Armor Men's Health Show

EP 590: To Snip Or Not To Snip? Vasecto-Myths & Realities After Roe v. Wade

July 13, 2022 Dr. Sandeep Mistry and Donna Lee
Armor Men's Health Show
EP 590: To Snip Or Not To Snip? Vasecto-Myths & Realities After Roe v. Wade
Show Notes Transcript

Today, Dr. Mistry and Donna Lee shed light on common vasecto-myths that strike fear into the hearts (and Hanes) of many urology patients. In the wake of the recent SCOTUS decision to limit access to reproductive healthcare, many people are pondering the obvious birth control question: "To snip, or not to snip?" If you're a listener who wonders, "Will it hurt?" "Is it reversible?" or even "Do you have to cut off my b*alls?" then listen up! Dr. Mistry and Donna Lee separate fact from fiction and explain why the "Mistry Vasectomy" is the best in town.

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:

Welcome to the armor men's health hour with Dr. Mystery and Donna Lee.

Speaker 2:

Hello and welcome to the armor men's health hour. I'm Dr. Mystery, your host, a board certified urologist here with my wonderful co-host and partner in crime. Donna Lee.

Speaker 3:

That's right. Tai everybody happy day to everybody listening all over the entire world.

Speaker 2:

We really appreciate you joining us, uh, for this show, whether it's on the radio or when we make it into a podcast mm-hmm

Speaker 3:

<affirmative> we're podcast,

Speaker 2:

We're podcast, it's the fanciest most technologically thing that we do on computers. Luckily, uh, when it comes to surgical stuff, we are cutting edge

Speaker 3:

You're surgical

Speaker 2:

Search. That is not a word. It is

Speaker 3:

It. Podcast castable is not a word

Speaker 2:

As well. I'm a men's health specialist, a board certified urologist, and this show is brought to you by the urology practice that I started in 2007 AAU urology specialist.

Speaker 3:

That's why you have all those extra gray hairs,

Speaker 2:

Lots of gray hairs. Mm-hmm<affirmative> some other gray hairs we have are my partners. Uh,<laugh> Dr. Lucas, Jack meetings, Dr. Christopher Yang and Dr. Stacy OG.

Speaker 3:

Luckily they don't listen.

Speaker 2:

That's right. Our other partners in the practice, we have four mid-level providers. We have a sex therapist in house, a pelvic floor, physical therapist, and most importantly, a commitment to going that extra mile to take care of you. We've had a number of out-of-state patients that have contacted us recently about, uh, kind of cutting edge, prostate procedures, high intensity focused ultrasound, all the other things that we do. And if you don't know what any of those things mean, I would encourage you to, uh, Google, uh, no, look at some for old podcasts.

Speaker 3:

Oh, there's

Speaker 2:

That? Wherever you get your podcast, we're Googleable, we're Googleable, Donna water, tell people about our practice.

Speaker 3:

Uh, you can find us in central Texas, um, or you can listen to our podcast around all of the world. Our locations are round rock north Austin, south Austin, and dripping Springs. If you know about those parts of the world and our numbers, 5 1 2 2 3 8 0 7 6 2. You know, we have a brand new shiny website just for this show. It's the armor men's health.com website. So you can see Dr. Mysteries, very handsome graying face there<laugh> and me with my real pretty hair extensions.

Speaker 2:

Very nice.<laugh> so is it, is it an extension when it comes right outta your scalp

Speaker 3:

That's hair? Okay. That's which I don't have's so I have extensions that's hair. Okay.

Speaker 2:

Yeah. So, um, recently there's been kind of a sea change in, uh, reproductive rights, uh, in this country. And especially if you live here in Texas, um, the idea that, um, uh, terminating a pregnancy could be part of a contraception strategy is going to be one that, uh, you know, that, that, that may not be possible. And, uh, increasingly, um, we have seen very, very, uh, sharp uptick in the interest in getting a vasectomy mm-hmm<affirmative>, which I think is, uh, probably the best, um, kind of, uh, indication that men are needing to take a stronger role in their reproductive health and their family planning needs.

Speaker 3:

Right. And I wonder about how often these men have been thinking about that until the recent change in the laws. So it's interesting, we're getting tons and tons of phone calls now.

Speaker 2:

So now I try to think of what keeps a man from getting a vasectomy. And for sure, I know it's the idea of somebody taking sharp

Speaker 3:

Instruments, castration. That's what

Speaker 2:

They think their thing in my legs.

Speaker 3:

That's right. They think they're being castrated some of them.

Speaker 2:

So I thought maybe I would try to explain kind of what a vasectomy is in our practice. Mm-hmm<affirmative> how is it different? And then let's say you're young and aren't completely sure that you don't want to have kids in the future. Mm-hmm<affirmative>, but you're, don't want to get anybody pregnant inadvertently, right. And what kind of choices you have going forward. And then I'll try to give some philosophical thoughts on the older parent, the older woman, and man who may wanna have a child in a way in which they can reduce the likelihood of birth defects and genetic anomalies and, and what role a male reproductive health strategy has. So, um, so I wanted to talk about like what, what men are scared of. So, number one, men, don't like to spend a lot of time getting the vasectomy. So, um, so let's say time. So in our, in our office, we do a single visit vasectomy mm-hmm<affirmative> you come in, get your consultation and your vasectomy in less time than it takes to get an oil change.

Speaker 3:

And with other offices, you might have to come in for this consultation and then return back in 30 days, they won't do it the same day.

Speaker 2:

The, uh, many times they will not do it. But, but with, with just kind of, since we started the practice, the single visit vasectomy has been an important component of what I try to provide. Mm-hmm<affirmative> second is the idea that the they're gonna be so anxious that they can't sit still. Yeah. And, and that's why we offer at no charge at no charge. We offer you an IV sedative. The IV sedative is called, uh, Meda lamb. Mm-hmm,<affirmative>, it's just a little dose of it. We can reverse it. If you wanna, like, you know, be functional for the rest of the day. You do have to have a driver, but Hey, somebody's gotta sacrifice something for you right on this important day.

Speaker 3:

Sure. This once almost once in a lifetime thing, and by the way, that medicine feels pretty, pretty good from what I've seen the guys,

Speaker 2:

As far as we know, I mean, the guys are usually dancing on their way outta here, and you wouldn't

Speaker 3:

Think somebody offered his shots the other day. It was great.

Speaker 2:

I will say that that nine times outta 10, the guy will tell me that the vasectomy was a much better funnier experience than he ever thought it would be.<laugh> mainly because I'm so funny. Well

Speaker 3:

That, and the music you have on there

Speaker 2:

Are eighties, new wave tunes going on. We listen to new order radio.

Speaker 3:

<laugh> you're not tired of that yet. No.

Speaker 2:

Okay. It's the same 14 songs over and over again.

Speaker 3:

<laugh>

Speaker 2:

Uh, the whole vasectomy only takes about, uh, between five and eight minutes. It's very, very quick. Mm-hmm<affirmative> um, so overcome that when it comes to pain, the discomfort from the vasectomy is very, very minimal. And afterwards how you keep the pain down is you just take it easy.

Speaker 3:

Yeah.

Speaker 2:

Like you, you have a weekend or three days in which you don't have to do thing.

Speaker 3:

Nothing. We'll write a prescription

Speaker 2:

For that ice pack. Mm-hmm<affirmative>, you know, if you're married, your wife has to just take care of you. There's no housework. You know, we prefer your kids not jump on you. I mean, that's pretty good.

Speaker 3:

It's pretty good. For three days. Like

Speaker 2:

I would have a vasectomy every month.

Speaker 3:

I'm getting one tomorrow.

Speaker 2:

That's

Speaker 3:

Right. I need a break.

Speaker 2:

I need a break.<laugh> if you need a break, get a vasectomy. Right. I send you home with some pain medication. Mm-hmm<affirmative> then people are worried that it's not gonna work.

Speaker 3:

Mm-hmm<affirmative>

Speaker 2:

For free mm-hmm. I will read your, your, your, your Serina afterwards, right. For free

Speaker 3:

For

Speaker 2:

Lifetime. So nobody does single visit. Nobody does IV sedation. No scalpel. We don't use a scalpel. A lot of people use the no scalpel technique. No. Yeah, that's true. Uh, we use a single incision. Uh, I only know a few people that will do a single incision instead of two incisions. Mm-hmm<affirmative> we use no metal clips takes me a little longer to not use metal clips to, to clamp off the tube, but I get better postop recovery results. Mm-hmm<affirmative> very little discomfort in the long run. And I really minimize long term complications using this dissolvable suture technique. Right? So there's no foreign bodies, like a metal clip. That's gonna stick in your body. Right. And it's reversible. And I rev reverse'em too.

Speaker 3:

And you're the best.

Speaker 2:

And so the reversal, and if you don't have, if you have insurance, it's covered by insurance in almost every

Speaker 3:

Instance, right? At least most of it, for

Speaker 2:

Sure. And then if you don't have insurance, what do we charge?

Speaker 3:

8 5800,

Speaker 2:

$800. You get charged$800 for a vasectomy with IV sedation. I read all the scene analysis. I give you antibiotics so that you don't get an infection. You have my cell phone when you leave. I mean, I don't know what else I can do to make it more comfortable.

Speaker 3:

Well, you have a cell phone number. He won't give you his actual cell phone.

Speaker 2:

Why would they want my cell phone?<laugh> oh, they don't wanna see my TikTok.

Speaker 3:

No, they don't.

Speaker 2:

<laugh> did you know that the TikTok is for you? Oh boy.<laugh>

Speaker 3:

The tick. You're such a dad. Have you watched the TikTok lately?

Speaker 2:

Have you watched the TikTok?

Speaker 3:

No, but I've gone to the target. I've

Speaker 2:

Gone. And the internets<laugh>. So, um, if you're interested in a vasectomy, uh, we have lots of spots available for you. We're making our, uh, availability for vasectomy is increasing. Uh, we're gonna start adding Saturdays now, uh, much of the chagrin of don't tell my wife.

Speaker 3:

Don't tell me, don't

Speaker 2:

Tell<laugh>. We're gonna add some Saturdays. Um,

Speaker 3:

Get a t-shirt maybe if you

Speaker 2:

Nice get t-shirt. Maybe it

Speaker 3:

Says sniped, but still equipped,

Speaker 2:

Snip,

Speaker 3:

But still. And the other one says, snip, snip, hooray.

Speaker 2:

And the, the other one says, uh, uh, nuts for

Speaker 3:

Urology nuts for urology. We got a lot of funny tshirt.

Speaker 2:

Well, if you need something to help clean your car an old t-shirt, we'll give you one of those too. Oh, no. Uh, we'll try to make, uh, the experience as comfortable for you as possible. It certainly as quick as possible. And if you want to come in and talk about other urologic things, you certainly can, whether it be urinary issues or history of other urologic surgeries, or if you want to talk about low testosterone, I would say probably about 10 to 15% of our vasectomy patients ultimately become low testosterone patients in our clinic. And so it gives you an opportunity to come and speak to a men's health expert.

Speaker 3:

Why don't we also clarify exactly where you're going under the man's another regions and how simple it is. Like where's the VAs deference.

Speaker 2:

The VAs deference comes from the testicles mm-hmm<affirmative> and it goes next to the penis shaft on either side. So our incision is right where the bottom of the penis and the scrotum attached to each other. So there's like that little bitty triangle of tissue that we kind of use as our, as our, as our mark mm-hmm<affirmative>. And we close that, that little area with a suture that dissolves on its own within about three or four days. Right? So minimal scarring, um, men are, uh, worried about a lot of things. And, uh, what we'll do after the commercial break is talk about kind of myths that men have about a vasectomy that we want to shed light on, because we want you to be comfortable with this, this decision, because mm-hmm<affirmative> oral contraceptives, they rely on regular use IUDs require an invasive procedure that takes longer than a vasectomy, believe it or not. Oh, and, uh, implantable, it sounds, contraceptives are also procedures that, you know, your partner may have to go through. And if you don't have a, a, you know, definitive partner and you don't wanna be ha saddled with the baby unexpectedly taking advantage of your, uh, your health and your, your reproductive health is really a very important thing for men to, you know, to consider mm-hmm<affirmative>, especially now, especially now, especially now. And we can, we can, um, arrange for you to store sperm, uh, for an additional about$200. You can store sperm

Speaker 3:

200 a year, a

Speaker 2:

Month,$200. And I think it's$50 a year. Really? No, it's$200 one time and then$50 a year.

Speaker 3:

Wow. That's inexpensive.

Speaker 2:

Yeah, we use, uh, I

Speaker 3:

Thought it'd be like 200 a month

Speaker 2:

Or something. No, no, no. It's very cheap. Okay. And don't do it yourself. Gentlemen.

Speaker 3:

Don't do it yourself in

Speaker 2:

Your freezer. It's in your ice cream.

Speaker 3:

<laugh> this shot tastes funny.

Speaker 2:

No, do not do.

Speaker 3:

<laugh> sorry.

Speaker 2:

You're gross. No, you're gross. So, um, it makes me really, uh, happy and proud to have people that listen to the show, come in and see us. Mm-hmm<affirmative> uh, last week we had a patient who heard our segment on buried penis and literally broke down in the room, really broke down, talking about how the, the problem was embarrassing, how they had never been able to talk to anybody about the variety of different issues. I hear that same kind of emotion when men come and talk to me about, uh, delayed mm-hmm<affirmative>, you know, topics that they just, they just have no idea of where to go or who to talk to about.

Speaker 3:

Right. I had a patient too, that called, he called my cell phone because the, the staff will give it to anybody and it's on my card. So I don't, I don't mind, but he happened to tune in one day and he listened to the, one of the episodes we did about retrograde. And he was very emotional when we were talking. And I talked to him as much as I could because I'm Dr. Donna, you know, you are not a Donna and we had a great conversation and he's a patient now. So, um, he's on your, on your schedule, so,

Speaker 2:

Well, uh, it's, it's great. So, um, uh, you know, we, we take insurance, we charge regular prices. Um, you know, we, we, we try to make the care that you get to be both, uh, affordable, um, excellent state of the art. And so don't think that just because you're hearing me just to the radio, that we couldn't have a, a relationship as patient and physician,

Speaker 3:

And I only charge people a hundred dollars just to talk to them. You are in the lobby.

Speaker 2:

Are you gonna use that special voice? Mm-hmm

Speaker 3:

<affirmative> Hey, big boy. Hey, big

Speaker 2:

Boy.

Speaker 3:

<laugh> Hey daddy, welcome. That'll be a hundred dollars.

Speaker 2:

You are so old. You think people do that over the phone still<laugh>

Speaker 3:

I can't figure it out.

Speaker 2:

So in our last segment, we talked about what you can expect during a vasectomy, uh, at our practice mm-hmm<affirmative>. And I thought that, um, what would be good to talk about are the myths. So we talked about what, what scares people and what we have done in our practice to try to keep the cost, the discomfort, the anxiety, all of those things to a minimum mm-hmm,<affirmative> so myths that I hear, uh, one of the myths is that, um, we're gonna cut your testicles off

Speaker 3:

We're<laugh>

Speaker 2:

We're going and test straight too. And I think that because, you know, so many people are used to dogs and getting them fixed. Yeah. And they use the same word for men getting fixed as if we were broken

Speaker 3:

<laugh> everyone, are you broken?

Speaker 2:

And so, um, somewhere, but there is no interruption of the testosterone that the testicles make. That's what they're also, uh, you know, uh, poised to do. Mm-hmm<affirmative>, um, to get into your, um, bloodstream. And so, so the, the testosterone will still get there. Some men are worried about an increased risk of prostate cancer, because there was some article many years ago that has been completely debunked. Oh, I have heard men, uh, be concerned that their testicles are more likely to twist after the vasectomy. And that is absolutely not the case. The, the, the main supports of the testicle that keep it in place, do not get interrupted by, um, by the vasectomy mm-hmm<affirmative>. And then people are concerned both ways that it can be reversed and that it reverses on its own.

Speaker 3:

Oh, well, honestly it depends on how you do it. I've seen your vasectomy and it's pretty darn near impossible to, to reconnect the VA deference on its own.

Speaker 2:

That's right. The vasectomy that I perform, we not only transect or cut the, the vast deference, I remove a piece, I use a little piece of muscle to keep in between, and then I burn the end. And so, uh, my, what we call recanalization rate is very low knock on wood. I haven't had one come back together for at least a decade. And so,

Speaker 3:

And tell them what the vast deference is, because I know some guys are like, what's

Speaker 2:

That the vast deference is the tube, the tube that transports sperm from the testicle and deposits it in the urethra. And that's what mixes. And then with semen that the prostate makes then comes out of you. Mm-hmm<affirmative>, um, there should be no reduction in your ability to get, or keep an erection. Another common myth is that men are concerned that they're. The fluid that comes out of them will change, right? When in fact that doesn't change at all, uh, the amount of fluid that your testicles contribute to your, your semen is minuscule. And so you won't notice a change in color consistency. You will not notice a difference at all, uh, in how, uh, sex feels or anything after your vasectomy. Mm-hmm<affirmative>, uh, all you're gonna have is, you know, blanks shooting, blanks,

Speaker 3:

You're shooting blanks, but the blanks feel just fine. They

Speaker 2:

Feel the blanks feel just fine<laugh> to everyone involved<laugh>. And so, um, uh, when you, when you choose to get a vasectomy, what you're really saying is that you're kind of in charge of your, you know, your component of family planning, mm-hmm<affirmative>, uh, for, uh, for your family and for your partner. And you're not going to leave the contraception only to your female partner, because I mean, more than a few men, you know, have been caught up kind of being parents before they were ready or wanted to<laugh>. I mean, I have six kids and I'm not ready.<laugh>

Speaker 3:

I'm like, what is he trying to say? You're trying to say that some men were surprised that their baby moms got pregnant.

Speaker 2:

Maybe, maybe, maybe they didn't know what was happening, or, you know, and, um, uh, certainly, you know, the best way to be in charge is to take control of your own reproductive health. Right? Uh, a lot of men, um, are, you know, not ready to be parents

Speaker 3:

Lazy.

Speaker 2:

And

Speaker 3:

Is that what you were

Speaker 2:

They'll use examples. Like, I don't wanna use a condom. It doesn't feel right. Or, uh, I'm sure she's on birth control and

Speaker 3:

I don't wanna pay this 50%.

Speaker 2:

<laugh> you're really in a mood to curse today.<laugh>

Speaker 3:

There's, some noises are gonna put in to save me from being in trouble with KLBJ the podcast

Speaker 2:

Is, uh, so you just want to, uh, understand that, uh, it's not going to change anything about how you are or what what's going on, but I don't wanna just paint a rosy picture. I want to talk about what are some potential downsides and negatives of getting a vasectomy, but this is true. The first thing three things are true of any surgical procedure. Mm-hmm,<affirmative> the risk of some bleeding, some infection and some pain. So what we do in our, in our clinic to, to minimize all of these things, mm-hmm,<affirmative>, I use only one incision, which minimizes the amount of bleeding, because it's one less incision than some people do. Mm-hmm<affirmative> I use a electrocautery device, it costs money. It, uh, you know, requires some equipment, but, but that's what we do. We don't charge you any extra. We just, we just try to do the thing.

Speaker 3:

Potter is extra. I

Speaker 2:

Try, I try to make it as, as similar to what you get in the operating room as possible. And if you are someone, uh, and many urologists do not expend that, um, you know, the resources on that equipment mm-hmm but we do, because I want you to have kind of a seamless experience, right? The second thing is the risk of infection. Um, we give you a three day course of antibiotics. If you, if you don't give it to the patient and you give'em a prescription, like 90% don't pick it up.<laugh> they don't remember. They were supposed to pick it up. They don't know what it's for. They don't care. Right. But because we do that and we give it to you in a package and tell your wife, Hey, feed this to him, please.<laugh> every 12 hours, uh, the likelihood of you, uh, being compliant with is much higher. Mm-hmm<affirmative> um, and then third, um, is pain. So we give you a prescription for a pain medication, right? A lot of urologists don't do that. And I don't know why this isn't, this isn't iron ball.<laugh> you know what I'm saying? This isn't an iron ball competition. This is, you know, some guys are sore and some guys are not.

Speaker 3:

Yeah, you don't have to take

Speaker 2:

It. You can get a jock strap with us. Like, if you're out there at Walmart at two in the morning, trying to find a jock strap, don't

Speaker 3:

Do that. You got'em and we have little pockets for little tiny ice packs that we're gonna sit in there.

Speaker 2:

That's right. And we'll send you out with an ice pack

Speaker 3:

Yeah. And kill with

Speaker 2:

Donna's face on that's.

Speaker 3:

Right.<laugh>

Speaker 2:

We should get those.

Speaker 3:

You're a face your face on one and me on the other. Cause there's two, you know? Oh

Speaker 2:

My God. All right. All right. We're that's what we're doing.

Speaker 3:

<laugh>

Speaker 2:

You know, one of our employees, you know, one of our employees is a, is, is trying to become a professional corn holder.

Speaker 3:

Yeah.

Speaker 2:

And, and, and we're gonna sponsor the sax. You know what we're gonna put on the sack. No, check your sack,

Speaker 3:

Check your S SAC. That's funny

Speaker 2:

With AAU

Speaker 3:

Urologist. What if she gets those? And all of a sudden her game goes to, it's not, and she's not good anymore.

Speaker 2:

Oh man. Well,

Speaker 3:

It's impossible. She's pretty good.

Speaker 2:

We'll let our competitors then be the

Speaker 3:

<laugh>

Speaker 2:

The people that sponsored it,

Speaker 3:

Check your sack,

Speaker 2:

Check your sack. Um, and, and we will check your SAC that day. As a matter of fact, um, the one complication it's not too big ones that you have to worry about is called post vasectomy pain syndrome. That is a very rare, very rare thing that we see in our, in our clinic. I'll see maybe four or five a year. And I do probably, um, somewhere close to 700 vasectomies a year. Right? So, uh, this is when maybe three or six months after your vasectomy, you have pain in your testicles. Mm-hmm<affirmative>. And the vast majority, 95% of patients will it'll go away forever, which is a simple course of anti-inflammatories and steroids. Mm-hmm<affirmative>. So the most important thing is if you're walking out of the, out there and you're having nut pain after a vasectomy and somebody else is your vasectomy, you call me you, you come I've. I, I, I pick up guys at the gas station all the time.

Speaker 3:

<laugh> for what? Oh,

Speaker 2:

For, for post vasectomy vein syndrome, because they see, they see the truck, you

Speaker 3:

Look like a doctor,

Speaker 2:

They see the truck and the awesome vasectomy.com uh, you know, logo on the back and, uh,

Speaker 3:

With the nuts hanging on the backside.

Speaker 2:

Yeah. And, uh, my volleyball team, my, for my daughter had a father who had post vasectomy pain syndrome that we fixed him up. And that's right. Um, if you have it, you know, even if the vasectomy wasn't done by me, uh, I can still fix it. And so definitely come and see me if you're having that trouble. Hmm. And then whether or not it worked or not. And like I said before, uh, if you get a senior analysis at six and 10 weeks and it's worked, then chances are better than, you know, 99% that is gonna work

Speaker 3:

Forever. You can get them, uh, for free too afterwards for that's free analysis

Speaker 2:

Forever. If, if, if you, if you want, if you get a vasectomy with me and six years later, you wanna check it again. There's no charge to you. That's right. Come on in. And you do it at home 80 bucks elsewhere. Please do it at home. Yeah. You have pay extra to use

Speaker 3:

Our stuff. It's weird when they come into the clinic, but it's

Speaker 2:

Okay. And we still have some old magazines.

Speaker 3:

Yeah. And they're really weird. They're very,<laugh> just ring your phone. Donna. How do they get a hold of us? Call us at(512) 238-0762. Our website, our brand new shiny websites, armor men's health.com, where you could submit your questions and they come directly to me. And, um, thank you so much for listening to the show and check out our podcast. Wherever you listen to podcasts.