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 answer a listener's question about erectile dysfunction after a vasectomy. The listener says, "I had a vasectomy in 2005, but since then I've been having trouble keeping an erection. Not sure what happened, but I'm 60 years old and was just concerned about this." As Dr. Mistry explains, sexual function and satisfaction can be affected by a vasectomy, but not in the ways most men fear. First, Dr. Mistry explains that psychological factors can play a role in the development of ED symptoms post-surgery. Things like dissatisfaction with the loss of fertility, fears about getting ED post-surgery, or the upset that any surgical procedure on the penis can cause are all thoughts/feelings that may impact a man's ability to achieve or sustain an erection. Another potential factor in ED is the pelvic floor dysfunction and mild pain that can sometimes occur after the vas deferens is severed during the vasectomy. If this is determined to be the cause, pelvic floor physical therapy to strengthen the pelvis will help increase blood flow and keep it in place during an erection. Finally, it is important to remember that up to 50% of men will experience ED by age 50. It could be that this listener's ED symptoms and vasectomy were unrelated. No matter the cause, ED is not something you should accept at any age without seeing a trusted urologist and learning more about the treatments available. At NAU Urology Specialists, we can help determine the cause of these symptoms and offer the best treatment options for you. If you or someone you love is experiencing ED--whether they've had a vasectomy recently or not--please give us a call today!
Don’t forget to like, subscribe, and share us with a friend! As always, be well!
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!
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Speaker 1:
Welcome 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. It is,'tis I, Donna Lee.
Dr. Mistry:
I'm a board certified urologist. This is a men's health show. We talk about medical health issues that are urologic in nature, certainly: erectile dysfunction, enlarged prostate kidney stones, kidney cancer, prostate cancer, on and on and on. Nipples to the knees, as we say.
Donna Lee:
When I said something about being a pee-pee doctor that I was helping, this, one of our patients complained that I was very juvenile and he did not appreciate my sense of humor. I would like to not apologize to that guy.
Dr. Mistry:
You are an acquired taste. We have a truck over here...
Donna Lee:
...taste yummy.
Dr. Mistry:
...just because of, you know, over the years, we've always been trying new ways to market. And so the truck is a black Tundra that's lifted and it says,"austinvasectomy.com" on the back. And the license plate is"snip."
Donna Lee:
That was my, my doing.
Dr. Mistry:
And it has two red balls coming off the carriage.
Donna Lee:
Cannot miss this truck.
Dr. Mistry:
There was such a famous truck that slate.com, the liberal news magazine, wrote a article after somebody sent them a picture of it on the psychology of truck nuts.
Donna Lee:
That's right.
Dr. Mistry:
And I will tell you, they were not kind.
Donna Lee:
They wanted to make fun of everybody. And then they like researched a bunch of cowboys that had big nuts on their truck. And they were like, and they called me and interviewed,'member? And they were like looking for an angle. And the lady was immediately laughing. She was like,"Why would you drive around with balls on your truck?" And I was like,"Well, we have a men's wellness show."
Dr. Mistry:
Yeah, we're urologists.
Donna Lee:
And then she was like,"Oh, wait. That's a positive message."
Dr. Mistry:
That's not funny at all. Check those truck nuts, everyone. I have really enjoyed doing this show. A lot of our guests comment on how incredibly comprehensive and holistic our approach to medicine is. And that's something that I take a lot of pride in. So if you have a urologic condition that you would like to have seen, and you're kind of in the Austin area, and if you're in Texas and just want to telemedicine appointment, that's still allowed luckily under the rules. We do lots of second opinions when it comes to prostate cancer from all over the country, because we offer high intensity focused ultrasound, which is a relatively cutting edge way of non-invasively treating prostate cancer. And we welcome you to join our family here at NAU Urology Specialists. And making an appointment is easy. So Donna, tell people how to make an appointment, and then if they have a question for the show, how to send that in.
Donna Lee:
That's right, so easy. Call us during the week at(512) 238-0762. You can visit our website and reach out to us through the website as well at armormenshealth.com. Send your questions to armormenshealth@gmail.com, where we will answer them anonymously. And if you're lucky, I'll send you a t-shirt. Our, we're in Round Rock, North Austin, South Austin, and Dripping Springs. Dr. Worldwide, we've got some questions.
Dr. Mistry:
That's funny. I was thinking, if you're lucky, you get a t-shirt. If you're unlucky, you get a jockstrap that's a little too small.
Donna Lee:
And you have to pay twice for your vasectomy.
Dr. Mistry:
That's right. Speaking of vasectomies, we are doing a ton of vasectomies.
Donna Lee:
We are so many vasectomies.,
Dr. Mistry:
There was a report out that, that they think that STD rates are going up because, because condom sales went up. I don't understand, but it sounds like those would go good. But in any case, people are thinking it's going to be quite a summer.
Donna Lee:
It's gonna be a busy season.
Dr. Mistry:
So if it starts getting fiery down below, come on in, everybody. We'll take care of that.
Donna Lee:
Nipples to the knees.
Dr. Mistry:
Nipples to the knees.
Donna Lee:
Speaking of vasectomy, I have a question about that. This listener says"Dr. Mistry, hi. Want to tell you I had a vasectomy in 2005, but since then I've been having trouble keeping an erection. Not sure what happened, but I'm 60 years old and was just concerned about this. Thanks."
Dr. Mistry:
So he had a vasectomy 15 years ago. And so then at age, starting at age, yeah, so starting at age 45, he started having erectile dysfunction.
Donna Lee:
Yep.
Dr. Mistry:
So this is a really good question and I'll just broaden it to what are some of the potential complications of vasectomy that we see, and what does not exist as a complication? So, it is possible to have pain after a vasectomy. It is possible to have some testicular swelling after a vasectomy. It's even possible for a vasectomy to reverse. But a vasectomy is not going to cause you to develop prostate cancer, and, anatomically, should not cause you to have erectile dysfunction.
Donna Lee:
Right.
Dr. Mistry:
But we have seen it. Okay? And so it's, and so you start thinking to yourself,"Why did you know, changing the oil in my car affect the decision my wife make on the drapes in the house, right?" Like, you don't, the two should anatomically--even though they're both like near the penis--you shouldn't have any real reason that you've developed erectile dysfunction as a result of a, of a vasectomy.
Donna Lee:
So just bad timing, maybe?
Dr. Mistry:
So several years ago, I really started thinking about what, what, what could be really kind of happening. And really the conclusion is this. So number one is it's psychological. So a lot of men that have had a vasectomy have never had anything done to their genitals. I mean, I hear it all the time."You're the first man to hold me there."
Donna Lee:
"Thank you."
Dr. Mistry:
Everybody's trying to be a comedian, you know what I'm saying, when they're getting a vasectomy. I always try to tell them,"I'm the comedian. Oh, wait. I said,"I'm the urologist." So...
Donna Lee:
"I'm the urologist."
Dr. Mistry:
"Wait a minute." So if, if you're doing a vasectomy, if you're having a vasectomy done, but the idea of losing the manlihood of being able to father children bothers you, that can also happen. So for women, after a hysterectomy, sometimes women are inconsolably depressed because the idea that they, you know, some people just culturally have been, you know, brought up to believe that the womb is like the center of their mission in life. And if they don't have a womb, they can no longer fulfill some purpose. And, and I do, and I have seen it. I have seen men after a vasectomy just completely like, just the act of being able to lose the ability to become a father, like really bothers them.
Donna Lee:
Aww. So you walked into the exam womb and there they were?
Dr. Mistry:
The"exam womb?" Fortunately, the vast majority of men understand that maybe two or three kids are enough, and let's just stop here.
Donna Lee:
Except for you.
Dr. Mistry:
And so they're happy. No, I have had more. So, so that is one. Another issue that can occur is some men, especially as they get older, don't masturbate regularly. And having to masturbate to give the semen samples may also be off-putting and psychologically damaging.
Donna Lee:
For sure. Yeah.
Dr. Mistry:
Some of it could be that the, the anatomic, like, like the, the, the taking of the vas deferns and cutting it, it can cause them to have mild pain or something called pelvic floor dysfunction that leads to erectile dysfunction. So if you don't, you can't keep your pelvis tight enough, then the blood flow will leak out of your penis, out of the valves, and, and, and, and that person will get like, get a quick erection, but then lose it, or may not feel the same firmness of their erection. So a pelvic floor dysfunction, as well as psychological things are going to be the more common reasons for a 45 year old man to develop ED right after a vasectomy. Now, forgetting about the vasectomy, about 50% of men who are 45 have ED.
Donna Lee:
So it might be just the timing.
Dr. Mistry:
And so there could be bad timing. And so, if it's...
Donna Lee:
50%?
Dr. Mistry:
50%.
Donna Lee:
Dang.
Dr. Mistry:
You're like,"That's not like most 45 year olds I've met."
Donna Lee:
It was a party. That was Saturday night.
Dr. Mistry:
So,"that was Saturday night." What kind of party are you going to with a bunch of 45 year olds?
Donna Lee:
It's between me and myself and those 40 year olds.
Dr. Mistry:
Those 45 year olds. So if you, if you just think about it though, but we don't accept it as normal because having ed in your forties seems like an incredible failure on your body's part. And so, it's, there used to be a real push for all men with ED who are under the age of 55 to see a cardiologist as well. And then nobody wanted to do that. And the cardiologist takes six months to see them. And they were like,"Well, you have ED. I don't know what to tell you." So, this is exactly the kind of patient that we love to bring in for a more comprehensive vascular exam. So we're talking about being sure the blood pressure in your legs are okay, making sure that the blood flow to your penis is working well. We can do a, we can do a special kind of Doppler ultrasound and make sure the blood flow is going. The blood flow going in and out are both important to keep an erection so we can test both of those things. We want to make sure that your blood pressure is healthy, that you're not a diabetic. And these are the kinds of things that we would check. So although a little broader of an answer than the listener was looking for, there should be really no good reason. Your testosterone's not going to drop just because the vas deferens has been cut. Your, nothing is gone, nothing has happened to the blood supply to your testicles, so they should be working just, just fine. And that's where the testosterone comes from. So, I don't want ED or prostate cancer or any of these things to be a concern if you're looking for a vasectomy. What's the most important thing when you choose a vasectomy provider is someone who's extremely experienced, who you feel very confident will do a great job, and who's going to explain the procedure in a way that makes you feel confident that if there a problem, that they'll be able to handle it.
Donna Lee:
And who's also got an award-winning podcast.
Dr. Mistry:
And I will tell you, an award-winning podcast. So if you'd like a vasectomy, you need to call our office. We're at austinvasectomy.com. You'll hear all the soothing things that I tell you prior to your vasectomy. And, Donna, how do people get ahold of us?
Donna Lee:
You can call us during the week at(512) 238-0762. You know, I've sent out that vasectomy podcast to a lot of guys and it's helped answer their questions, because you explain exactly what happens, what to expect...
Dr. Mistry:
Bringing it home.
Donna Lee:
That's right. Bringing it home. Our website is armormenshealth.com and our Gmail address that you can send your incredible questions just like this one is armormenshealth@gmail.com. Please listen to our podcast. We have them available to you wherever you listen to free podcasts and on our website. You can even catch them on KLBJ's website. But yeah, they're free for you and magical and delicious. Thank you, Dr. Mistry.
Dr. Mistry:
Thank you, Donna.
:
The Armor Men's Health Hour will be right back. If you have questions for Dr. Mistry, email him at armormenshealth, ed gmail.com.