The Armor Men's Health Hour

Family Planning -Dr. Mistry and Donna Lee Discuss Vasectomies and Vasectomy Reversals

May 02, 2020 Dr. Sandeep Mistry and Donna Lee
The Armor Men's Health Hour
Family Planning -Dr. Mistry and Donna Lee Discuss Vasectomies and Vasectomy Reversals
Chapters
The Armor Men's Health Hour
Family Planning -Dr. Mistry and Donna Lee Discuss Vasectomies and Vasectomy Reversals
May 02, 2020
Dr. Sandeep Mistry and Donna Lee

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 Dr. Mistry and Donna Lee discuss two procedures that play a big part in family planning- the vasectomy and vasectomy reversal. 

Dr. Mistry discusses the role of a urologist in family planning, which ranges from fertility and hormone testing to surgical interventions, all of which are geared towards helping people achieve their family goals. The Mistry Vasectomy is a 20 minute, single-incision procedure that can be done in one visit. Patients receive IV sedation to ensure that it is pain-free, which also helps to reduce anxiety or nervousness about the procedure.

But what if you have already had a vasectomy, only now you want to continue growing your family? We've got you covered. Dr. Mistry talks about options for continuing to build your family after a vasectomy, which include a vasectomy reversal and even sperm extraction. Several factors such as age, sexual activity, and the amount of time that has passed since your vasectomy, should all be considered when looking at your options.

Regardless of which step you find yourself at in the family planning process, our providers would love to answer your questions and be a part of your treatment team.

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

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

Show Notes Transcript

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 Dr. Mistry and Donna Lee discuss two procedures that play a big part in family planning- the vasectomy and vasectomy reversal. 

Dr. Mistry discusses the role of a urologist in family planning, which ranges from fertility and hormone testing to surgical interventions, all of which are geared towards helping people achieve their family goals. The Mistry Vasectomy is a 20 minute, single-incision procedure that can be done in one visit. Patients receive IV sedation to ensure that it is pain-free, which also helps to reduce anxiety or nervousness about the procedure.

But what if you have already had a vasectomy, only now you want to continue growing your family? We've got you covered. Dr. Mistry talks about options for continuing to build your family after a vasectomy, which include a vasectomy reversal and even sperm extraction. Several factors such as age, sexual activity, and the amount of time that has passed since your vasectomy, should all be considered when looking at your options.

Regardless of which step you find yourself at in the family planning process, our providers would love to answer your questions and be a part of your treatment team.

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

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:

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

Dr. Mistry:

Hello and welcome back to the Armor Men's Health Hour. I'm Dr. Mistry as always with my host Donna Lee.

Donna Lee:

Hello! I got the giggles all of a sudden, so happy to be back.

Dr. Mistry:

For those of you that listen to the show, you may recall that Donna Lee is in fact a comedienne, a professional comedienne.

Donna Lee:

Mhmm. I'm the 7th funniest mom in America per Nick at Night.

Dr. Mistry:

...Nick at Night. And she and I have a running gag that one day I'm going to come up with a whole comedy set.

Donna Lee:

You wish.

Dr. Mistry:

Okay. Are you ready for my first one?

Donna Lee:

Okay.

Dr. Mistry:

Okay, here it is. Ready? What is the difference between a man and a woman?

Donna Lee:

You know I don't like this joke. What?

Dr. Mistry:

There's a "vas deferens."

Donna Lee:

Oh, gosh. Can I just tell you I didn't know what a vas deferens was until I started working for you 3 years ago?

Dr. Mistry:

Don't you think that's a really good nerdy 8th grade biology joke?

Donna Lee:

If you know what a vas deferens is. Now we have to tell the listeners what a vas deferens is.

Dr. Mistry:

Yes. And...

Donna Lee:

What is a vas deferens, Dr. Mistry?

Dr. Mistry:

Alright, alright. So the vas deferens is the tube that connects the testicles to the prostate, and that's where sperm is transported so that we can make babies.

Donna Lee:

Okay, so tell the joke again.

Dr. Mistry:

Okay. What's the difference between a man and a woman?

Donna Lee:

What is the difference between a man and a woman?

Dr. Mistry:

There's a vas deferens.

Donna Lee:

What?!

Dr. Mistry:

You get it because it's like a "vast difference?"

Donna Lee:

That is so funny!

Dr. Mistry:

Okay.

Donna Lee:

Oh geez. That joke.

Dr. Mistry:

Man, I'm going to kill. I'm so gonna kill on comedy night.

Donna Lee:

That's the one joke you have going on tour?

Dr. Mistry:

Well, I don't know. Do I need a lot more material?

Donna Lee:

Good luck. Hey, funny tidbit, when I opened for D.L. Hughley at the improv in Houston, we had 7 shows, so I went out and then his guy, his feature went out. Then I also featured for him at some point. I always made $600 and he made like $30,000 for the weekend.

Dr. Mistry:

Nice.

Donna Lee:

Talk about that big difference.

Dr. Mistry:

There's a vas deferens in money there. I thought we talked the segment about the two different surgeries that we do for the vas deferens. This month I was confronted with a patient who had a very enlarged vas deferens and it was very thickened.

Donna Lee:

Is that equivalent to a large penis?

Dr. Mistry:

No, it is not. This is one that you don't want to have. It was very tender and painful, it's calcified vas deferens, and it's one that resulted, we think from a trauma that the patient experience and has now led to infertility and chronic pain. So we're going to remove the whole vas deferens--you know what that surgery is called?

Donna Lee:

The vas deferens-ectomy?

Dr. Mistry:

Believe it or not, it's just called a vasectomy, but that's going to be a much bigger, much more involved procedure than we would usually associate with a vasectomy.

Donna Lee:

I like mine better. Vas deferens-ectomy.

Dr. Mistry:

I thought we'd just kind of review, especially during these times. For those of you, if you're at home from work and you're able to recuperate, you may be interested in having a vasectomy during this, during this time. The vasectomy is a very commonly performed, well tolerated procedure. It takes about 20 minutes. We do it here in the office.

Donna Lee:

And we have great music that plays in the background.

Dr. Mistry:

Well if you like 80's new wave alternative, because that's pretty much all that's going to play. And the reason that you can tolerate the music is because we do offer IV sedation...

Donna Lee:

Because you're high as a kite!

Dr. Mistry:

...using intravenous midazolam, which wears off pretty quick. Most patients are able to walk out of here even though they're pretty loopy, sleepy, or really funny.

Donna Lee:

They're always smiling.

Dr. Mistry:

They're super funny.

Donna Lee:

Every time.

Dr. Mistry:

It's a lot of fun. I really like doing it. You know, we're thinking about hiring a new marketing company, and we talked about marketing for 20 minutes during his vasectomy. And then when I called him to make an appointment, he goes, "Who's this?"

Donna Lee:

And what did we talk about?

Dr. Mistry:

What did we talk about? So that's another running joke we say about people when they go back to write reviews about the vasectomy, they say, "Well, don't remember it, but everything went well."

Donna Lee:

That's right, I'm not getting my wife pregnant.

Dr. Mistry:

One of the reasons that we started the IV sedative is because it allows us to do something called a single visit vasectomy, which means that you can come in, get your consultation for the vasectomy, and get your procedure in the same day, which is extremely convenient. It makes it more likely that you're going to go through with the procedure because you only have to come and wait in the waiting room and wait for me and you know, do all that stuff one time.

Donna Lee:

At other offices, you have to go in 3 times, at least.

Dr. Mistry:

1, 2 or 3 times. 2 or 3 times. It becomes inconvenient when people are already kind of nervous about the procedure. And so we try to eliminate that one barrier by doing it. Another real benefit from the vasectomy with IV sedation is that you don't remember it getting done. And early on in my practice I had this theory that when you're getting worked on down below, that's already kind of an anxiety provoking experience. And if you can remember the pulling or the tugging or the or the, or the sharpness of any kind of instrument, I bet you kind of makes you like have some anxiety.

Donna Lee:

That sounds like a one star Yelp review to me.

Dr. Mistry:

Yeah, like a PTSD kind of experience. And I think a lot of men were having discomfort after their vasectomy just because of that experience of having gone through it. As a result of that, we have much higher rates of actually completing the vasectomy because the anatomy is a lot easier to deal with. And we have a lot less people complaining of pain and discomfort afterward. That's really great. So the IV sedation really puts us in a different category. We use a single incision. So both vas deferens...

Donna Lee:

That's why it's called a "Mistry" vasectomy.

Dr. Mistry:

It is a mystery. But you don't even remember [inaudible]. We used to have a jock strap with a question mark. That was our quote unquote t-shirt. Because nobody's going to wear their vasectomy t-shirt. But you may wear your vasectomy underwear.

Donna Lee:

That's funny. We need to reimplement that for sure.

Dr. Mistry:

Yeah. The joker. Anyway, it was a "Mistry" vasectomy because you know, you don't...

Donna Lee:

You can check this out too on our website, austinvasectomy.com, and Dr. Mistry goes into detail about the mystery of vasectomy.

Dr. Mistry:

You would almost think that I love this. I should do it for a living.

Donna Lee:

And get paid for it?

Dr. Mistry:

And get paid for it. But we do something else here too, and that's the vasectomy reversal. We do quite a few vasctomy reversals as part of our male fertility offerings here. The vasectomy reversal is done on some estimates on about 10% of patients that have a vasectomy rethink that decision.

Donna Lee:

Wow. 10%.

Dr. Mistry:

Yeah. You know, you never know.

Donna Lee:

Not always the guy, the 60 year old with a hot 20 year old, just sometimes.

Dr. Mistry:

When I was in training, that's what it used to be. It used to be that down in Houston, the couple would fly in from out of town. He would come into the hospital to get a vasectomy reversal and she would go with the Galleria and go shopping. But what's interesting is second wives are older than they used to be.

Donna Lee:

Oh really?

Dr. Mistry:

They sure are. They're sure are.

Donna Lee:

Are they in their late 20's now?

Dr. Mistry:

And so if you're thinking about getting a vasectomy reversal, but your second spouse happens to be 38 or 42, then it may be wiser in terms of the chance of getting a baby to instead of doing a reversal of the vasectomy to do an extraction, which we can do right from the testical or epididymis and then go through IVF. We have some wonderful IVF partners that we use. And so that's one of the important considerations that we ask men to go through before they make a decision on becoming dads again is what would be the most likely way for it to happen? There are a number of reasons men want to have a vasectomy reversal. There's remarriage, which is probably number one. There's just rethinking family size as economic situations change. And then of course, the most tragic is loss of a child. And it's an unfortunate tragedy that we deal with probably, you know, 3 to 6 times a year, we have a couple come in with the tragic loss of a child. The vasectomy reversal is a way, you know, for that family to find some happiness out of a tragedy. You can get a vasectomy reversal in the office in some places, you can go down there or someplace that will do it in the office. I think it's much, much more comfortable to get it done under general anesthesia because it takes, you know, an hour and a half to do it and you've got to sit still for an hour and a half and somebody's working on your stuff. I mean, so we do most of ours in the operating room. The price for a vasectomy is around $6,000--a vasectomy reversal that is, it's about $6,000. It is not covered by insurance. And for an additional $500, we'll do something else, which is that at the time of your reversal, we will collect sperm that you can cryo-preserve and you're not going to get, you're not going to find that opportunity virtually anywhere. It adds about half an hour to the case. It requires me to, you know, to examine the sperm under a microscope to make sure there's moving sperm. It gets sent, to a cryo-preservation facility and, just for a little bit of extra money, you have that confidence that even if the vasectomy reversal doesn't work, then you have sperm that's in the freezer that you could use for IVF or some other assisted reproductive kind of thing.

Donna Lee:

And how well does that work?

Dr. Mistry:

The reversal? Well, you know, a lot of people think of the reversals like just a plumbing job. Like you just took a tube and you're just, and you're just kinda occluding and you just have to take that occlusion out and put it back together. But that, you know, the reproductive anatomy is really a living, breathing, evolving system. So when you occlude the vas deferens with a vasectomy, the sperm backs up into the testicle and there can be damag done to the epididymis and testicle that doesn't allow the vasectomy reversal to work. So the numbers I usually quote is if you've had a vasectomy in the last 2 years or less, the reversal rates about 90%. If it's less than 7 years, the reversal rate is somewhere between 75% and 85%. But if it's a, you know, 15 years or older, that number can drop to as low as 35%. So the time since your vasectomy could have a big impact on success as well as the, any pain or complications you may have had.

Donna Lee:

Good to know. We had the guy in his 60's who wanted his vasectomy reversal 30 years ago.

Dr. Mistry:

It couldn't make me happier.

Donna Lee:

I try to get him to come in.

Dr. Mistry:

It couldn't make me happier. So let's hope we can get him in. And that was probably the longest, most boring joke that I've told.

Donna Lee:

He also didn't have a girlfriend though.

Dr. Mistry:

Oh, he didn't?

Donna Lee:

No, or a wife.

Dr. Mistry:

He was just getting ready for it.

Donna Lee:

At 65, he's ready.

Dr. Mistry:

Good for him.

Donna Lee:

That's funny. Oh my goodness. Well, you can reach us during the week at (512) 238-0762. Listen to our podcasts wherever you listen to podcasts or you can relive all of this magic again. And our website is armormenshealth.com. Send us your questions. We'll answer them next week or as soon as possible. Armormenshealth@gmail.com. Y'all have a wonderful day.

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The Armor Men's Health Hour is brought to you by Urology Specialists of Austin. For questions or to schedule an appointment, please call (512) 238-0762 or online at armormenshealth.com.