Armor Men's Health Show

Bonus Episode: Nerve Damage Punching Below the Belt? Dr. Mistry on Genital Numbness and Bladder Paralysis Following Spine Surgery

• Dr. Sandeep Mistry and Donna Lee

Share episode

In this episode, Dr. Mistry and Donna Lee answer a listener question about pelvic numbness and difficulty achieving an erection following spinal surgery. Dr. Mistry explains that trauma to the lumbar and sacral regions caused by swelling, surgery, or underlying conditions can affect our motor and sensory nerve outputs, including those that connect to our bladder and genitals. As a urologic surgeon, Dr. Mistry commonly treats patients who have symptoms like bladder paralysis and erectile dysfunction from such neurological changes. At NAU Urology Specialists, we use cutting edge biothesiometry evaluations to measure the temperature and vibratory sensation of the genitals to assess nerve function--crucial information in determining the best course of treatment. Tune in to learn how the right supplements, prescription medication, hormone therapy, and even vibrating penile rings can work together to increase genital stimulation and improve sensation. If you or someone you love has urinary or sexual dysfunction following spinal trauma or surgery, call or visit us online today to learn more about available treatments!

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

Our Locations:

Round Rock Office

970 Hester’s Crossing Road
 Suite 101
 Round Rock, TX 78681

South Austin Office

6501 South Congress
 Suite 1-103
 Austin, TX 78745

Lakeline Office

12505 Hymeadow Drive
 Suite 2C
 Austin, TX 78750

Dripping Springs Office

170 Benney Lane
 Suite 202
 Dripping Springs, TX 78620

Speaker 1:

<silence>

Speaker 2:

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

Speaker 1:

Hello

Speaker 3:

And welcome to the Armor Men's Health Show. This is Dr. Mystery , your host, board certified urologist, founder of N A U Urology Specialist. And I'm joined by my , uh, wonderful sidekick and co-host Donna Lee. Hey

Speaker 4:

Everybody. Welcome to the show.

Speaker 3:

Donna. We are , uh, really growing as a practice. Uh, uh, why don't you tell people , uh, what's happening?

Speaker 4:

Oh my goodness. If you're listening to the show before September, we have two new doctors coming. This is so exciting 'cause there's so few urologists in the world, <laugh>, and we found two

Speaker 3:

We're really lucky. E even the , uh, other hospitals and other people in town that have helped us re recruit these , uh, physicians are amazed that we're able to find some people. Uh, there's a great shortage of urologists. Uh , for those of you that are looking for appointments out there, you certainly know about that shortage. Mm-hmm . <affirmative> and the long wait times. So , uh, we're happy to be able to announce shorter wait times. We'd really love to get you in for your primary or second opinions for your urologic conditions. Uh , Donna, where are our offices and how do people make that appointment? You

Speaker 4:

Can call us at (512) 238-0762 our website, armor men's health.com. And we're located in central Texas, round Rock, north Austin, south Austin, and Dripping Springs, Texas. And you know what? We're really behind on questions.

Speaker 3:

We are, and a urologist is a special type of surgeon. So remember that we're surgeons. We do a residency that takes about five years. Mine took six. Um, you just

Speaker 4:

Were so extra.

Speaker 3:

Yeah , a little extra. Uh, uh, that's after medical school, so you go to medical school and then you do a five year surgical residency where you spend all of your time hoping to be in the operating room. And then when you graduate, you spend all your time in clinic. Yeah, that's

Speaker 4:

A

Speaker 3:

Lot of school , but we still miss the operating room. And so you'll hear on this show and a lot of our guests being surgeons, a lot of people that we get to work with and, you know, we want to do what's best for you. So sometimes it's medical management and sometimes it's surgical management. But your questions , uh, and your continued interest in our show is what continues to drive us. So we love your questions. Donna, hit us with one. Okay.

Speaker 4:

From a very special listener and friend. Um, hi Donnelly. I've been a faithful listener to your show for several years now, but haven't heard this particular issue addressed. So here's the question for Dr. Mystery , and perhaps he can help myself and others. I'm 63 and on the 18th of May, I had L four five laminectomy with removal of synovial cyst and instrumentation with fusion. I've dealt with the age-related spinal stenosis for over two years now, 10 weeks post-surgery. I have no back pain, but still have pelvic region numbness, difficulty achieving an erection and no libido. My spine surgeon says it's only a matter of time, but I'm concerned that this is happening to me. Pre-surgery, I had no erection issues or health issues. Your thoughts are appreciated. Thanks and love your show.

Speaker 3:

Well, that's a great question. Um, you know, after spine surgery, there can be a number of urologic kind of changes that may or may not be permanent or may or may not be commonly experienced. So the, the nerves that go to the pelvis come out of the spinal cord a little higher than you might think, but , uh, specifically in the lumbar and sacral regions, you're going to get the motor and sensory nerve outputs and that may get affected either by swelling or by surgery or by the actual underlying condition as well. So urinary problems are something that we see not uncommonly. Uh, it's both because the patient themselves is older and kind of at risk for urinary problems, but also the nerve outputs that go to the bladder can be negatively impacted. And so waking up after spine surgery and not being able to pee is something that we see, you know, quite frequently. Generally speaking, a catheter is placed temporarily, maybe for a day or two, they'll come into the office and, and hopefully after 48 or 72 hours, this kind of bladder paralysis, it gets alleviated. But , uh, occasionally what's being done is we're uncovering an underlying prostate problem, and we're going to have to take care of that. Now, when it comes to this issue with low libido, inability to get an erection and numbness, it makes me wonder what was the chicken and what was the egg. Mm-hmm . Okay. So if I couldn't feel my penis, my libido would drop too . And , and if my erections depended on continuous stimulation mm-hmm. <affirmative> and I couldn't feel my penis, I would also have erection problems. Makes sense. So I think a combination of , um, I I , I think that probably, if I had to guess for this listener, sensation in the pelvis is probably the, the first problem. And then that led to erectile dysfunction. And then of course, if your erections and your pelvic sensation and your penis are important to you, then you know, you would feel a loss of libido. So in terms of how we would kind of approach this , uh, particular , uh, patient mm-hmm . <affirmative> is we have a type of evaluation that we do in the practice called biometry. Okay . Biometry. And what we do is we can assess the temperature and vibratory sensation of the genitals. We use this in men and women both. And , uh, have you seen that little probe that we use in the office? I have, yeah. It's fascinating. It , it , it has, has like this little vibrating tip on it. Yeah . And then the other one has like a , Hey ,

Speaker 4:

Y'all can't find me one day,

Speaker 3:

<laugh> , you know, Donna, we need the probe back. <laugh> ,

Speaker 4:

It's almost done.

Speaker 3:

Almost done. Two more minutes. Two more minutes . And, and the temperature one is also fascinating. It , it has a little temperature probe that goes up or down in terms of temperature mm-hmm. <affirmative> , <affirmative> . And it allows us to assess the nerve function of the genitals. Okay . So for this listener, that's what we would do. We would assess the, the vibratory and the temperature sensation of the genitals and see if that's been diminished. If that's been diminished. Hopefully, you know, those sensory nerves tend to come back after the swelling , uh, and things like that kind of e evolve and improve after spine surgery.

Speaker 4:

But he's already, what, 10 weeks out? Yeah , I guess . And how far out should he give it a second

Speaker 3:

Chance? I think, I think 12 weeks is at the minimum. Okay. Uh , but , uh, but it could take longer. I mean, sometimes these, these neuro p this the neurologic injuries that occur from stretch can take up to a year to improve. That's what we see. Oh , wow . You know, after prostate surgery. So it can take a little bit of time, but that doesn't mean that this patient has to live like

Speaker 4:

Know he doesn't have to wait double either .

Speaker 3:

Either he doesn't have to wait. Gotcha . Meaning we can find ways to augment him immediately. For example, we can make sure that his testosterone level is normal. We can make sure that he's temporarily augmented with medications that will help him maintain his erection a little bit longer. Mm-hmm. <affirmative> , we would certainly wanna put him on supplements that will help with nerve regeneration. Right. And we would want to make sure that, you know , uh, we can evaluate over time and give him some confidence that his sensation and vibratory sensation are kind of improving over time. Then we will talk about, let's say his vibratory sensation is down and he needs more stimulation mm-hmm. <affirmative> , then we have a variety of different things that we can offer, including those vibratory rings that we've seen , uh, used in the clinic. So, you know, diabetics or men who lose their erection when they're kind of changing position because of a loss of sensation. Mm-hmm. <affirmative> , these are patients in whom that type of vibratory ring or vibratory penile ring are things that, that we will use more commonly when it comes to sensation, if their sensation is diminished. Uh, just kind of temperature sensation. There are different creams , uh, that we can offer to improve that. Should

Speaker 4:

He just get a hot girlfriend?

Speaker 3:

I will say that that probably fixes most problems <laugh> except for the financial ones. <laugh> . That's right.

Speaker 4:

They're expensive though .

Speaker 3:

They're expensive <laugh> , it's really the ex-wife that's more expensive. Oh, true, true. That's right. So , uh, you know, I guess, you know, pick your poisoning <laugh> , uh, when it comes to o o other things to help , uh, we do offer that p r p shot of the penis to help regenerate sensation. We like the arter cell supplement that helps with endothelial regeneration. Yeah . That's amazing. Uh , uh, and so , um, there can be some role for shockwave therapy when it comes to nerve regeneration, at least in the penis. And so we have some adjuncts that can help , uh, you know, improve things. But truth be told, I think that a 90 day course of Cialis making sure that the guy's testosterone is working okay. Mm-hmm. <affirmative> , and then confirming nerve sensation is probably gonna be exactly what this doctor would've ordered , uh, for , for that, that patient.

Speaker 4:

Wow. That was a good ending to that.

Speaker 3:

That was good . I I , I think that for that was sexy. I think that for patients <laugh> , uh, just, you know, neurosurgeons, you know, they're very focused on what they're doing. Right. The nerves as they should be. And if you don't have pain that doctor thinks that he has like perfectly taken care of your problem. Right. I'm not a neurosurgeon. I care about, you know, your penile function, your erectile function. Mm-hmm. <affirmative> , I can't fix your spinal stenosis. But what , what I mean by all that is that sometimes a surgeon, you know, when there's a complication that's out of their realm mm-hmm . <affirmative> may not know how to deal with it, and so may downplay like kind of what's happening. Oh, I see. And so , uh, that, that's, that , that , that doesn't mean they're a bad surgeon. It means that they're probably not a very good urologist. <laugh>. <laugh> . Excellent. And that makes sense. As one of our previous guests said, you don't want your thyroid removed by a guy that does a lot of robotic prostatectomy. That's true. Uh, and so, and , and, and you , you may not want your erections fixed by a guy who does a lot of spine surgeries . That's true. So , uh, we would love to , uh, kind of take care of these kinds of problems if you've been seen before, and if you've been seen by a urologists and they kind of, you know, didn't take you seriously, then don't feel that all urologists are the same. I mean , uh mm-hmm . <affirmative> , you know , we , we consider ourselves to be , uh, top-notch and , uh, highly cutting edge. Uh, and really , uh, we'll do almost anything to kind of , uh, restore your function. Donna, how do , how do patients see us either as primary or as second opinion? You

Speaker 4:

Can call us at (512) 238-0762. Visit our website, armor men's health.com. And don't forget, you can hear our podcasts. They're amazing. They're free, and they're available just for you at any place where you listen to free podcasts. Thanks, Dr. Miss Tree .

Speaker 3:

Thank

Speaker 2:

You, Donna. Dr. Mystery wants to hear from you. To submit a question, visit armor men's health.com. We'll be right back with the Armor Men's Health Show .