we can look at the blood flow and the plaque thickness of the corporeal body that’s being bent. We’ll do testosterone measurements and then of course, physical exam that will include measuring and kind of identifying where those plaques are. And then, you know, offering treatment. Usually again, treatment is going to be something more behavioral, with mechanical stretching but can include injections and surgery if somebody is deemed appropriate.

Donna Lee: 

You know, we had another question that’s kind of similar if we offer any quote unquote “natural options” for enlarging or straightening penises. So this is kind of natural, right? I mean it’s not supplements, but the treatment you were talking about with the study is kind of a, it’s not an invasive thing.

Dr. Mistry: 

Absolutely. So if you’re trying to look for a more natural therapy solution, to me what that means is that you’re not interested in surgery, you’re not interested in injections, and you’re not interested in pharmaceutical agents. So, I’ll just take all 3 of those off the table. So mechanical stretching with a vacuum erection device seems to me to fit that bill. The use of a penile straightening clamp that we, the one that we use a lot is called Andropenis A-N-D-R-O-penis. You can look that up. We also use an L-arginine supplement. The one that we use is from Metagenics called ArginCor. It’s a very high grade L-arginine, which is a nitric oxide booster. And then we also use anti-inflammatory supplements like a curcumin. So that’s going to be kind of the more natural way that we deal with this. I would say that as a mini step out of the natural arena, using something like a daily Cialis is really going to help keep that curvature from getting any worse. There can also be some pain associated with the condition. So, there are some natural approaches that we can take. We have a nutritionist on staff, Robert Mendiola, who’s excellent about helping to identify maybe some inherent inflammatory conditions that you may have that could be making it worse. And, that’s what we work on. So behavioral and natural techniques to help get better and stronger erections along with hand-in-hand with our regular traditional medical treatments.

Donna Lee: 

Well, we’re just about out of time for that segment, but stay tuned. We’ll be right back.

Speaker 3: 

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.

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