Bonus Episode: Nerve Damage Punching Below the Belt? Dr. Mistry on Genital Numbness and Bladder Paralysis Following Spine Surgery

In this episode, Dr. Mistry and Donna Lee answer a listener question about pelvic numbness and difficulty achieving an erection following spinal surgery. Dr. Mistry explains that trauma to the lumbar and sacral regions caused by swelling, surgery, or underlying conditions can affect our motor and sensory nerve outputs, including those that connect to our bladder and genitals. As a urologic surgeon, Dr. Mistry commonly treats patients who have symptoms like bladder paralysis and erectile dysfunction from such neurological changes. At NAU Urology Specialists, we use cutting edge biothesiometry evaluations to measure the temperature and vibratory sensation of the genitals to assess nerve function--crucial information in determining the best course of treatment. Tune in to learn how the right supplements, prescription medication, hormone therapy, and even vibrating penile rings can work together to increase genital stimulation and improve sensation. If you or someone you love has urinary or sexual dysfunction following spinal trauma or surgery, call or visit us online today to learn more about available treatments!

Voted top Men's Health Podcast, Sex Therapy Podcast, and Prostate Cancer Podcast by FeedSpot

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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Episode Transcript

Speaker 1 (00:00):


Speaker 2 (00:09):
Welcome back to the Armor Men's Health Show with
Dr. Mystery and Donna Lee.

Speaker 1 (00:15):
Hello

Speaker 3 (00:16):
And welcome to the Armor Men's Health Show. This
is Dr. Mystery , your host,board certified urologist,
founder of N A U UrologySpecialist. And I'm joined by
my , uh, wonderful sidekick andco-host Donna Lee. Hey

Speaker 4 (00:29):
Everybody. Welcome to the show.

Speaker 3 (00:30):
Donna. We are , uh, really growing as a practice.
Uh, uh, why don't you tellpeople , uh, what's happening?

Speaker 4 (00:36):
Oh my goodness. If you're listening to the show
before September, we have twonew doctors coming. This is so
exciting 'cause there's so fewurologists in the world,
, and we found two

Speaker 3 (00:46):
We're really lucky.
E even the , uh, otherhospitals and other people in
town that have helped us rerecruit these , uh, physicians
are amazed that we're able tofind some people. Uh, there's a
great shortage of urologists.
Uh , for those of you that arelooking for appointments out
there, you certainly know aboutthat shortage. Mm-hmm .
and the long waittimes. So , uh, we're happy to
be able to announce shorterwait times. We'd really love to

(01:08):
get you in for your primary orsecond opinions for your
urologic conditions. Uh ,Donna, where are our offices
and how do people make thatappointment? You

Speaker 4 (01:15):
Can call us at [phone] our website, armor
men's health.com. And we'relocated in central Texas, round
Rock, north Austin, southAustin, and Dripping Springs,
Texas. And you know what? We'rereally behind on questions.

Speaker 3 (01:28):
We are, and a urologist is a special type of
surgeon. So remember that we'resurgeons. We do a residency
that takes about five years.
Mine took six. Um, you just

Speaker 4 (01:39):
Were so extra.

Speaker 3 (01:41):
Yeah , a little extra. Uh, uh, that's after
medical school, so you go tomedical school and then you do
a five year surgical residencywhere you spend all of your
time hoping to be in theoperating room. And then when
you graduate, you spend allyour time in clinic. Yeah,
that's

Speaker 4 (01:54):
A

Speaker 3 (01:55):
Lot of school , but we still miss the operating
room. And so you'll hear onthis show and a lot of our
guests being surgeons, a lot ofpeople that we get to work with
and, you know, we want to dowhat's best for you. So
sometimes it's medicalmanagement and sometimes it's
surgical management. But yourquestions , uh, and your
continued interest in our showis what continues to drive us.
So we love your questions.
Donna, hit us with one. Okay.

Speaker 4 (02:16):
From a very special listener and friend. Um, hi
Donnelly. I've been a faithfullistener to your show for
several years now, but haven'theard this particular issue
addressed. So here's thequestion for Dr. Mystery , and
perhaps he can help myself andothers. I'm 63 and on the 18th
of May, I had L four fivelaminectomy with removal of

(02:36):
synovial cyst andinstrumentation with fusion.
I've dealt with the age-relatedspinal stenosis for over two
years now, 10 weekspost-surgery. I have no back
pain, but still have pelvicregion numbness, difficulty
achieving an erection and nolibido. My spine surgeon says
it's only a matter of time, butI'm concerned that this is
happening to me. Pre-surgery, Ihad no erection issues or

(02:59):
health issues. Your thoughtsare appreciated. Thanks and
love your show.

Speaker 3 (03:03):
Well, that's a great question. Um, you know, after
spine surgery, there can be anumber of urologic kind of
changes that may or may not bepermanent or may or may not be
commonly experienced. So the,the nerves that go to the
pelvis come out of the spinalcord a little higher than you
might think, but , uh,specifically in the lumbar and

(03:27):
sacral regions, you're going toget the motor and sensory nerve
outputs and that may getaffected either by swelling or
by surgery or by the actualunderlying condition as well.
So urinary problems aresomething that we see not
uncommonly. Uh, it's bothbecause the patient themselves
is older and kind of at riskfor urinary problems, but also

(03:50):
the nerve outputs that go tothe bladder can be negatively
impacted. And so waking upafter spine surgery and not
being able to pee is somethingthat we see, you know, quite
frequently. Generally speaking,a catheter is placed
temporarily, maybe for a day ortwo, they'll come into the
office and, and hopefully after48 or 72 hours, this kind of
bladder paralysis, it getsalleviated. But , uh,

(04:14):
occasionally what's being doneis we're uncovering an
underlying prostate problem,and we're going to have to take
care of that. Now, when itcomes to this issue with low
libido, inability to get anerection and numbness, it makes
me wonder what was the chickenand what was the egg. Mm-hmm .
Okay. So if I couldn't feel mypenis, my libido would drop too

(04:35):
. And , and if my erectionsdepended on continuous
stimulation mm-hmm.
and I couldn'tfeel my penis, I would also
have erection problems. Makessense. So I think a combination
of , um, I I , I think thatprobably, if I had to guess for
this listener, sensation in thepelvis is probably the, the
first problem. And then thatled to erectile dysfunction.

(04:59):
And then of course, if yourerections and your pelvic
sensation and your penis areimportant to you, then you
know, you would feel a loss oflibido. So in terms of how we
would kind of approach this ,uh, particular , uh, patient
mm-hmm . is wehave a type of evaluation that
we do in the practice calledbiometry. Okay . Biometry. And

(05:22):
what we do is we can assess thetemperature and vibratory
sensation of the genitals. Weuse this in men and women both.
And , uh, have you seen thatlittle probe that we use in the
office? I have, yeah. It'sfascinating. It , it , it has,
has like this little vibratingtip on it. Yeah . And then the
other one has like a , Hey ,

Speaker 4 (05:40):
Y'all can't find me one day,

Speaker 3 (05:41):
, you know, Donna, we need the probe back.
,

Speaker 4 (05:45):
It's almost done.

Speaker 3 (05:46):
Almost done. Two more minutes. Two more minutes
. And, and the temperature oneis also fascinating. It , it
has a little temperature probethat goes up or down in terms
of temperature mm-hmm.
, .
And it allows us to assess thenerve function of the genitals.
Okay . So for this listener,that's what we would do. We
would assess the, the vibratoryand the temperature sensation
of the genitals and see ifthat's been diminished. If

(06:09):
that's been diminished.
Hopefully, you know, thosesensory nerves tend to come
back after the swelling , uh,and things like that kind of e
evolve and improve after spinesurgery.

Speaker 4 (06:20):
But he's already, what, 10 weeks out? Yeah , I
guess . And how far out shouldhe give it a second

Speaker 3 (06:24):
Chance? I think, I think 12 weeks is at the
minimum. Okay. Uh , but , uh,but it could take longer. I
mean, sometimes these, theseneuro p this the neurologic
injuries that occur fromstretch can take up to a year
to improve. That's what we see.
Oh , wow . You know, afterprostate surgery. So it can
take a little bit of time, butthat doesn't mean that this

(06:45):
patient has to live like

Speaker 4 (06:47):
Know he doesn't have to wait double either .

Speaker 3 (06:48):
Either he doesn't have to wait. Gotcha . Meaning
we can find ways to augment himimmediately. For example, we
can make sure that histestosterone level is normal.
We can make sure that he'stemporarily augmented with
medications that will help himmaintain his erection a little
bit longer. Mm-hmm.
, we wouldcertainly wanna put him on
supplements that will help withnerve regeneration. Right. And

(07:10):
we would want to make surethat, you know , uh, we can
evaluate over time and give himsome confidence that his
sensation and vibratorysensation are kind of improving
over time. Then we will talkabout, let's say his vibratory
sensation is down and he needsmore stimulation mm-hmm.
, then we have avariety of different things
that we can offer, includingthose vibratory rings that

(07:31):
we've seen , uh, used in theclinic. So, you know, diabetics
or men who lose their erectionwhen they're kind of changing
position because of a loss ofsensation. Mm-hmm.
, these arepatients in whom that type of
vibratory ring or vibratorypenile ring are things that,
that we will use more commonlywhen it comes to sensation, if
their sensation is diminished.

(07:51):
Uh, just kind of temperaturesensation. There are different
creams , uh, that we can offerto improve that. Should

Speaker 4 (07:57):
He just get a hot girlfriend?

Speaker 3 (07:58):
I will say that that probably fixes most problems
except for thefinancial ones. .
That's right.

Speaker 4 (08:04):
They're expensive though .

Speaker 3 (08:05):
They're expensive , it's really the
ex-wife that's more expensive.
Oh, true, true. That's right.
So , uh, you know, I guess, youknow, pick your poisoning
, uh, when it comes too o other things to help , uh,
we do offer that p r p shot ofthe penis to help regenerate
sensation. We like the artercell supplement that helps with

(08:28):
endothelial regeneration. Yeah. That's amazing. Uh , uh, and
so , um, there can be some rolefor shockwave therapy when it
comes to nerve regeneration, atleast in the penis. And so we
have some adjuncts that canhelp , uh, you know, improve
things. But truth be told, Ithink that a 90 day course of
Cialis making sure that theguy's testosterone is working

(08:50):
okay. Mm-hmm. ,and then confirming nerve
sensation is probably gonna beexactly what this doctor
would've ordered , uh, for ,for that, that patient.

Speaker 4 (08:59):
Wow. That was a good ending to that.

Speaker 3 (09:01):
That was good . I I , I think that for that was
sexy. I think that for patients , uh, just, you know,
neurosurgeons, you know,they're very focused on what
they're doing. Right. Thenerves as they should be. And
if you don't have pain thatdoctor thinks that he has like
perfectly taken care of yourproblem. Right. I'm not a
neurosurgeon. I care about, youknow, your penile function,

(09:22):
your erectile function. Mm-hmm.
, I can't fixyour spinal stenosis. But what
, what I mean by all that isthat sometimes a surgeon, you
know, when there's acomplication that's out of
their realm mm-hmm .
may not know howto deal with it, and so may
downplay like kind of what'shappening. Oh, I see. And so ,
uh, that, that's, that , that ,that doesn't mean they're a bad
surgeon. It means that they'reprobably not a very good

(09:43):
urologist. . .
Excellent. And that makessense. As one of our previous
guests said, you don't wantyour thyroid removed by a guy
that does a lot of roboticprostatectomy. That's true. Uh,
and so, and , and, and you ,you may not want your erections
fixed by a guy who does a lotof spine surgeries . That's
true. So , uh, we would love to, uh, kind of take care of
these kinds of problems ifyou've been seen before, and if

(10:04):
you've been seen by aurologists and they kind of,
you know, didn't take youseriously, then don't feel that
all urologists are the same. Imean , uh mm-hmm .
, you know , we ,we consider ourselves to be ,
uh, top-notch and , uh, highlycutting edge. Uh, and really ,
uh, we'll do almost anything tokind of , uh, restore your
function. Donna, how do , howdo patients see us either as
primary or as second opinion?
You

Speaker 4 (10:24):
Can call us at [phone]. Visit our website,
armor men's health.com. Anddon't forget, you can hear our
podcasts. They're amazing.
They're free, and they'reavailable just for you at any
place where you listen to freepodcasts. Thanks, Dr. Miss Tree
.

Speaker 3 (10:38):
Thank

Speaker 2 (10:38):
You, Donna. Dr.
Mystery wants to hear from you.
To submit a question, visitarmor men's health.com. We'll
be right back with the ArmorMen's Health Show .