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 talk about a subject much dreaded by aging men: the radical prostatectomy. While no one wants to have their prostate removed, recent medical advances have seriously improved surgery outcomes and reduced the well-known side effects of impotence and incontinence. Dr. Mistry and his team of surgeons frequently perform radical prostatectomies robotically using state-of-the-art tools. If you are interested in having a robotic prostatectomy, finding a surgeon who is experienced in this operation and comfortable performing it is key. Whether you've heard horror stories from family or friends who have had their prostate removed and are afraid of a similar outcome or you've had a cancer diagnosis and don't know what your options are, call us today!
This episode was previously aired on 6.5.21. 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!
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
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!
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 to the Armor Men's Health Hour. I'm Dr. Mistry, your host, here as always with my co- host Donna Lee.
Donna Lee:
Hello, everybody. I'd like to thank you so much for being so witty all the time and stealing my thunder.
Dr. Mistry:
I think I'm the funny one of the crew. This is a men's health show. I'm a board certified urologist and this show is brought to you by the urology practice I started in 2007, NAU Urology Specialists.
Donna Lee:
13 years ago. That's why you have gray hair all over your face.
Dr. Mistry:
That's right. I'm an old man now. We are the second biggest urology specialty clinic in Austin and proud because it means that we've worked a little harder.
Donna Lee:
That's right. And we're a little cuter on the weekends.
Dr. Mistry:
You keep saying that.
Donna Lee:
A little push up bra.
Dr. Mistry:
Is that what it is?
Donna Lee:
A little more lipgloss on a Thursday night, looking forward to Friday.
Dr. Mistry:
You must've been a lot of fun before you're married.
Donna Lee:
I was not. Well, I was, yes, but don't tell Michael.
Dr. Mistry:
I never met somebody that actually went to one of those steak bars on a Thursday afternoon for ladies night.
Donna Lee:
Sirloin Stockade. Lockhart, Texas.
Dr. Mistry:
I was thinking like Steiner Ranch Steak House, but you went to Sirloin Stockade.
Donna Lee:
Yeah, that's for sure.
Dr. Mistry:
I just[inaudible] the VFW meeting ended. There's Donna in lip gloss and a push up bra.
Donna Lee:
Eating again. I had to diet after that.
Dr. Mistry:
This show is focused on men's health issues. Many of them are urologic in nature, but we bring up a number of different subjects, things that men should know about health-wise, steps men should take to lead a healthy life. We've seen a ton of guys in the clinic that just come for general wellness checkups, and we love that. Just this idea of,"I'm 30, I'm 40 I'm 50. I'm not sure if I'm getting all the basic things I'm supposed to get, but also are there additional tests, things that can be a little bit more cutting edge, a little bit more informative, things that don't cost too much money, that can tell me something about, about myself?" An example of that is the heart saver CT scan that we often get that tells us about any cardiac plaque or calcifications of the coronary arteries. Cost less than a hundred bucks.
Donna Lee:
My husband had that done.
Dr. Mistry:
Yeah. It costs less than a hundred bucks. And it can tell you exactly, you know, if you're at risk. And, and we use it a lot. When we find younger guys who have high cholesterol levels to decide whether or not they need treatment or not. So if you're looking for a general wellness checkup, it's something that we, we love to see you for when it comes to men's health issues. Most of the men have another men's health issue they come for--ED, BPH, something of that nature.
Donna Lee:
Their penis leads them to the right direction.
Dr. Mistry:
That's right. I think that they're...
Donna Lee:
It's like a little arrow or a big arrow.
Dr. Mistry:
A big arrow. We don't say little arrow.
Donna Lee:
No little arrows around here.
Dr. Mistry:
That's right. That's right. So if you have questions or you want to see us as a patient, Donna, how do people get ahold of us? How do they find us?
Donna Lee:
That's right. You can call us at(512) 238-0762 during the week. You can ask for me if you'd like. Our Armor Men's Health Gmail is where you can send your questions that are amazing and we'll keep them anonymous just for you. I'll also send you the podcast after it airs on KLBJ News Radio. Armormenshealth@gmail.com. And then our website is armormenshealth.com. We're in Round Rock, North Austin, South Austin, and Dripping Springs, Texas. So for those of you in Ireland, this means nothing to you, but we'll answer your questions anyway. So what do we have a topic to discuss today?
Dr. Mistry:
I thought we'd talk about, oh, I discuss oftentimes on the show, various things that we do for prostate cancer patients. We have high intensity focused ultrasound. We've discussed radiation therapy with Doug Rivera from Austin Cancer Center. We've talked about, oftentimes talk about the importance of pelvic floor physical therapy to maintain continence. I've talked about erectile dysfunction and I've talked about nutrition with Shefaly, our in house nutritionist. But I was thinking to myself the thing that I do the most commonly is I take people's prostates out. And we don't talk about that very often.
Donna Lee:
We don't talk about it very often.
Dr. Mistry:
And I think it's a scary subject for a lot of guys to think about and to talk about And we've both had family members that have been diagnosed with prostate cancer and have to weigh the options of whether removing their prostate or how they're going to treat it.
Donna Lee:
Do you really need a prostate? Is it like a spleen?
Dr. Mistry:
You don't need a spleen either, ironically.
Donna Lee:
All right. That's what I'm wondering. Can you just, you can live a life without it?
Dr. Mistry:
Or brain. I don't know on that one. I've been doing just fine. So the, the prostate gland is a reproductive organ. It plays a role when you're young to make semen to feed the sperm. So the sperm come from the testicles and that gets fed into the prostate and then the prostate makes a fluid to help those sperm live as they're supposed to, live inside the uterus and fallopian tubes of a woman right before they find the egg. That's like the job of the prostate. So that's why 20 year olds don't have a problem with prostate. The body spends a lot of time making sure the prostate is like healthy and well-oiled. But just like a car that sits in the garage, you know, your 50 year old prostate, that's not trying to have a baby anymore...
Donna Lee:
Getting tired.
Dr. Mistry:
It's going to get tired and old and it's going to have problems with it.
Donna Lee:
That was a heck of an analogy.
Dr. Mistry:
Well, that's why we say that if you want to keep your prostate healthy, make sure you're ejaculating all the time.
Donna Lee:
Oh Lord.
Dr. Mistry:
Because now you're fooling your prostate and thinking that it's trying to have babies.
Donna Lee:
Oh, okay. That makes sense.
Dr. Mistry:
So for all those wives out there...
Donna Lee:
Just let your husbands ejaculate.
Dr. Mistry:
Because it's called prostate exercise, and it's going to keep that prostate healthy, and in fact, rates of prostate cancer are less in men who ejaculate more often. And we get patients that the classic patient that's going to benefit from a prostate removal, also known as a radical prostatectomy, is going to be a younger patient, which we define when it comes to prostate cancer as under 70. So we're not talking about a 40 year old, who sometimes do have prostate cancer, but if you're under 70 and in reasonably good health and your cancer is considered to be fairly aggressive, we would consider taking the prostate out.
Donna Lee:
Okay.
Dr. Mistry:
What, when we diagnose prostate cancer in the office, we use all these tools. There's all these mathematical models and all these tools that we can use. The most popular one we use is called the Memorial Sloan Kettering Cancer Nomogram. We can use the data from your biopsy, your PSA, and we can tell you based upon thousands and thousands of men, what is the likelihood that your cancer is going to spread or would benefit from getting it removed? And so we can give you numbers. It's not just like our feeling, some general feeling.
Donna Lee:
I sense that...
Dr. Mistry:
I sense that you would have a better outcome with a massive surgery. Now the radical prostatectomy is, would be considered a major surgery. It takes about two hours. I do those procedures robotically. People often wonder like, is the robot doing it?
Donna Lee:
Right. Because you're in a different room.
Dr. Mistry:
I'm not in a different room. I'm right next to the table.
Donna Lee:
You're across the street...
Dr. Mistry:
I am not.
Donna Lee:
...telling your robot what to do with your booty.
Dr. Mistry:
Via, via text messaging?
Donna Lee:
" Dear Robot, do this..."
Dr. Mistry:
"Dear Robot, please do this." That's not at all what happens. The, the console that we use is hardwired to the robot. It's just like using an, a wired RC controller. There are four arms that the robot has that we can control. And the, the robot little hands move in what we call articulated movement, so they can sew just like our human hands.
Donna Lee:
Wow. How many years training do you have to become a robotic surgeon?
Dr. Mistry:
Well, when I was training way back in the old days, there were only, there were only four robots in the country. And at Baylor, it took us a hundred cases, you know, before we even felt like we could reasonably tell people to do this. And today, most trainees come out knowing how to do the robot. So most of the time, if you get a well-trained urologist, they can do a robotic procedure. Now, depending on how you practice, you can come out knowing something and not practice it, and maybe you don't want to go to that guy. But making sure that the surgeon that you go to seems reasonably comfortable in the procedure, was well-trained, and I personally think that you should go to one that does a wide variety of robotic cases, because if you there's a problem in the room and you need somebody with special set of skills and they don't have that, then that I think is going to be an issue.
Donna Lee:
Right. Because not all urologists do that.
Dr. Mistry:
Not all urologists do that.
Donna Lee:
I think people might assume that.
Dr. Mistry:
That's a, that's a great point. A lot of times, when you go to a big group where you'll meet the doctor and they'll want you to do a surgery, they'll send you to one of their partners, which is fine, but you should meet that partner and you should make sure you feel comfortable with them because, in the end, that relationship between surgeon and patient is so critical, you're, you're putting your life in their hands and you should know whether they feel comfortable and you feel comfortable with them. When you remove the prostate gland, which you don't need to live, as we mentioned, it's located right in the middle. Like if you had to put the center of our universe, it's right there. It's right next to the nerves that give us erections, it's right in the place where we learn how to not pee on ourselves, it's right in front of the rectum.
Donna Lee:
God sure knew what to do.
Dr. Mistry:
You know, when God was designing the prostate, he was like,"You know what, let's leave that right there. I'll put it behind the pubic bone in the most dangerous place. So please, people, don't mess with it." But we decided we're going to go and try to take that out sometimes. And at Baylor where I trained, they really helped develop the techniques for open removal of the prostate, which was, we did hundreds and hundreds of times during training. And so when we transitioned to the robot, a lot of those skill sets were able to be transferred, you know, to that technology. Nowadays, you can reasonably be out of the hospital that day, whereas before it would be three days. You could reasonably get your catheter out, which you have to put in for the healing of the bladder and urethra, you can get that out in seven days, which used to be much longer. And, and the complications that people have, like impotence and incontinence, have improved greatly. And so if you have a family member that had their prostate out and had a terrible experience, I hear that all the time. You know,"My dad had his prostate out 30 years ago and was miserable after that." Or,"I have a friend who had his prostate out and was miserable after that." I think that that, that era is a different era. And today we're much more used to people coming in and say,"Oh yeah, I had my prostate out, but you know, I'm feeling great." And because the oncologic outcomes, meaning of the cancer cure outcomes are so much better, I think that if you I've been diagnosed with prostate cancer and you've been scared about getting a radical prostatectomy, even though one's been recommended to you, you, you should seek a second opinion. Maybe it's just the surgeon you're not comfortable with. And once you find the right surgeon and the right therapy for you, your, your ability to be happy with your therapy goes through the roof.
Donna Lee:
Awesome. Well, thanks for that. That was very detailed.
Dr. Mistry:
How do people get ahold of us?
Donna Lee:
You can call us at(512) 238-0762. And our website is armormenshealth.com. Thank you so much.
Speaker 1:
The Armor Men's Health Hour is brought to you by Urology Specialists. For questions, or to schedule an appointment, please call(512) 238-0762 or online at armormenshealth.com Men's health.com.