EP 679: ED Catastrophe After Surgery? Find the Right Treatment That Works for YOU at NAU Urology Specialists

In this episode, Dr. Mistry and Donna Lee address listener questions about “catastrophic ED.” Many urology patients experience ED after major surgical procedures. Dr. Mistry answers two listeners–one with “full-time ED” after a radical prostatectomy, the other following back surgery–who have tried many ED therapies to no avail. If you or someone you love has significant ED that isn’t responding to treatment, never fear! Our team at NAU boasts board-certified urologists, nurse practitioners, pelvic floor physical therapists, sleep therapists, dietitians, and a network of ties to Austin-area specialists dedicated to helping restore your sexual function. Tune in to learn how prostate cancer can lead to ED and what to do when the pills, pumps, and penile rings aren’t working. To schedule your consultation, call us at 512-238-0762 or visit us online today!

Voted top Men's Health Podcast, Sex Therapy Podcast, and Prostate Cancer Podcast by FeedSpot

Dr. Mistry is a board-certified urologist and has been treating patients in the Austin and Greater Williamson County area since he started his private practice in 2007.

We enjoy hearing from you! Email us at armormenshealth@gmail.com and we’ll answer your question in an upcoming episode.

Phone: (512) 238-0762

Email: Armormenshealth@gmail.com

Website: Armormenshealth.com

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Transcript

Speaker 1: 0:00

<silence>

Speaker 2: 0:07

Welcome to the Armor Men's Health Show with Dr. Mystery and Donna Lee.

Speaker 3: 0:15

Hello and welcome to the Armor Men's Health Show. I'm Dr. Mystery , your host, board certified urologist and founder of NAU Urology Specialists here in Austin, Texas. Joined as always by my wonderful co-host, Donna Lee.

Speaker 4: 0:28

Hi, welcome to the show everybody. Thanks for listening.

Speaker 3: 0:31

Donna's a professional comedian and she's also our business development manager here in the office. Uh, and we've been very fortunate to have her with us for how many years now?

Speaker 4: 0:38

Seven years.

Speaker 3: 0:39

Seven years. It's

Speaker 4: 0:40

Felt like 10 minutes

Speaker 3: 0:41

Underwater. Mm . So <laugh> , this is a men's health show. We deal with things between the nipples and the knees. We are , um, here in Austin, we have four offices. We have , uh, six urologists that are a part of this practice. We have an interventional radiologist, and we have , uh, seven or eight advanced practice providers now, seven, seven advanced practice providers. Mm-Hmm . <affirmative> . We also have in-house, pelvic floor physical therapy in-house, sex therapy, in-house, sleep medicine, and in-house health coaching. So , uh, really taking about, you know, taking care of you from your nipples to your knees is something that's very important for us. Mm-Hmm. <affirmative> . Donna, how do people get ahold of us or send us questions?

Speaker 4: 1:18

And I wanna remind people we're on KLBJ on Saturdays at 3:00 PM but then our podcasts are wherever you listen to your free podcasts. So check out us wherever you can. We're located in Round Rock, north Austin, south Austin, and Dripping Springs, Texas. Our website to send your questions is armor men's health.com. And before we go on, I wanted to tell the listeners that I think you should come do some standup at one of my standup shows about like women and hormones. 'cause we have a show called Empty Gestures. Yes. So we're gonna have an audience full of women. That would be your patients. Yes.

Speaker 3: 1:48

That would be exci . Exciting. So that

Speaker 4: 1:50

Would be cool. So we'll invite the listeners. That's right .

Speaker 3: 1:52

I used to go to bars to pick up chicks, and now I'm gonna go to bars to pick up patients. <laugh> . Is that , is that what we're saying? <laugh> ? Good job. Good job, Donna.

Speaker 4: 1:58

You're welcome. You told me to make you some money. There you go . Because I don't know how, but there you go. There

Speaker 3: 2:02

You go. Uh , do , do we have any questions to answer today? We

Speaker 4: 2:05

Do. This gentleman sent in a question about is prostate. I , it always shows me crazy when people say prostrate, but anyway, this guy said it correctly. He said, Dr . Mystery , my prostate was removed with robotics and now I have full-time. Erectile dysfunction. Viagra doesn't work and pumps don't work. What is my next alternative without surgery? I'm 78 years old and otherwise in good health. Well ,

Speaker 3: 2:25

That's a great question. So , um, I guess we'll start first by , uh, prostate cancer treatment for prostate cancer and how and why it causes erectile dysfunction. Mm . So prostate cancer is , uh, the most common solid organ in cancer diagnosis in men. Mm-Hmm. <affirmative> it leads to a lot of treatment and fortunately does not lead to a lot of death. So it's not a very deadly disease, but it is one that needs to be dealt with often. Mm-Hmm. <affirmative> . And one of the treatments that we have , uh, that's very commonly done is to remove the prostate gland. Now it's done robotically, almost probably the vast majority of all prostates in this country are removed robotically now. Um, the robot people

Speaker 4: 3:03

Are still doing it, otherwise,

Speaker 3: 3:04

The da Vinci robot is so ubiquitously available, and if you're really doing prostates, you're probably gonna do 'em robotically. So really, it would only be in the instance in which there was either so much scarring or some kind of issue occurred where the , uh, prostate could not be removed. Mm-Hmm. <affirmative> . But interestingly, my , even my own younger partners, when I asked them, what would you do if , if you, if the robot broke <laugh> ? Mm-Hmm . <affirmative> . They were like, oh, yeah, we'll just stop. We won't, we won't proceed with the procedure, you know ? Oh . As opposed to those in my generation would be like, eh , just gimme a knife. I'll take it out <laugh> . Um, and so easy breezy, it , it , it really is a generational thing. Uh , mm-Hmm . <affirmative> , because we didn't have the robot when we were , uh, initially training, but rather had that later in our , um, in our lives. But what the robot has done is made things a little bit better, incontinence or leakage after a prostate removal has gotten better and impotence or an inability to get an erection also has gotten better, you know, as the or, or the , the outcomes have gotten better. Mm-Hmm. <affirmative> , uh, with the newer technology.

Speaker 4: 4:02

So you get erectile dysfunction with either way the procedure's done most of the time. Is that correct?

Speaker 3: 4:07

It happens very commonly. So , uh, the nerves that go, that go to your penis to innervate it, to allow the relaxation of the smooth muscle, to allow it to fill with blood, those nerves run right adjacent to the prostate gland. Hmm . So the prostate in and of itself doesn't play a role for erections. It's because of its proximity to these nerves that when you remove the prostate, oh , you can cause this problem. Okay. And so that's important for people to distinguish, because I think patients often come to us thinking that any surgery on your prostate's gonna make you impotent. And that's not, that's not the case. Mm-Hmm. <affirmative> , it's going to be these surgeries that are done for prostate cancer where you're removing the prostate. That's where you're at risk of damaging these nerves and leading to , uh, in this listener's case, permanent erectile dysfunction. Hmm . So now this is what we would put in the catastrophic ed , uh, you know, category. And so here are some things that you shouldn't do. If the viagra's not working, you shouldn't go to someone and get shockwave therapy. Hmm . Even though we offer shockwave therapy, this is really meant for people with organic erectile dysfunction. This is when , when you're actually getting something on your own. If you get nothing, if you're having no erections at all Mm-Hmm. <affirmative> , then raising you from the dead is not what this shock wave or ultrasound therapy is really going to be good at. Right.

Speaker 4: 5:23

And buyer beware because those commercials will convince people otherwise.

Speaker 3: 5:27

Sure. And especially, you know , uh, people come in all the time having bought something online or something here, something there. And I think he's just frustrating and really preying upon people's, you know, hopefulness as opposed to really delivering a medical treatment that's likely to work. Mm-Hmm. <affirmative> . So , uh, this particular listener, after he's tried meds without any success, he also said that he tried , uh, a pump. Mm-Hmm. <affirmative> . And he said the pump didn't work. So what he's talking about is something called the vacuum erection device. Mm-Hmm. <affirmative> , it looks exactly like the Austin Power Swedish Mm-Hmm . <affirmative> penis stretcher. It

Speaker 4: 5:59

Really does

Speaker 3: 5:59

<laugh> . It is, it is a tube that goes over your penis and it, it creates a vacuum seal at the base of your penis. Mm-Hmm. <affirmative> . And then you, you activate it, it creates a vacuum and your, your , your penis fills with blood.

Speaker 4: 6:13

So then what? Then you have sex right . Immediately right

Speaker 3: 6:17

After, then you can, then you put a constriction ring right around your penis .

Speaker 4: 6:21

It slides off of the VED.

Speaker 3: 6:22

It does. Okay . It does. And it goes from the base of your penis. Mm-Hmm. <affirmative> . And then you're able to keep an erection. Now, that's the good part. The bad part is there's a lot of user error in this. It is not straightforward. It is complicated to use this thing. Yeah. So you have to, you have to learn how to use it properly and make sure you have the tools . So what's one problem that, well, as you're making the vacuum, sometimes people scrotum gets sucked into the, the vacuum as well. Mm-Hmm . Because it's right there. Sure. Sometimes they don't get a good enough seal. And the most important and most common problem is that the constriction ring is not the right one. Oh,

Speaker 4: 6:58

I thought you were gonna say the woman is going, what are you doing, <laugh>? Isn't that the number one problem? Yeah .

Speaker 3: 7:02

Get outta the bathroom. Whatcha doing

Speaker 4: 7:03

There? <laugh> ,

Speaker 3: 7:04

It's also uncomfortable to use It. Is , um, I , if you've just had your prostate removed. Mm-Hmm. <affirmative> , sometimes you can leak urine when the vacuum gets activated. Oh . So that's dirty and not fun and kind of messy unless

Speaker 4: 7:17

You like

Speaker 3: 7:17

That. Unless you like it. And then you have the, you have to, to get a good seal, you want to use a lubricant like KY to create a good seal. Mm-Hmm. <affirmative> . Um, and not all men are made the same. What? I know, it's shocking. So it's not a one size fits all in this constriction ring? No. Because the ring has to be tight enough to keep the blood flow in, but not so tight that it's so uncomfortable to use that you don't want to use it ever. Hmm .

Speaker 4: 7:43

That makes sense.

Speaker 3: 7:43

So there are hundreds, literally hundreds and hundreds of constriction rings on the market. You don't have to use the three that came with the device that you bought. There's many, many, many online, any, any sex shop will have tons of constriction rings because, you know, rings are a thing. And so really understanding how important it is to make that therapy work for you is something that we really emphasize here in our clinic. We will show you how to use it. We want you to use it before your prostate's out. We want you to really focus that the more motivated you are to use these different kinds of things, the more likely you are to have success and to be able to continue your sexual relationship. Right . Once that's done, though, and so for this particular listener, pills didn't work. And for whatever reason, the the pump is not, you know, satisfactory to him. Mm-Hmm. <affirmative>. So next thing that we do is we move on to trimix injections. So trimix is a combination of three vasoactive medicines that cause relaxation of the arteries and thus filling of the penis with blood. It does require an injection, so you have to inject yourself, but

Speaker 4: 8:45

You guys are in the bathroom a lot. Before you have sex <laugh> , you're manipulating the vacuum erection device.

Speaker 3: 8:50

We're having to manipulate everything ourselves. Right ? Right . We're trying mix , mix . I mean, it , it gives you some idea of how important sex is. <laugh>, we're willing to do almost anything for it . It ,

Speaker 4: 8:58

Wait a minute, let me go move the earth. That's to an erection. Are

Speaker 3: 9:02

You kidding? We even get married to people <laugh> . So you really have to go, you know, if you're motivated, then we can usually get you an erection and have, and help you, you know, have some satisfactory relations. The injection is given or self delivered by the patient. Just the minutes before you want to have sex. And if properly dosed, you can, you can function like a rock star .

Speaker 4: 9:27

You will give a five star review. That's

Speaker 3: 9:28

Right. You will get a five star review. You will get a five star review.

Speaker 4: 9:31

You get one too. You get one

Speaker 3: 9:32

Too <laugh> because it gives you an erection. And then depending on your dosing , uh, it can last for, you know, as long as you want it to last. Mm-Hmm. <affirmative> . And so this is great, especially if you are, you can't tolerate the oral pills for some reason. Let's say you have bad reactions to Viagra or to Cialis .

Speaker 4: 9:48

You're taking it wrong.

Speaker 3: 9:49

Now , uh, with this little injection, you can get a very nice erection and many men are , are satisfied with it. There's some quirks to it. It has to be kept at a certain temperature in the fridge, and you, you gotta use a needle. And , but, but if you're motivated, we will make sure that you are appropriately taught , uh, how to , how to use this. Uh, it is not generally covered by insurance, but it's not terribly expensive. I think that , um, you know, if you, if you maximize the vial, you , it probably costs you about $7 a use. Mm . Uh , okay . And it works very well. You can travel with it and we can make all sorts of accommodations. So , uh, really great. Uh , thanks to this listener for this complicated question. Donna, how do people get ahold of us?

Speaker 4: 10:29

You can call us at (512) 238-0762 or visit our website, armor men's health.com. You can submit your questions right there. We'll answer them anonymously on this show just like we did for that gentleman . Hello

Speaker 3: 10:40

And welcome to the Armor Men's Health Show. This is Dr. Mystery, your host. Join us always by my co-host, Donna Lee.

Speaker 4: 10:46

Hi everybody. Welcome to our show.

Speaker 3: 10:48

I'm a board certified urologist , uh, expert in men's health. We have a clinic, NAU urology specialist that I started in 2007. We are growing bigger and bigger every day, and we would love to take care of you as a primary patient or even a second opinion. We love second opinions. You love

Speaker 4: 11:04

A second opinion.

Speaker 3: 11:04

I love second opinions on this show. If you're a frequent listener, you'll know that , uh, I believe strongly that the care that you receive has a lot to do with the motivations and the particular expertise of the doctors that you see. And that not all doctors were made the same. That's right. Uh, and so , uh, if you have a, a urologic condition and you're just wondering if maybe there was another way to take a swing at it, we would love to see you for a second opinion. This is true of cancer diagnosis. Mm-Hmm . <affirmative> , this is true of a lot of things that you think are even maybe simple like testicular pain or frequent urination. How your doctor is going to, what they believe in is going to impact greatly how you get treated. Mm-Hmm. <affirmative> . Uh , so if you have an a , a a , you know, a medical condition that is not treated to your satisfaction, we would encourage you to come in. And I would say that of any health system or , um, a medical condition, if you, if you don't feel like you're getting the treatment that you would hope to get , uh, you should look around.

Speaker 4: 11:59

I think that's , uh, really telling when I talk to people about how many BPH h procedures you offer or you know about or we offer in the clinic, and there's like, what, 10 or 11 mm-Hmm . <affirmative> options. Mm-Hmm . <affirmative> . And I always hear, oh, my urologist offered me green light .

Speaker 3: 12:11

Yes. One, I , I offered one. What

Speaker 4: 12:13

Do you mean there's 12 pro options?

Speaker 3: 12:15

Yeah. Yeah. And that's one of our favorite things that we have here are make America pee again , um, uh, you know, system and Mm-Hmm . <affirmative> and paperwork and , uh, and , and how we , uh, kind of present you things. And that goes for BPH as well as for urinary issues like leakage that women may have. Mm-Hmm. <affirmative> . And so , uh, we take care of that whole, you know, the , the whole array of, of options. Now, an argument could be made that you can't be good at everything then. Right. And that, and that's a very strong argument. Mm-Hmm . <affirmative> . I , I'll accept that. Yeah . So I don't do green light laser. Dr. Yang does, I don't do a terrible large amount of UroLifts, but Dr. Nen does. I don't do holaps at all. That's holmium laser nucleation of the prostate. Dr. Krieger does that one. Mm-Hmm. <affirmative> . So if I think that your, that your particular medical condition is gonna be best suited by a particular operation, and I'm not the one to do it, then I'm gonna put you in good hands to do that. Mm-Hmm. <affirmative> . Um, and so I , that's

Speaker 4: 13:08

Rare, by the

Speaker 3: 13:08

Way. I don't know. I , I , I hope it's not rare. I hope that everybody wants to make sure their patients get the top-notch care. Yeah . Ironically, because I'm more like of this previous generation now, I'm no longer the , the young buck on the, on , on , on the block. But

Speaker 4: 13:20

You keep asking people to call you buck.

Speaker 3: 13:22

A lot of the stuff that I do, Dr. Buck is the stuff that, you know, is be considered older. Mm-Hmm . <affirmative> . So I do still do open procedures to remove prostates that are enlarged. And then the rotor rooter , the turp , uh, is a pretty classic part of my armamentarium. Mm-Hmm. <affirmative> . And then I do aqua ablations. That's where we use the water jet to open up the channel. Mm-Hmm . <affirmative> . But very good point. Uh, Donna , uh, where are our offices? How do people get ahold of us? And , uh, tell me about any questions

Speaker 4: 13:47

You can reach out to Dr. Mistry or anyone on our team at , uh, 5 1 2 2 3 8 0 7 6 2 or visit our website, armor men's health.com. If you're in Texas, we are in central Texas. That's round Rock. North Austin. South Austin and Dripping Springs, Texas, where they love dripping. They love

Speaker 3: 14:04

Dripping.

Speaker 4: 14:04

We're trying to fix that dripping. Um, I do have another question, kind of piggybacking the first question about Viagra. This patient sent in Dr. Misery . I'm a 61-year-old male. I've had multiple back surgeries. I also have erectile dysfunction that was initially treated with Viagra. Finally had a semi rigid implant. He would like to know, because he is otherwise healthy, no diabetes, no high blood pressure. Uh, he would like to know what his options are because he is very frustrated.

Speaker 3: 14:29

Well, I guess , uh, I'd have to understand more about this, this, this particular listener. It sounds to me like he already had a penile implant inserted. And so the penile implant is kind of the last stop on the train, right. When it comes to erectile dysfunction. Mm-Hmm. <affirmative> . And I'm gonna describe what, what a penile prosthesis is, and then , um, hopefully, hopefully help people, you know, feel comfortable about inquiring about something like this. Hmm . But in, in what's probably one of the most amazing engineering feats, okay, <laugh> ,

Speaker 4: 15:04

We replicated a penis. A

Speaker 3: 15:06

A urologist. Okay. Said

Speaker 4: 15:08

Hmm ,

Speaker 3: 15:09

Hmm . What could <laugh> , that erectile dysfunction is pretty terrible, but what should we do? So he invented a silicone device that goes into the penis completely in the penis, that you then have a little pump in your scrotum that you pump. And the thing gets hard. It's amazing.

Speaker 4: 15:26

And the sensation is really the same, you've said It is,

Speaker 3: 15:29

Yes. I mean, I don't have one <laugh> . I don't have one. And I've never had sex with somebody that had one. Oh, okay. But , but technically, technically, those men that have had

Speaker 4: 15:38

It, because the nerves are still there,

Speaker 3: 15:40

The , the , the surface of the penis feels normal. Okay. And so, normal orgasm, you should be, you know, you should, it should feel fine. And if you have a prostate, you'll even orgasm and have an. Okay . So , uh, but if you've had your prostate removed, then that's what makes Semens. So you won't have any come out of you.

Speaker 4: 15:58

Real quick though, going back to the pump, that's the thing we've talked about before. That's the third ball.

Speaker 3: 16:02

That's the third ball. The

Speaker 4: 16:03

Third testicle. So you're pumping it up? Pumping it up . Is it behind the other two? So it's not super visible to the woman.

Speaker 3: 16:08

The woman will never know. She

Speaker 4: 16:09

Doesn't care because she

Speaker 3: 16:10

Doesn't see it. I mean, I I When's the last time you spent any scot time? Zero. Zero. You okay ? Yeah , you're right. I mean, you were just lucky my husband . You're just lucky to be naked together. You know what I'm

Speaker 4: 16:18

Saying ? You know , my husband might have one and I just don't know .

Speaker 3: 16:20

You wouldn't even know who's sat down there . What am I doing down there extra? Did I make a wrong turn? <laugh>. So now you have this inflatable penile prosthesis. It's a surgery. Mm-Hmm . <affirmative> that's done. I hope so. It takes about an hour to an hour and a half to put 'em in.

Speaker 4: 16:35

How does it get put in? Is it filet open the penis?

Speaker 3: 16:38

No, just a very small incision. It's like a, it's like ,

Speaker 4: 16:40

Like a breast implant. They go into part of the body and they go that they roll it up. And

Speaker 3: 16:44

That's , that's exactly right. So it's, it's not that luck . Luckily nothing is filet open. Okay.

Speaker 4: 16:48

Well that other, that panum procedure, remember? Yes. The doctor that we interviewed and the Google search that I did said the penis is filet open like a cat.

Speaker 3: 16:56

I don't dunno about a cat who filets a cat

Speaker 4: 16:58

Who filets a cat . I don't know . That's what , but that's a gross. It is gross. But this is not that. It's, it's a rolled up silicon thing . Make gross . Anybody

Speaker 3: 17:04

From the A-S-P-C-A ? I don't think she meant

Speaker 4: 17:05

That <laugh> beat us

Speaker 3: 17:07

And do not beat us . And I would avoid dinner at her house on

Speaker 4: 17:10

Saturdays. I'm Asian, you know . Oh, sorry. That was bad. <laugh> .

Speaker 3: 17:16

Oh , great. Now the A-S-P-C-A and the , and the Pacific American , uh, Asian society's gonna get on us , they're gonna disown me. So you have this , uh, penile prosthesis that's covered by many insurances, not all. Mm-Hmm. <affirmative> . Uh , and you'll be subject to your , your deductible. It's about , uh, a one week recovery and then six weeks after it's put in, you can start using it. Mm-Hmm. <affirmative> . Uh, we actually have Dr. Chris Yang, who specifically spent an entire year doing nothing but building erections

Speaker 4: 17:43

In Florida.

Speaker 3: 17:44

In Florida where

Speaker 4: 17:44

All the old men are living . Where all the living

Speaker 3: 17:46

The old guys are. Yeah. Mm-Hmm. <affirmative> . So this is an amazing opportunity for those of you that are either unable to respond to the medications, don't wanna do injections , uh, and are kind of at the end of your rope. Mm-Hmm. <affirmative> . So it sounds to me like this listener has one that's not working. Mm-Hmm. <affirmative> That's what it sounds like to

Speaker 4: 18:02

Me . And yeah. He might be a little embarrassed. And

Speaker 3: 18:03

He used the term semi rigid . Mm-Hmm. <affirmative> . So we have, we, we more commonly use an inflatable one. One that you have to pump up. Mm-Hmm . <affirmative> . It's called the inflatable penile prosthesis. But there is another version of this prosthesis called a malleable prosthesis. Oh . That just stays hard all the time. Oh,

Speaker 4: 18:20

I

Speaker 3: 18:20

Want that. And you gumby it up and down. Yeah . Like when you don't want to use it, you just gumby it down.

Speaker 4: 18:24

You mean push it ? What does gumby mean? Pushing it down.

Speaker 3: 18:27

Gumby is a clay, you know, it's like a character clay .

Speaker 4: 18:30

Yeah. I mean , who gumby is, but so Oh, you just like move it down.

Speaker 3: 18:33

You just move it outta the way . Yeah, yeah.

Speaker 4: 18:34

Yeah . Oh yeah. I'd want that if I was a guy. 'cause I'd want everybody to know I'm coming at them big old penis in my pants.

Speaker 3: 18:40

It's not meant to be like that. Oh . It's usually meant for people with , uh, poor dexterity of their hands. Oh , <laugh> . So , so ,

Speaker 4: 18:48

Okay.

Speaker 3: 18:49

So they can't pump it up. Wow. Uh , we also use it commonly in like , um, spinal cord injury patients who, you know, maybe it helps them urinate better by having a more rigid penis that they can grab onto . So there's other reasons to do it besides just this reason. Sure . There's fewer things that can go wrong with it because mechanically it's simpler to have just a simple prosthesis. Mm-Hmm. <affirmative> . So, and , and , and it may be the case that when this patient or listener was, was given a proposal of different options. Mm-Hmm. <affirmative> , he simply chose one that doesn't go blow up and down. Mm . I see . And so, and so in that case, we can actually switch it out. So if somebody's unhappy with their malleable prosthesis, we can go in and switch it out for a inflatable penile prosthesis, which may give him better sensation, it'll give him a bit better girth. You know, and he just may enjoy that process a little bit better than what he's doing currently.

Speaker 4: 19:39

Yes . So the same procedure type. Yes . The same insertion, same point of reference.

Speaker 3: 19:42

Pretty much. Pretty much. Gotcha . The incisions for the malle are a little bigger because Mm-Hmm . Um , is it the bigger thing? They don't , they don't blow up. Uh , you know, so , so , so it's not even like a , like a, like a breast implant. You put it in empty and then you fill it , uh, after it's already in place. Mm-Hmm. <affirmative> . Gotcha . So, so that's,

Speaker 4: 19:56

I mean, I wouldn't know <laugh> .

Speaker 3: 19:59

I'll never tell <laugh> you're gonna fall over everywhere you go. <laugh> . I think, I think we've figured it out. Donna

Speaker 4: 20:07

<laugh> . I keep tipping over. I don't know why . Lost all this weight. I just fall forward.

Speaker 3: 20:11

So , uh, for this particular patient though , uh, there's another interpretation of his question. And that's, he wants normal erections again. And that one, I'm gonna tell you , if you already have an implant in all the mechanism and all the, the , the plumbing and everything that's there to give you an erection that is gone. Oh . So that is a one-way street. It shouldn't dissuade you from considering it. Okay. But you should know that it's a one-way street. Because if you want have sex into your late sixties and seventies, and you have disease like prostate cancer, big back problems, or any one of these millions of things, you're really gonna want to do something that is reliable, that, that will work. You know? And that is satisfactory to you without the risk of side effects. Mm-Hmm. <affirmative> and surgical implantation of the inflatable penile prosthesis is a good option. Mm . Donna, if people wanna learn about it or , uh, visit with us for any other reason, how do they do that? If

Speaker 4: 21:00

You'd like more Gumby references, call us at (512) 238-0762 or visit our website, armor men's health.com. You can submit your questions. There's a little button at the top right. This says Submit your question here. And again, we're in Round Rock, north Austin, south Austin, dripping Springs, Texas. And listen to our podcasts. Wherever you pot ,

Speaker 2: 21:17

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