Treating Hydroceles and Abdominal Pain: Dr. Mistry and Donna Lee Answer Listeners' Questions

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 few listener questions. The first question is from a listener asking for Dr. Mistry's recommendation on the best way to remove a hyrdrocele. Hydroceles are fluid sacs that develop around the testicle. Dr. Mistry explains that draining a hydrocele is a mistake for two reasons: not only will it come back, but it will be harder to address after scar tissue builds up from the first attempt at draining. Instead, Dr. Mistry strongly suggests hydroceles be removed surgically. He performs many of these in a surgery center where patients can be put to sleep, but they go home the same day and recover fully in about a week. Dr. Mistry can also perform what's called a scrotoplasty to improve a sagging scrotum that might remain after the hydrocele is removed.
 
The second listener question addressed today is from a 44 year old listener who has developed acute lower abdominal pain that is especially bothersome while driving. They ask Dr. Mistry, "Should I be concerned?" While severe acute abdominal pain should immediately be evaluated to rule out emergency situations like appendicitis, it is likely this person is dealing with a more nagging, chronic pain that suggests a musculoskeletal cause. After a thorough evaluation of the affected area to rule out problems in the nearby organs (including the bladder), Dr. Mistry suggests pelvic floor physical therapy, including massage to promote myofascial release, could be of great benefit to anyone with this issue. No matter the cause, our team at NAU Urology Specialists will be able to take care of you or refer you to a trusted health partner in the area to make sure you get the best care. 

This episode originally aired on 4.24.21. Don’t forget to like, subscribe, and share us with a friend! As always, be well!

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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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Transcript

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 office manager and fellow radio co-host, Donna Lee.

Donna Lee: You know what? I have a Calm app that I listened to to go to sleep. Your voice could be on my Calm app.

Dr. Mistry: You think so?

Donna Lee: Yeah, it's very smooth and mellow.

Dr. Mistry: They say I have a face for radio.

Donna Lee: You do. Matthew McConaughey is also on this app and he puts me to sleep in three seconds flat.

Dr. Mistry: Oh man. Alright, alright, alright. This is a men's health show. This is brought to you by the urology practice that I started in 2007: NAU Urology Specialists. I am Dr. Mistry. That is my real name.

Donna Lee: M-I-S-T-R-Y.

Dr. Mistry: That's right. Mistry. We were once accused of being...

Donna Lee: Gimmicky.

Dr. Mistry: ...gimmicky.

Donna Lee: Which rhymes with mystery.

Dr. Mistry: What? I don't think so.

Donna Lee: Gimmicky/Mystery.

Dr. Mistry: We have a full service urology clinic. We treat all forms and manners of urologic conditions, but then we have a special interest in men's health. We have a number of providers that provide exceptional care when it comes to hormonal health, erectile dysfunction, and really trying to get to the bottom of even some kind of fertility issues and atypical type complaints. Just this week, Donna, we saw a patient who came in with poor semen parameters and had seen two other urologists. And because of our close relationship with Texas fertility center, we get virtually all of their patients for advanced fertility kind of work up on the male side because they do on the female side a lot of the IVF kind of work. And our workup uncovered a multitude of underlying conditions that have been completely overlooked by their previous providers--you know, severe thyroid disease , lots of nutritional problems, terrible diet, bad lifestyle choices. And you know, it comes down to this feeling of what is my job as a doctor? I'm here to make sure that you're getting your best out of the care that we're providing and not just trying two or three different things that I learned way back when and not trying to expand the kind of medicine that we're doing. So we , we did a great job with this guy, improving his sperm parameters and addressing things that you wouldn't think a normal urologist would, including making sure that his thyroid was taken care of and his diet and nutrition. And that's the kind of care you're going to get in our practice.

Donna Lee: Right. Now I know why the other guys missed it, because they probably aren't specialized like we are in those regards.

Dr. Mistry: And even a lot of the professors that I had back in training who are fertility gurus, they don't do a lot of this stuff in their office, even though they write papers about how it's important to do this kind of stuff.

Donna Lee: Really?

Dr. Mistry: That's right, because it's out of their wheelhouse. So we try to expand our wheelhouse every single day. If you've got a problem that other people have had trouble getting their arms around, please come to us so that we can have a chance to do it. And if we don't, then we'll send you to a great network of referring doctors that we really trust in town.

Donna Lee: Real quick, on the poor parameters of sperm to the positive parameters, where , where did he go from one end to the other?

Dr. Mistry: He had sperm that was, that was low in number, they weren't moving very well, and they looked funny to getting his wife pregnant with a really good semen analysis in just about three months.

Donna Lee: Oh, really?

Dr. Mistry: So that's pretty good because it takes, it takes a minimum of three months to get anything that you do to change the way your sperm looks . So we did it as quickly--but, but he was committed. That's another difference. He was committed to changing his diet. He took all of his meds. He stopped his bad habits and he got the outcome he wanted.

Donna Lee: Oh , isn't it amazing what happens when you stop your bad habits? You get your wife knocked up?

Dr. Mistry: Oh boy, that sounds, that sounds like less of a less of incentive.

Donna Lee: Is that appropriate? That was very medically sound of me .

Dr. Mistry: Oh my goodness. We have four physicians. We have five mid-level providers in an office waiting to take care of you. Donna, how do people get a hold of us?

Donna Lee: You can call us if you'd like an appointment or just like to hear my silky smooth voice at (512) 238-0762 . Our website is armormenshealth.com and you can send us your questions to armormenshealth@gmail.com. We will answer them anonymously, I will respond to them all. And I'm working on getting these t-shirts, so if you've asked for a t-shirt and you're waiting, I'm working on it! We were waiting for the t-shirts to get made. Oh , you can listen to our podcasts wherever you listen to podcasts. And we have a couple of quick questions that we could probably get answered here.

Dr. Mistry: Let's do it.

Donna Lee: We talked about hydrocele several times in the past, but this quick question is, "I have a hydrocele. I would like to bid it farewell. I was reading that there are options for addressing this, like draining with a needle, laser process, and surgery. What do you recommend?"

Dr. Mistry: That's a great question. A hydrocele refers to a fluid sac that develops around the testicle. A hydrocele is different than a spermatocele, which is also another kind of scrotol kind of cyst.

Donna Lee: Do they look the same?

Dr. Mistry: They can often look the same, but the difference is a hydro, the testicle floats inside of a hydrocele so that, so it's like a water bed for the testicle.

Donna Lee: Mhhm. So 1970s.

Dr. Mistry: And a spermatocele, the spermatocele comes off of the testicle. So the, the fluid doesn't surround the, the testicle. Removing a spermatocele is , or a hydrocele are really in the wheelhouse of virtually any urologist. Those are the cases that we really enjoy doing because we get to play a game of don't pop the cyst while we're removing it.

Donna Lee: Ugh. Is this in-house or do you have to go to a surgery center?

Dr. Mistry: We ask that you go to a surgery center and go to sleep because it's just a lot easier to do. There are some doctors that will stick a needle into a hydro seal and drain it. I do not do that.

Donna Lee: Because it'll return?

Dr. Mistry: Because not only will it return, but it makes fixing it later harder because the more you kind of instrument it, the more scarred it gets. So I always advise patients, you know, if it's bothering you enough to get it fixed, then let me fix it right the first time. The surgery takes me about, you know, a standard hydrocele, about 45 minutes. You don't have to stay in the hospital, and the recovery is fairly quick. Within a , about a week you're, you know, back to normal. The scrotum, if it gets real big and you know floppy from the hydrocele, it will shrink , you know, ultimately, but for those people that have a really, really big one, we can also do what's called a scrotoplasty at the time where we take all that , all that extra scrotol skin away and tuck it up nice and tight.

Donna Lee: Oh, it's like the opposite of the buried penis.

Dr. Mistry: Yes. But it's funny that you say that because a lot of times these hydroceles, it'll stretch the skin and i t's, it exists right under the penis, so the penis looks shorter. And so when we do the hydrocele repair, we'll do something called a, w e will remove something called the scrotal w eb. It's the skin that goes from the undersurface of the penis to the top of the scrotum. And it will make it look like you are like four inches longer.

Donna Lee: Superman with a big penis.

Dr. Mistry: You think Superman has a big penis?

Donna Lee: I sure hope so.

Dr. Mistry: Why would God give him that many things?

Donna Lee: Well, you're right, because he's always got [ inaudible] on out in front of him.

Dr. Mistry: He's got everything. Why does he have to have that, too ?

Donna Lee: Probably the big truck.

Dr. Mistry: I don't think so.

Donna Lee: Jerk.

Dr. Mistry: There has to be some, some, some evenness and fairness somewhere.

Donna Lee: In the world? He's Superman, he deserves a big penis.

Dr. Mistry: Very good. What's the other question?

Donna Lee: The other question is, "Hello, I'm 44 and I've developed an acute pain in my lower abdomen about where the seatbelt rests. I notice the pain more when I'm driving. Should I be concerned?"

Dr. Mistry: That's a great question. So , this is , what the, what they're talking about is abdominal pain in the lower front part of the abdomen and what could be the cause of that? So urologically...

Donna Lee: A tight seatbelt?

Dr. Mistry: Urologically, we have, the bladder is kind of located right there. But outside of the urinary system, you have the intestines that can sit there that can cause pain, but also the muscles and the skin and all the nerve tissue that run in that area can also be there. If the pain is more when you're sitting , for example, we usually , try to look for a pelvic floor or a musculoskeletal kind of cause for that. And a lot of our patients that have this kind of abdominal pain will benefit from pelvic floor physical therapy, or kind of a massage technique called myofascial release of the area. There's also some people that can , so a sports hernia is maybe something you've ever heard of also can report pain right in that lower pubic region. But those are people that are usually gonna hurt mainly when they're stretching their, their core, not when they're sitting. So mainly when they're standing or doing certain types of workouts. So , I think lower abdominal pain with a seatbelt , or in that seatbelt area , a musculoskeletal cause is going to be, you know , the , the most, the most common that we're going to see. But evaluating your bladder as well as the other organs that live in that area, I think would be a very smart way to get, get done. And certainly something that we would be happy to do.

Donna Lee: You know, we have pelvic floor physical therapy in house.

Dr. Mistry: That's what I'm saying. And we can rule out anything really dangerous as the cause, too . It's probably not like your appendix or anything. Those things would be more acute pain, not, not a more chronic issue.

Donna Lee: Right. Okay. Well, we need to get that guy in, because I'm very concerned about his driving and his pain. How do they get ahold of us?

Dr. Mistry: You're going to ask me? (512) 238-0762. And you can send us questions or even an appointment request at armormenshealth@gmail.com.

Donna Lee: That's right. You can visit our website and send in an inquiry as well. Our podcasts, I would like to mention again, if, if a listener is listening and doesn't know that we are the number two most popular men's wellness podcast on the entire internet as proposed by feedspot.com.

Dr. Mistry: And not just alphabetically either.

Donna Lee: It wasn't alphabetically. You said that one day, and then I got a little worried and I checked. The first guy's not alphabetical.

Dr. Mistry: But that's why it's Armor Men's Health Hour. We're just--in case an alphabetical list, we're also be...

Donna Lee: Can we be double, triple A Aardvark Men's Health Hour?

Dr. Mistry: Triple Aardvark Men's Health Hour. Just to make sure we get to the top.

Donna Lee: We'll be right up there, when you open the yellow pages we're right at the top.

Dr. Mistry: I have no idea why people think that we're funny.

Donna Lee: Because I'm funny.

Dr. Mistry: Yeah, I guess so. They do say you're funny.

Donna Lee: I am funny.

Dr. Mistry: All right. Well, Donna, once again, tell people how to get ahold of us and how to make an appointment with us and where to email us.

Donna Lee: That's right. You email us at armormenshealth@gmail.com. That email comes directly to me. I will respond to them. I can also send you the podcast after it airs on this fabulous station we call KLBJ. Our website is armormenshealth.com. And give us a call it's (512) 238-0762. We will talk about your pee pee all day long. Thank you, Dr. Mistry.

The Armor Men's Health Hour will be right back. If you have questions for Dr. Mistry, email him at armormenshealth@gmail.com.