Early Loss of Erections, Peyronie’s Disease, and Shockwave Treatment for Erectile Dysfunction

Speaker 1: 0:09
Welcome back to the Armor Men’s Health Hour with Dr. Mistry and Donna Lee.

Dr. Mistry: 0:16
Welcome back to the Armor Men’s Health Hour. I’m Dr. Mistry, your host, here with Donna Lee, my co-host.

Donna Lee: 0:19
Hello. Welcome back. Happy Sunday!

Dr. Mistry: 0:23
You know, I’d like to take this opportunity to tell everybody a little bit about our practice. I am a board certified urologist. I started our urology practice, NAU Urology Specialists here in Austin…

Donna Lee: 0:33
Formerly North Austin Urology.

Dr. Mistry: 0:37
That’s right. That’s why the “NAU,” because when we opened a South Austin location, they would look at it funny.

Donna Lee: 0:42
Nobody would send us patients.

Dr. Mistry: 0:42
Well, we got pretty busy, but still, I think the patients sometimes gave us a little eye. We do a wide variety of urologic services. Everything from robotics to microscopic surgery. We treat infertility, prostate cancer, kidney cancer. We treat various forms of infertility. We also do vasectomies. We treat kidney stones and the whole array of general urology. To us, when you’re in it all the time, you feel like everything is related to urology, right?

Donna Lee: 1:13
It is. Everything points back to that.

Dr. Mistry: 1:15
Everything origins there. We also take a very holistic approach to men’s health issues. We have a nutritionist in house, we have a pelvic floor, physical therapist in house. And Donna Lee, I think that we really try to provide a really comprehensive approach to patients even when they don’t come to us with a questionable urology issue.

Donna Lee: 1:33
Right. I think I was most impressed when I started with you and you were talking about pelvic floor physical therapy and I wasn’t quite sure what that entailed when I started because I came from family practice, but you told me once that stuck with me to this day is that 60% of your patients get better with physical therapy where you don’t have to do surgery for a lot of those patients. And that struck me, because I’m like, “You’re a surgeon, wouldn’t you want to do surgery on all those patients” So I thought that was so nice of you.

Dr. Mistry: 1:56
There’s very few things more disappointing to a surgeon than to do surgery, and then they have the same problem afterwards, and so ineffectual surgery. So that’s not why I was put here. And so if there’s a problem that I think can be fixed with a physical therapy, I don’t think I’m unlike, you know, many, many other orthopedic surgeons or spine surgeons, they would rather not not operate on somebody if a less invasive way is going to help them. And unfortunately, the patients who are likely to improve with physical therapy probably weren’t going to get better with surgery anyway. That means that their problem was different. Big thanks to all of our listeners on the radio as well as our listeners on the podcast. You know, I had a good friend who said he’s addicted to the show.

Donna Lee: 2:37

Dr. Mistry: 2:37

Donna Lee: 2:38
Wow, that’s awesome.

Dr. Mistry: 2:38
He lives in California and he’s probably listening to this podcast, I don’t know, a month from now. And he said that he really can feel that we’re having a good time on the show and that made me feel good.

Donna Lee: 2:47
Wow, that’s awesome. Do we have his name? Can we give him a shout out?

Dr. Mistry: 2:50
Yeah, Adrian Cooper. Good job, Adrian.

Donna Lee: 2:53
Thanks, Adrian.

Dr. Mistry: 2:53
And so, we really do have a lot of fun bringing you this show and bring you information. We would love to hear your questions and hear your feedback. Obviously we get to see a lot of your faces in the office when you come to see us as patients. But if you have questions, as it was said to me months ago now, for many people in the community, this is an hour you get to spend with a urologist that you’ll never get in real life. So we would love to hear your questions.

Donna Lee: 3:18
No copay necessary.

Dr. Mistry: 3:19
How do people get ahold of us?

Donna Lee: 3:21
Oh, they can call us during the week at 512-238-0762. Our email address for any question you have for Dr. Mistry or any of the specialists that we’ve had in the recent shows is armormenshealth@gmail.com. That’s armormenshealth@gmail.com. Our website is armormenshealth.com. So we keep it easy. We have four locations, round Rock, North Austin, South Austin, and Dripping Springs. We’ve had a lot of amazing questions and this one keeps recurring, so I think that it’s probably something on everybody’s mind after the age of 40, but this patient sent in, “Is there a way for men with erectile dysfunction to fix this problem? My penis gets hard, but once it stands up, it loses the erection. One clinic said it was due to too much plaque.”

Dr. Mistry: 4:02
Okay, well those are some great, there’s a lot of things wrapped up in that. Early loss of erections can be an early sign of erectile dysfunction. And when we talk about erectile dysfunction in our clinic, I usually try to talk about the different factors that go into what leads to a good erection. You have to have an intact nervous system…

Donna Lee: 4:20
A hot wife…sorry, go ahead.

Dr. Mistry: 4:20
You’re going to get shot. You want to have an intact nervous system, an intact psychology. You want to have an intact blood flow. And these things are all important components. And I also think that an intact hormonal system is important. If you’re starting to have early loss of erections, and you are still able to complete the act, then we usually try to start you on some supplements, L-arginine, anti-inflammatory supplements, and lifestyle modification. I can’t tell you the number of people that I’ve met where just simply starting to walk more or get into some kind of regular exercise regimen dramatically improves their erections. You wouldn’t believe it if you just told it to somebody, but when I see a guy who’s 40 pounds overweight and I tell him, “Listen, if you lose 20 pounds, your erections are going to getting a lot better,” I would bet money every time that that guy’s erections are going to get better. When you’re having mild ED, really focusing on lifestyle changes to get your normal erections back to normal, it really couldn’t be more important because once you start down the road of using medicines or using advanced surgery or anything else to get an erection, you’re kind of like just expecting to get worse year after year and that’s not what we want. We want you to try to help you fix whatever your underlying condition is. That doesn’t sound so, I don’t know, it doesn’t sound so sexy for a lot of doctors because you know, because I’m prescribing you modifications to your lifestyle as opposed to, instead of pills. But I think that the majority of patients listening will appreciate that. I mean, they don’t want us just to kind of look at something and prescribe a pill. They want us to help address it. But if you’re losing your erection early and somebody thinks that you have a plaque, then that could be that on their exam or in your intake to them it was felt like you have Peyronie’s Disease, like a curvature of the penis. And it is Peyronie’s disease is a disease that causes a curvature of the penis because of a deposition of a hard plaque or calcium scar along the erectile bodies. And if that does happen, if there was a lot of that, then that is true. You can have kind of a poor keeping of the blood in the penis and an early loss of erection. Another cause that a lot of men don’t really recognize is a loss of sensation. So, some guys will say that, you know, when I’m being stimulated I can stay erect, but then the moment I change positions, I lose my erection. So those patients, sometimes we come up with different strategies, things to improve sensation of the penis. Now we’re looking at improving your nervous system function and that’s kind of the take that we have.

Donna Lee: 6:45
…Or don’t change positions.

Dr. Mistry: 6:46
Just vanilla.

Donna Lee: 6:54
Just missionary style vanilla.

Dr. Mistry: 6:54
But vanilla is popular I guess. But don’t sneeze or anything else because you’re about to end that session, you know, anything that’s going to interrupt.

Donna Lee: 7:02
Worst sneeze ever.

Dr. Mistry: 7:06
This is actually an interesting patient case because it’s a wonderful potential opportunity for the use of shockwave therapy for erectile dysfunction. What we’re doing with shockwave is we’re using a very low intensity shockwave to help re-modulate or to regenerate the erectile tissue as well as the arterial and other vascular structures within the deep parts of the penis. It is something that has been around all over the world for a number of years, has become increasingly popular here. And our practice has been offering this service for the last about 6 months.

Donna Lee: 7:45
And we have amazing feedback.

Dr. Mistry: 7:50
With amazing feedback.

Donna Lee: 7:50
We’ve had two patients, one patient after 5 visits and it’s completely painless, it just sounds like a ticking in the office, I can hear it from my office. But one patient after 5 treatments, he said he could stop using Viagra. He didn’t mind that he didn’t need Viagra anymore, so that’s a good thing. Another one said he was in chemotherapy for cancer and he didn’t think he was going to have a hard penis ever again. And he said after 5 treatments, he already feels a huge difference. So he’s super excited.

Dr. Mistry: 8:17
Huge difference. You know what my friend from California said, he said, we do a lot of penis talk on this show.

Donna Lee: 8:26

Dr. Mistry: 8:26
…and I told him, you’ve known me for 30 years. What did you think I was going to talk about on the radio? But if you’re interested in learning more about shockwave therapy, the first thing I would tell you is do some research. We in our practice don’t believe in certain technologies that haven’t been proven to work. If you’re thinking about buying a product that just kind of taps, you know, physically on the penis because you think that’s what shockwave is, I’d encourage you to research. We’re more than happy to talk to you either via consultation on the phone or preferably in the office so we can do an exam and do a hormonal examination to tell you more about what the benefits are for shockwave therapy for ED. And if you have severe ED, don’t be duped. It’s unlikely to work. And we want everybody to be satisfied, and we don’t want to have you undergo a therapy that’s unlikely to work. So if you have mild to moderate erectile dysfunction, early loss of erections, things of that nature, I think that shockwave is something to really consider. And it’s something that we’re happy to provide.

Donna Lee: 9:30
And remember, it’s painless. It’s absolutely painless. The patients loved it.

Dr. Mistry: 9:35
Well, another great show. We had a great guest on, and just a wonderful opportunity to talk about men’s health issues. So Donna Lee, thanks a lot for being my co-host.

Donna Lee: 9:45
Aww, well, thanks for being the main dude. We appreciate it. We have a lot of awesome guests coming up in the next few weeks. And then also we’re moving to Saturday.

Dr. Mistry: 9:52
We are moving to Saturday after the first of the New Year.

Donna Lee: 9:54
3:00 to 4:00 PM on Saturdays. So put the earmuffs over your kid’s ears in the car.

Dr. Mistry: 10:00
Ear muffs?

Donna Lee: 10:00
So they can’t hear anything.

Dr. Mistry: 10:02
Alright. Well tell people how to get ahold of us.

Donna Lee: 10:04
Call us at 512-238-0672. Our website is armormenshealh.com. Or email us at armormenshealth@gmail.com with all your questions. Happy Sunday!

Dr. Mistry: 10:15
Happy Sunday!

Speaker 1: 10:17
The Armor Men’s Health Hour is brought to you by Urology Specialists of Austin. For questions or to schedule an appointment, please call (512) 238-0762 or online at armormenshealth.com.