The Armor Men's Health Show

Bonus Episode: Bend Your Peyronie's Back Into Shape With Xiaflex Injections, Phalloplasty, and More!

• Dr. Sandeep Mistry and Donna Lee

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In this segment, Dr. Mistry and Donna Lee talk about the causes of and treatments for Peyronie's disease. If you have developed a bend in your penis or if, when erect, it stands at an unnatural angle, you may have Peyronie's disease. While the exact cause is unknown, Peyronie's disease may be caused by the slowly accumulating effects of microtrauma to the penis sustained during intercourse with a less-than-fully-erect penis. Scar tissue can develop along the penis shaft, causing the often painful and distressing changes associated with this incredibly common condition. More severe, acute trauma to the penis can also cause Peyronie's to develop practically overnight, so please be careful when having vigorous intercourse--the most common cause of serious penile trauma. Fortunately, there are many treatments for Peyronie's disease that address it's various causes and effects. There are different interventions depending on the degree of penile curvature and the severity of symptoms. While people with a lower degree of curvature might benefit from Xiaflex injections, those with more severe curves should consider one of the surgical options offered by NAU Urology Specialists. No matter your disease progression, getting an evaluation and proper measurement of your curvature by a urologist is essential in identifying the right treatment.

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.

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Speaker 1:

<silence> Welcome back to the Armor Men's Health Show with Dr. Mystery and Donna Lee. Hello and welcome to the Armor Men's Health Hour. I'm Dr. Mystery , your host here, as always, with my co-host, the wonderful, charming, and professional. Oh, no wait, <laugh> , it's me. Oh, it's you again. <laugh> . Okay. It's Donna Lee this time. Hello, Donna. Welcome.

Speaker 2:

That's right. Happy day everybody. Thank you. I was so excited about the compliment and then it turned again, so I'm used to that. Every

Speaker 1:

Time a patient says that they really like hearing you on the radio mm-hmm.

Speaker 2:

<affirmative> , they're smart,

Speaker 1:

And they don't mention me. They're

Speaker 2:

Smarter people for it . They kind . That's my , well, it should, because you're very mean to me. You're very Cuomo like with me, Cuomo. Oh . Oh , wait . He was flirting with everybody. <laugh> . Nevermind. <laugh> . We

Speaker 1:

We're gonna see how well that comment agents <laugh>. This is a men's health show. I'm a board certified urologist. Uh , my last name really is Mystery.

Speaker 2:

M i s T R Y.

Speaker 1:

It's gimmicky.

Speaker 2:

You were gimmicky and I was called juvenile and childish.

Speaker 1:

Very good. Very good. Yes. We wanna thank you listeners for giving us that feedback. <laugh> , thank you so much. It makes us feel real good about ourselves. <laugh> this <laugh>

Speaker 2:

Those were patients though . <laugh> ,

Speaker 1:

This show was brought to you by the urology group that I started in 2007. N A u Urology specialists. Uh , I think that we provide a different kind of urologic care for your problems. A more holistic, a more integrative approach. Mm-hmm . <affirmative> , we have four physician providers, we have five physician assistants. We have an integrative health provider, so they're really worried about a more natural approach to your disease processes. Mm-hmm.

Speaker 2:

<affirmative> , that,

Speaker 1:

That's how we integrate nutrition and supplements and advanced testing into your , um, into your treatment program. She has a real strong interest in helping your heart health or your cardiometabolic health, which is fascinating because it affects so many of our cancer and, and infertility patients. Mm-hmm. <affirmative>,

Speaker 2:

We

Speaker 1:

Do sleep medicine here because although urology and sleep medicine may not seem like they're attached, if you have sleep apnea, your likelihood of having low testosterone is much higher. Right. If you have sleep apnea and don't sleep well, it increases the cortisol level and the stress level of your body. It makes you more akin to diabetes. It makes you more akin to erectile dysfunction. Makes you more akin to other things that, that are going to harm yourself. So, right.

Speaker 2:

They're all connected to the penis bone.

Speaker 1:

Everything is connected to the penis bone. Mm-hmm . And that's something that I learned my very first day in medical school.

Speaker 2:

Oh, okay . I was a teenager. I ,

Speaker 1:

I went on urology day <laugh> . I only went to medical school on urology days, <laugh> . So , uh, the integration of these different specialties mm-hmm .

Speaker 2:

<affirmative>

Speaker 1:

Is something that I have a real interest in. And because of that, this, this practice was born out and so when you come to us, you're gonna get a different kind of care. You're gonna be shown natural therapies, you're gonna be shown , uh, surgical therapies that don't require medications. We're looking to avoid long-term complications and give you advice and attention that you may not be , uh, used to getting. And so , uh, I would say probably 40% of our new patients are coming to us from other urologists, you know, because they want kind of a different perspective. If you've been diagnosed with prostate cancer, almost every book will tell you to get a second opinion. Mm-hmm.

Speaker 2:

<affirmative> come

Speaker 1:

To us for that second opinion.

Speaker 2:

Yep .

Speaker 1:

Uh , we don't own radiation machines or have any kind of , uh, other kind of , uh, economic , uh, self self issue . So, you know, we will give you very honest advice, things that balance your lifestyle and your life years. And if you have a family member diagnosed with prostate cancer, please encourage them to get a second opinion. We'd love to see them.

Speaker 2:

Doctor , second opinion Doctor , worldwide,

Speaker 1:

Worldwide, because we have the podcast that's worldwide. Mm-hmm.

Speaker 2:

<affirmative> , uh,

Speaker 1:

Donna, if people wanna make an appointment with us or make that second opinion visit , uh, how do they get ahold of us?

Speaker 2:

You can call us during the week. We're happy to schedule you for that second opinion with Dr or one of our amazing providers. 5 1 2 2 3 8 0 7 6 2. Our website, as you know, is armor men's health.com, where you can see our smiling faces. Did you know on our website the name of the podcast at the bottom was covering our faces, our eyes like, like we were

Speaker 1:

Batman and Rooney.

Speaker 2:

Yeah. Batman and <laugh> . Robin and I asked the marketing company to move the words up. Just a little <laugh> so you can see our faces now.

Speaker 1:

Very good. So

Speaker 2:

If you wanna see our faces, armor , men's health@gmail.com, send us your questions. Um , that's our email address, armor men's health@gmail.com. In

Speaker 1:

Our practice, we see a lot of what I used to call flp . Funny

Speaker 2:

Look at penis .

Speaker 1:

So F L P . And we actually had an ad out once that said, do you have an F L P ? Does your husband have an F L P ? Send them to us <laugh> . And the idea was like, we would take care of people that needed circumcisions, we would

Speaker 2:

Take care . I was not in charge of that marketing . We

Speaker 1:

That's correct. My wife was not happy about that one . And , and genital warts and things like that, that we could kind of clean up and make look better. Most patients who are concerned about the appearance of their penis are concerned about curvature of the penis. Mm-hmm.

Speaker 2:

<affirmative> , also known as

Speaker 1:

Peyronie's disease.

Speaker 2:

Why is this , why is it disease? The word disease? It always sounds weird to me.

Speaker 1:

Peyronie's disease,

Speaker 2:

Peyronie's stature,

Speaker 1:

Stature, Peyronie's shape, <laugh> , it is estimated that , uh, maybe somewhere in the order of about 5% of men , uh, maybe up to 10% of men have an abnormal penile curvature. Mm-hmm .

Speaker 2:

<affirmative> ,

Speaker 1:

Uh , it can come on suddenly, like overnight.

Speaker 2:

It's so weird.

Speaker 1:

It can be dramatic. Right.

Speaker 2:

And

Speaker 1:

With

Speaker 2:

No trauma, with

Speaker 1:

No trauma, it can be associated with pain. It can sometimes not be associated with pain. It can be associated with prior trauma or surgery most of the time not.

Speaker 2:

And weird sex positions.

Speaker 1:

That's correct. Mm-hmm . <affirmative> . And so if you, if you've had a penile fracture Right . Which is where you break it, people often wonder how you can break it. You

Speaker 2:

Can break it, but it's

Speaker 1:

Just like breaking a , your

Speaker 2:

Ear.

Speaker 1:

A French baguette <laugh>, a stale French baguette.

Speaker 2:

Oh . Whack it, if you whack it real hard on the counter, it

Speaker 1:

Just doesn't, just doesn't bend. And so , uh, if, if that happens usually during intercourse, it sometimes it has to be repaired. Like you have to go and sew mm-hmm .

Speaker 2:

<affirmative> the

Speaker 1:

Breakage. Yeah .

Speaker 2:

Then in

Speaker 1:

The future, you may develop peries, but most patients don't have peyronie . Some interesting facts about peyronie , there's a very high concordance between peyronie and low testosterone, and a lot of men with peyronie are having early ed erectile dysfunction. Mm-hmm.

Speaker 2:

<affirmative> . And

Speaker 1:

The way I think about it in my mind is like the penis starts becoming a little softer. Mm-hmm.

Speaker 2:

<affirmative> , and

Speaker 1:

Then you keep having sex. So the penis, because it's not as rigid, starts moving in a lot of different axis . Axises . And then that trauma, that repeated microtrauma leads to the deposition of scar tissue, and then eventually this plaque. Now

Speaker 2:

Another reason not to have sex. Thank you.

Speaker 1:

That is absolutely the wrong conclusion. That's

Speaker 2:

What I heard. And I'm very excited about that .

Speaker 1:

That's when you have to say a lot of nice things. So it stays hard the whole time going

Speaker 2:

Home to tell Michael.

Speaker 1:

So if you have it, it causes the deposition of the scar tissue mm-hmm .

Speaker 2:

<affirmative> , and it

Speaker 1:

Can cause a hardness.

Speaker 2:

That makes sense. And

Speaker 1:

That's like a latex balloon where one part is made of, you know, a non banding material mm-hmm.

Speaker 2:

<affirmative> ,

Speaker 1:

It'll, it'll turn in that direction.

Speaker 2:

Right.

Speaker 1:

So if you have this kind of curvature and it doesn't bother you, then don't do anything about it. But if it's hurting or if it's getting worse, what if it's

Speaker 2:

Hurting her ? It

Speaker 1:

Can hurt her. That's exactly. Or him , we don't judge hurting you or her. Mm-hmm .

Speaker 2:

<affirmative>

Speaker 1:

If it's, if it's visually unappealing to you and you want that repaired, we have lots of treatments available, and I've talked about some of those in the past. We have a , a penile stretching , uh, type intervention. We have a medicine called Xiaflex, which is, which is a scar breakdown kind of medicine that we inject in there. And recently we've been doing both ultrasound or what we call spark wave or shockwave therapy. Mm-hmm .

Speaker 2:

<affirmative>

Speaker 1:

And our pelvic floor physical therapist has been doing a microneedling technique.

Speaker 2:

Right. That's cool.

Speaker 1:

And she says that she's been having some amazing results.

Speaker 2:

Right. She started doing these techniques with the idea that the patient would eventually need to go to spark wave therapy, but she's handled them so well that they don't need the spark wave therapy. <laugh> great . She joined the needling .

Speaker 1:

Does she know we charge for the spark wave <laugh>? Who's she stealing from?

Speaker 2:

She's not making any money. Yeah.

Speaker 1:

<laugh> , she's just

Speaker 2:

Fixing pieces .

Speaker 1:

Anyway , another example of how we're looking out for your best interest. And so if you are out there and have poni or have some type of curvature, we would love to have take care of you. But, but really what I wanted to talk about was those patients in whom everything has failed. So this week I saw a patient , uh, 64 years old, incredibly robust, you know, out there working hard, great erections, otherwise very happy, except the curvature is making his peepee real short.

Speaker 2:

Oh .

Speaker 1:

And he doesn't like that for sure. And it , it is the case that for every 10 degrees of curvature, you may lose an entire inch of length of your penis.

Speaker 2:

Dang.

Speaker 1:

And so , uh, we do have a surgery that we can do called a patch graft phalloplasty, where we take the scar out and replace it with a piece of synthetic tissue.

Speaker 2:

Mm-hmm. <affirmative>

Speaker 1:

That what the tissue that I use is called ss i ss. It's the , um, it's made from the intestines of pigs.

Speaker 2:

Oh, so

Speaker 1:

It has no cells in it? No , it's an acellular matrix, but it's a thick sheet.

Speaker 2:

So you ink when you have sex <laugh>

Speaker 1:

And do I taste bacon? So , uh, it is , uh, uh, the downside , the upsides of it are the plaque goes away because that's what he's really interested in.

Speaker 2:

Right. It

Speaker 1:

Can restore some length

Speaker 2:

Mm-hmm. <affirmative> ,

Speaker 1:

Um, and , um, which can be good and it works if the Xiaflex or other less invasive , uh, uh, less invasive interventions didn't work.

Speaker 2:

Mm-hmm. <affirmative>,

Speaker 1:

The downsides are you can lose some sensitivity to the head of your penis, at least temporarily. And it might structurally weaken how stiff the erection is. Oh . So it's not good if you have real weak erections. Mm-hmm . <affirmative> , it's better if you're younger and have strong erections, but if you have Peyronie's or if you have advanced erectile dysfunction and you haven't been given solutions that meet your needs mm-hmm .

Speaker 2:

<affirmative> ,

Speaker 1:

We would love to see you and take care of it for you.

Speaker 2:

All I can picture is Gonzo from the Muppets.

Speaker 1:

That's exactly what he said.

Speaker 2:

Really?

Speaker 1:

Yes. <laugh> .

Speaker 2:

I just googled Zo the

Speaker 1:

Other guy. I had another guy this week because of trauma. He developed a Peyronie's and he said, and I said, how's everything going? He goes, everything is going great except my erections. They're kind of like the guy on the Gonzo and the Muppets <laugh>. So we're gonna fix him too.

Speaker 2:

Wow. Well, you can call us during the week if you have questions about your gonzo shaped penis at 5 1 2 2 3 8 0 7 6 2. That's funny. Our website's, armor men's health.com, and you can check out our podcast wherever you listen to free podcasts. Thank you so much, Dr.

Speaker 3:

The Armor Men's Health Show is brought to you by N A U Urology Specialist. For questions or to schedule an appointment, please call 5 1 2 2 3 8 0 7 6 2 or online at armor men's health.com.