Armor Men's Health Show

"Polite Penile Pulsing": Why "Shockwave Therapy" for ED Isn't Scary At All

• Dr. Sandeep Mistry and Donna Lee

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Thanks for tuning in to the Armor Men’s Health Hour Podcast today, where we bring you the latest and greatest in urology care and the best urology humor out there.

In this segment, Donna Lee is joined by NAU Urology Specialists Provider, Dustin Fontenot, PA-C. Today's topic is the use of shockwave therapy for erectile dysfunction. While the name might sound scary, the procedure is actually completely painless and is more akin to an ultrasound than anything else. Donna Lee explains that the providers and staff at NAU Urology Specialists lovingly refer to this extremely successful intervention as "Polite Penile Pulsing" to better capture its harmless nature. Shockwave therapy is a great alternative to medications like Viagra and Cialis because it increases blood flow in the penis by repairing blood vessels, allowing the patient to be spontaneous and not have to wait on medication to kick in and then deal with the side effects. It is also affordable at $400 per treatment or $2000 for 6 sessions when purchased up front. Most importantly, our physicians are expertly trained on the machines used for our "Polite Penile Pulsing" therapy and will only encourage patients to seek this treatment option if it is likely to be successful. Patients with neurologic causes for their severe ED (such as those who have had a complete prostatectomy) are not good candidates for shockwave treatments and would be better suited to different interventions. If you or a loved one is experiencing erectile dysfunction and would like to learn more about shockwave therapy, please give us a call or visit our website to learn more. 

If you enjoyed today’s episode, don’t forget to like, subscribe, and share us with a friend! As always, be well!

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

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Speaker 1:

Welcome back to the Armor Men's Health Hour with Dr. Mistry and Donna Lee.

Donna Lee:

Welcome to the Armor Men's Health Hour with Dr. Mistry and Donna Lee. This is Donna Lee, your host for the segment. Dr. Mistry stepped away, but we have our special, amazing PA here, Dustin Fontenot. Welcome Dustin.

Dr. Fontenot:

Hi.

Donna Lee:

Dustin. I wanted to talk with you for all of our listeners and podcast listeners about that super sexy, awesome new vibrant treatment called shockwave therapy.

Dr. Fontenot:

Yes.

Donna Lee:

You're doing a lot of those.

Dr. Fontenot:

I am.

Donna Lee:

I hear the machine. Dustin's in the clinic and I hear that machine going. I had a gentleman in my office one day, who was a vendor working on our phones or something, and you had a patient in the room, and it's a very distinct clicking noise. There's absolutely no pain involved, but he was absolutely mortified. So I said, calm down, because he is like,"What is that noise?" It's just so loud, but it really isn't doing anything painful or anything. So tell us about shockwave treatment, why we're probably going to rename it"Polite Penis Pulsing." What does it do for erectile dysfunction? How many treatments are involved? Tell us everything you know about shockwave treatment because the patients are asking.

Dr. Fontenot:

Okay. The shockwave treatment is a, it's a technology that's been around for a long time, used in orthopedic injuries as well as wound care. And basically, in kind of simplified terms, it uses a low intensity shockwaves to basically help promote healing. And they discovered in Europe several years ago that it could also be used to benefit in some of urological needs, including erectile dysfunction. So the primary mechanism is essentially, it's arthrogenic. So it stimulates kind of neovascularization, which is just the development of new blood vessels, which, and the vast majority of erectile dysfunction, the cause of it is sort of a breakdown of these blood vessels in the endothelial lining of the blood vessels, and so this technology helps sort of repair and stimulate it. What we do is, our protocol, we use six sessions and they're done about a week apart--2000 shocks. You don't feel this. It takes about 15 minutes. They're just pulsations to the penis and around the area. And, you know, most men will start seeing results somewhere in the first couple of months throughout the treatment.

Donna Lee:

So it's weekly?

Dr. Fontenot:

Yeah, so we do them weekly for six weeks, but you can skip a week. It doesn't necessarily have to be weekly. We are seeing some excellent results. The literature suggests that it's about an 85% success rate.

Donna Lee:

85%?

Dr. Fontenot:

Yeah.

Donna Lee:

That's awesome. Wow. That's really high. I know we're really transparent about pricing. Tell us about pricing. And I know other people, or clinics are doing it and people are starting to call around and price check.

Dr. Fontenot:

Yep. So we charged$400 a session, and like I said, we recommend six sessions and more can be added on if necessary. We do offer a discount if you pay for six sessions up front. So we do sell six sessions for$2000, so you get a$400 discount there if you pay up front. And so far, most of our men that have gone through the protocol have only just needed the six. We haven't had to add anything on yet.

Donna Lee:

Oh, good. Well, I know we're doing a lot, because that clicking, like I said, my office is in the back and I can hear it. And I'm like,"Oh, there it is again." Is there any side effects or any issue?

Dr. Fontenot:

None, absolutely. None. Which is, it's really kind of the draw to it is that, so the patients that I've treated, you know, some of them, whereas they may able to use a Viagra or Cialis or something like that and get good results from it from a functionality standpoint, but the headaches and the nasal congestion and all the typical side effects just kind of make it not even worth it. You know, a lot of these men are looking for an alternative to that, that they can avoid sort of that reliance on the medication. And that's another thing. Right? So instead of having it, you kind of are now you're sort of ready whenever and versus that preparation, or you have to say, you know, hang on, honey, give me a few hours, let me pop this pill.

Donna Lee:

Right. And you're supposed to take Viagra on an empty stomach and that kind of defeats date night, a romantic dinner?

Dr. Fontenot:

Yeah. So many rules around it.

Donna Lee:

Right? Tell us what priapism is, and does it ever happen with shockwave therapy?

Dr. Fontenot:

Never. Priapism is a prolonged erection, something that lasts over four hours.

Donna Lee:

Like in the commercial?

Dr. Fontenot:

That's right. And that's only going to be due to, it really, ever rarely happens from an oral medication. It's usually through a TriMix injection, which is a direct injection into the penis to get an erection. But because we're just restoring your native erectile function with the shockwave treatment, it's, it would never be an issue.

Donna Lee:

Oh, I remember the last patient that came in with priapism and we were on high alert. Like we were all trying to act like we weren't looking...we were all looking. Bless his heart. But that was also a TriMix patient, I remember that. So...

Dr. Fontenot:

Yeah, it's almost always is.

Donna Lee:

So you don't want to put a needle in your penis all the time?

Dr. Fontenot:

No, not all the time. Maybe just on Saturday nights.

Donna Lee:

Or weekends. Well, you know, Dr. Mistry and I always joke that since we're the second largest urology group in Austin, we're a little prettier--that means we're a little prettier on the weekends. Trying a little harder with our pushup bras around here. So with shockwave treatment, and there's so many questions that are to be asked, one guy, I remember I took the phone call and he was calling around different clinics. I don't know what other clinics charge, but he said that we were much better priced. So I assume so. The other clinics are, I assume, some of them aren't urology clinics.

Dr. Fontenot:

Yeah. Unfortunately, there are a lot of out outside clinics out there, probably not associated with a urologist. The other kind of thing is that this technology is kind of the Wild West right now, whereas, there's lots of different machines out there. And so you kind of have to know what machine is being used, what protocol they're using. And I'd also be cautious to, at an outside clinic that, again, not associated with urology clinic that sort of just takes anybody in that wants to get this done, because there are some patients that are not good candidates for this, you know.

Donna Lee:

Oh, that's a good point.

Dr. Fontenot:

We'll be straight up and tell you, you know,"We'll do it if you really want to do it. But the chances of you getting any benefit out of it are probably few and far between."

Donna Lee:

Which patients are those? Are those the ones with like super extreme erectile dysfunction or Peyronie's disease with a super serious curve?

Dr. Fontenot:

Well, Peyronie's disease actually, there is some indication to use shockwave therapy for treatment of it. But the main patients would be patients that do not have a vascular cause for their erectile dysfunction. So a patient that has a neurological cause, such as a patient that had a, say they had prostate cancer and they had their prostate removed and their, you know, their ED as a result is more of a neurological issue, not so much a blood flow issue--that patient would not benefit from the shockwave therapy. So just from what I've heard through other patients, I've treated as some of the other clinics are just sort of like, you know, if you got cash in your wallet, they'll go ahead and do your treatment for you. So, you know, and that's just kind of comes down to, it's sort of getting a proper evaluation and being comfortable with who you get your treatment from and knowing that you do get a multitude of options presented to you. Not just one.

Donna Lee:

So some of these clinics too, that aren't urology based, they have, they don't, I don't know if they even have a doctor on site, do they? They have like a technician?

Dr. Fontenot:

Uh, that I don't know.

Donna Lee:

So I know there's some men's wellness clinic who has like an MD in Hawaii or somewhere like in another place.

Dr. Fontenot:

Right. I'm not sure again, I would just kind of...

Donna Lee:

Be leery?

Dr. Fontenot:

...be leery of it and just kind of, you know, I think a big thing is also is knowing what technology they're using because there is a lot of variance between the machines that are being used out there.

Donna Lee:

Gotcha. Anything else you can tell us about shockwave therapy? Like if I'm a guy coming in, I'm scared to death because it's, I'm hearing the word"shock" and I know we said it's absolutely painless. It's literally a pulsing, right? It's just that there's going to feel a little pulsing on their penis?

Dr. Fontenot:

Yeah. You really don't even feel that. Yeah. The sound is more obtrusive than anything else, but it just think of it as an ultrasound almost, you know--not that men know what that is, but, or probably have ever gotten one. But you've probably maybe seen your pregnant wife get one, but, you know, when they put the little probe over the belly, it doesn't hurt. So, it's very similar to that.

Donna Lee:

That's a good question. So what all happens to the patient gets undressed? So the most embarrassing part is probably just getting the undressed partner in front of the medical assistant?

Dr. Fontenot:

I guess. If that's embarrassing, I don't know.

Donna Lee:

Oh, they probably enjoy that.

Dr. Fontenot:

We're so used to it here. Everybody just walks in and takes their clothes off.

Donna Lee:

So what happens? They lay down on the table and what is applied to their body and where?

Dr. Fontenot:

Just use a little ultrasound jelly and the probe...

Donna Lee:

On the penis?

Dr. Fontenot:

Yeah. So the probe is on the penis as well as underneath the scrotum and the perineum, and it just gets applied all throughout there and we run the probe up and down, very centrally and...

Donna Lee:

I was going to say, are there any side effects like other than the patients really happy to see Dustin?

Dr. Fontenot:

Oh yeah, we've definitely gotten erections before, right there on the table.

Donna Lee:

Oh really?

Dr. Fontenot:

Yeah. It's like, Oh, well I guess it works!

Donna Lee:

Oh, I would be embarrassed, I guess. I guess you've seen this a thousand times.

Dr. Fontenot:

Yeah, It's okay.

Donna Lee:

Oh my heavens. Well, what else can you tell us about the appointment to make it less scary for the patients?

Dr. Fontenot:

There's really nothing scary. I mean, it's, yeah, it's piece of cake.

Donna Lee:

We've named our machine Chaka Khan.

Dr. Fontenot:

Yeah.

Donna Lee:

Yeah. And we're trying to figure out how we can hit a button and it just plays,"I Feel For You" while you're doing the treatment. So I think it will work on it.

Dr. Fontenot:

We also call it the shocker, too.

Donna Lee:

The shocker? Even though we promise there's no shocking involved, we are going to trademark"polite penis pump, pulsing."

Dr. Fontenot:

Pulsing.

Donna Lee:

Pumping, pulsing...Well, if you're interested in learning more, you can send us an email. Actually, Dustin sometimes responds to them directly about shockwave therapy or polite penile pulsing--amormenshealth@gmail.com is our email address, and then armormenshealth.com is our website address. And you can call us during the week at(512) 238-0762. You can also search for our podcasts. They're all free and amazing on iTunes and SoundCloud, and even at home with Alexa, you can impress your wife about how much you know about shockwave therapy. And thank you so much, Dustin, for joining us and we'll talk to you next time.

Dr. Fontenot:

Absolutely. Thank you.

Donna Lee:

Thanks!

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The Armor Men's Health Hour will be right back. If you have questions for Dr. Mistry, email him at armormenshealth@gmail.com.