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 explain why urinary leakage in men is an issue that should be addressed by a urologist--not ignored or tolerated! While urinary leakage is very common (if irritating) in women, it is generally more concerning in men. Leakage can be anything from post-void dribbling, or small urine leakage after you've used the restroom and put back on your clothing. There is also urge incontinence, which happens when you can't get to the bathroom quickly enough. Urge incontinence can lead to full-scale bed-wetting and embarrassing accidents that can quickly cause rashes and infections. Male incontience is often caused by an enlarged prostate, some kind of blockage, or even pelvic floor issues--all of which can usually be resolved with non-surgical interventions, including pelvic floor physical therapy. At NAU Urology Specialists, our pelvic floor physical therapists are very experienced in treating male patients (as well as female ones). Another cause of male urinary incontinence is complications from prostate surgery/removal. Because this surgery often damages your urinary sphincter, leakage can occur. Our providers are well-trained in the surgical repair of this issue with either an artificial urinary sphincter or a mid-urethral sling, both of which have high success rates and are usually covered by insurance. If you or a loved on are struggling with urinary incontinence--no matter how severe--please call us today to learn more about the many options we have, both surgical and non-surgical, for treating this issue!
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. This is Dr. Mistry, your host here as always with my incredibly resourceful co- host, Donna Lee.
Donna Lee:
We always wonder what you're about to say. You know, your voice sounds just like it does on the commercials.
Dr. Mistry:
Really?
Donna Lee:
Mhmm. They're so smooth and silky.
Dr. Mistry:
I have a face for radio, they say. This is a men's health show. This show is brought to you by NAU Urology Specialists. That's the urology specialty clinic started in 2007.
Donna Lee:
NAU stood for...
Dr. Mistry:
North Austin Urology is what it stood for, but now it's NAU, because when we opened up that Dripping Springs and the South Austin office, it sounded weird. So if it sounds like a mouthful...
Donna Lee:
That's what she said.
Dr. Mistry:
That's what she said. I'm a board certified urologist. And what we try to do on this show is give you advice on your health, trying to improve your longevity, both in your life, as well as your personal area.
Donna Lee:
Personal area?
Dr. Mistry:
You like that? Longevity. Who's the comedian, now?
Donna Lee:
It's you, of course.
Dr. Mistry:
We are seeing patients. We are open to seeing new patients. And Donna, how do people get ahold of us, and how do they make an appointment with us, and where are we?
Donna Lee:
You can call us during the week at(512) 238-0762. Our website is armormenshealth.com. Our email address is armormenshealth@gmail.com. Is it better if I sing it? Armormenshealth@gmail.com
Dr. Mistry:
Please stop that.
Donna Lee:
We're in Round Rock...
Dr. Mistry:
I have Betty Boop working for me.
Donna Lee:
...we got Round Rock, South Austin, North Austin, and Dripping Springs. And before we move on to the big meaty part of the segment, we have a Tony in Sugar Land who we needed to say hello to.
Dr. Mistry:
Hi, big Tony.
Donna Lee:
Hi, big Tony.
Dr. Mistry:
We don't even know if you're big.
Donna Lee:
We don't know.
Dr. Mistry:
How about just hi, Tony from Sugar Land.
Donna Lee:
We almost called him daddy, but big Tony might work.
Dr. Mistry:
Yeah, please don't do daddy. This week in the clinic was another really busy fun week. We had a couple of patients that have a problem that we don't often talk about on the radio.
Donna Lee:
We don't? I thought we talked about everything.
Dr. Mistry:
But this, this week I, we had a, we had a listener come in because we talked about that condition where you can't peel the foreskin back and you have pain and cutting at the very base of it.
Donna Lee:
The frenulum?
Dr. Mistry:
The frenulum issue. And he heard it had never heard that it could be fixed. Walked in, popped the money down, zipped, unzipped his pants, said,"Please cut this thing right now." Let me clarify some of what you said. He didn't just walk in, he made an appointment. He didn't plop his money down, he paid what was appropriate. And then he... He did unzip his pants.
Donna Lee:
...he disrobed? Yes.
Dr. Mistry:
He disrobed in an inappropriate fashion.
Donna Lee:
Exactly. And he was very well handled.
Dr. Mistry:
See? Now you made it uncomfortable.
Donna Lee:
I didn't, I, no, I didn't mean to. Anyway, yeah, I remember that. Yeah, so.
Dr. Mistry:
Anyway, it was an awesome case, and he, you know, left here with a problem taking care of that he didn't know. And so another similar issue has to do with leakage in men. We hear all the time about urinary leakage in women. If you're a woman out there and you're having problems with stress incontinence, that means you're leaking when you're jumping up and down or urgent incontinence, which means that you're leaking when you can't get to the bathroom fast enough, we have innumerable treatments for you. And if, if you want a treatment that doesn't involve a sling or any kind of major surgery, we have amazing options available for you here. But if you're a man and you're leaking...
Donna Lee:
You're out of luck.
Dr. Mistry:
No, no, we have so many things for you. No, that's not what I said at all. But leakage in a man is uncommon. So if you're out there and you're leaking and you're a man, you really need to be seen. I thought I'd talk about urinary leakage in men and go from like what I would consider the more common types of leakage and what it means to the less common.
Donna Lee:
So leakage is anything from just a little bit dribbly to a full on leak, or...?
Dr. Mistry:
Yeah. That's right. Or, or peeing the bed.
Donna Lee:
Peeing the bed.
Dr. Mistry:
And a lot of people. I think if, if you were like peeing the bed regularly, you would probably go see the doctor. But we're surprised all the time by people who just don't go see the doctor.
Donna Lee:
Why is that?
Dr. Mistry:
We can be frightening. Blood pressures go up, we tell them bad news, stuff like that.
Donna Lee:
But you want to fix it.
Dr. Mistry:
So if you're, if you're a wedding, the bed man or woman, and you're grown, you need to come in and see us. And you might have constructed some kind of story in your mind:"I'm a heavy sleeper..."
Donna Lee:
"I like wet dreams."
Dr. Mistry:
...something, some--you, you may, you may have any kind of story in your mind. None of those stories are accurate. You need to come in and be seen because your body's not supposed to pee itself at night.
Donna Lee:
Oh, boy.
Dr. Mistry:
So then we have the type of leakage that we call post-void dribbling. That means that you pee, and then you put your underwear back on, and then dribble a little bit in there.
Donna Lee:
Makes sense.
Dr. Mistry:
And that's the most common type of leakage that we see. Most often we see it with an enlarged prostate or some kind of blockage, but in young guys, we see it with pelvic floor problems. So, if you're having stained underwear and you are leaking when you get up after you've pee, that's called post-void dribbling. And we'd like to see you for that.
Donna Lee:
That's right. I, pelvic floor physical therapy is an amazing thing that I did not know about until I started with you.
Dr. Mistry:
And we have three well-trained amazing pelvic floor, physical therapist. And what makes ours unique is most, most of the people in this field see women predominantly and ours are so well-versed and taking care of men.0.
Donna Lee:
Right.
Dr. Mistry:
The next type of leakage is when you can't get to the bathroom fast enough. And men make up these stories in their mind, like,"Well, I just wait too long before I go to the bathroom." But just like the bed- wetting, it shouldn't happen. You shouldn't leak just because you think you waited a little too long. So if you're routinely leaking before you get to the bathroom, before you take your pants down, then that is something that we have so many treatments for. Most of them are nonsurgical. We just have medical treatments for them.
Donna Lee:
So what I'm getting at, or what you're getting at is it is not normal to leak.
Dr. Mistry:
It is not normal to leak. But I would say the one area that we really would like to spread the word is if you've had your prostate removed or some kind of surgery on your prostate and you're having leakage, that's something that we can usually repair surgically. And a lot of men out there have had their prostates removed, whether it be for an enlarged prostate or whether it be for prostate cancer, which is more common, and you're having leakage when you cough or sneeze or when you're getting up out of a chair, it's because the sphincter mechanism that controls your urination has been damaged.
Donna Lee:
Where's the sphincter?
Dr. Mistry:
The sphincter is between where the prostate is and where the urethra leads out of your body, and it's like a musc-, muscular band that goes around the urethra and squeezes shut so that you don't pee on yourself. But when you remove the prostate gland, the very end of the prostate called the apex sits right next to this sphincter, and the sphincter can be injured or damaged.
Donna Lee:
It sounds painful.
Dr. Mistry:
Nowadays in our, in our current way of dealing with this, we have robotic surgery and things of that nature that kind of limit that damage. But even with that, some of our patients end up having leakage. In national numbers, we kind of quote 96% of men are continent or have no trouble and 4% have problems. But I think the real number is probably close to 20% of people have some problem. And the older you are when you have your prostate removed, or the less-fit you are if you're kind of, you know, overweight and have poor muscle tone anyway, then you're more likely to have leakage after your prostate is removed. And we have some awesome, awesome ways to repair it.
Donna Lee:
Hmm. I love that you're so excited.
Dr. Mistry:
I am.
Donna Lee:
That's so cute. All right, go ahead, urologist.
Dr. Mistry:
Well, it is. We have, I love problems that I can fix. Problems that I can't fix, like...
Donna Lee:
This is why you hate golf.
Dr. Mistry:
That's right. I can't can't fix golf games. So one of the things that we do is called an artificial urinary sphincter, also invented at Baylor College of Medicine, the finest medical institution. This is a silicone ring that's put around the urethra that fills with fluid and squeezes. It it's ingenious. Everything is inserted or implanted internally, so there's nothing that you can see. And you have like a little pump, like the old Reebok shoe that you would pump up, you know, to make it the shoe tighter around your foot. You, it's a little bitty pump that you pump up and it squeezes and the pump actually opens up the sphincter and then it automatically squeezes shut and stops you from peeing on yourself. It takes me about an hour and a half to put in and six weeks afterwards, you're good to go. Dry as a bone.
Donna Lee:
Dry as a bone?
Dr. Mistry:
In many cases. And the other option that we have is called a mid urethral sling. This is called a hammock. It's a hammock, essentially. We put in, we put in a sling or a piece of mesh that compresses the urethra, compresses it shut so it increases the resistance to leakage. And we have had many men be very happy with the results of a, of a male sling. This procedure takes about an hour and a half. It's done in the hospital, both the sphincter as well as the sling are covered by insurance.
Donna Lee:
Oh, good.
Dr. Mistry:
And, very, they have high success rates when you have the appropriately chosen patient. And you want to go to a proven doctor that knows how to do implants and slings.
Donna Lee:
Who's done more than one, maybe?
Dr. Mistry:
Who's probably done or not just reading about it on YouTube.
Donna Lee:
Google.
Dr. Mistry:
The YouTube sling artist.
Donna Lee:
I'm a doctor on Google, by the way.
Dr. Mistry:
You are not.
Donna Lee:
I have a piece of paper at home that says,"Dr. Donna McBride."
Dr. Mistry:
So if you are leaking out there and you're a man, we would love to see you. If you're leaking out there and you're woman, we would love to see you. We have so many--if you're scared of having a piece of mesh put in you or having something that you're, that you're afraid that somebody's only gonna offer you one type of treatment, then please come in. I mean, surgery is only one aspect of what we do. Trying to find the right treatment for what ails you is really a bigger part of our mission here. How do people get ahold of us and how do people send us emails for information?
Donna Lee:
That's right. If you want more information on this topic or any other topic, you can email us at armormenshealth@gmail.com. You can call us at(512) 238-0762. You can check out this podcast wherever you listen to free podcasts and ours is just simply the best. So thank you, Dr. Mistry.
Speaker 1:
The Armor Men's Health Hour is brought to you by Urology Specialist for questions, or to schedule an appointment, please call 5 1 2 2 3 8 0 7 6 2 or online at Armour men's health.com.