BPH patients and male modesty during exams.

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I work in the medical training industry where we provide live simulated patients to train medical students and advanced nursing students on how to be respectful and courteous while performing sensitive personal exams on patients. I am also a BPH patient myself and have endured invasive physical exams myself

Unlike most women who seek medical preventive care every year, especially during their child bearing years, most men avoid going to a doctor until they exhibit serious symptoms so it is not unusual for a man of 50, 55, or even 60 to have not had a physical exam in decades. It seems that most of us do not want to admit that we are aging and our bodies are beginning to fail us.

Going to urologist for the first time can be stressful on a number of levels both physical and psychological. So I would like to ask the men in this group for what your medical providers said or did (or did not do) to make you feel comfortable and keep you keep your dignity. What did they get right and what they got wrong. What upset you most? How much privacy did you receive? Did the gender of the urologist or nurse practioner matter? Were other personnel present during your exams either to assist or act as a chaperone?

If you could give any advice to a future doctor or nurse practioner on how to make such exams more comfortable for the patient what would it be?

Thank you.

BobbyT

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15 Replies

  • Posted

    my rezum procdeure for bph was very painful. i was writhing in agony and and clenching my teeth. as i was suffering.... i glanced over at the Nxthera rep who was having a good giggle at my expense. he obviously had no idea what it's like to go through this kind of thing. Reps should not be allowed unless they are nurses or PA or other licensed health professional.

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    • Posted

      John98818

      Did the Informed Consent form you signed before the procedure specifically state company reps may or would be in the room during your procedure?

      If not, you may have legal recourse.

      If nothing else I'd complain to the sales reps company about his unprofessional behavior. He won't be laughing then.

      Regards,

      Raffie

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  • Posted

    I underwent two cystoscopies over thirty years. The first by a board certified urologist. The pain was off the charts -- 9 on the 10 scale at least. He said to me: "Don't be a sissy. What are you complaining about??!!." An idiot who could not appreciate that not all urethras are alike.

    The second procedure -- at age 72 -- I was left in the hands of two youngish 20-something female nurses. For the insertion of the wand. They dabbed me with some lanocaine gel and then went right to work. Again, the pain off the charts, despite my recalling for them the first incident. There I am in stirrups with two 20-somethings wiring my buddy with a steel probe. And in agony. Humiliating and excruciatingly painful. The uro came in and seemed as surprised as the first uro 30 years ago. He remains my uro on the assumption they are all alike.

    And the kicker, I have no cancer but I have had urinary difficulty for years...especially in recent years. I had to determine that bp meds (I was taking Losartan before bed) can aggravate BPH for their diuretic characteristics. NOW WHY THE HELL DIDN 'T THE URO KNOW THAT?? It's as if you have to read your own chart and then escape to the web or a web site like this one to get the straight scoop on your own well being.

    Too mechanized, too one size fits all in their approach. If I were a young doc, I'd take great pride in getting it right -- for the patients peace of mind and body.

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    • Posted

      P.S. I now take Losartan at breakfast. HUGE difference. That...and compression socks during the day. Both "techniques" learned about on the web. The uro is either clueless...or, at my next appointment, about to learn that he had better start sharing ALL of what he should have learned in med school.

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    • Posted

      Losartan is not a diuretic. It is for blood pressure. I take both Losartan and Hydrochlorazide for urination.

      The older one gets the more comfortable one feels with either male or female practitioners, most of whom have never had BPH and are not much aware of the patient's suffering.

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    • Posted

      With rare exceptions, the "care" is gone out of health care. I didn't realize that the AMA limits the number of physician graduates every year in the U.S., presumably to keep their money and status unchallenged.

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    • Posted

      Technically, yes, not a diuretic. But diuretic effect just the same. I am not allowed to post web articles here, but if you google the subject you will see that losartan enhances urinary frequency.

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  • Posted

    i had urinary problems from around 50 years old . The first Uro i saw felt my prostate and was convinced i had prostate cancer and just announced it to me without any other tests being done at that point . It put me in a very bad state mentally until several weeks passed and a biopsy confirmed prostatitis . in my opinion cancer should not be suggested without real evidence . Anxiety can make your overall health worse including prostatitis .

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    • Posted

      Not that I was there -- but perhaps he mentioned the word "cancer" in the overall conversation and you assumed the worst? Indeed, brain needs to be engaged more often if you're an MD. They often either say too little...or too much .

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  • Posted

    I've had several cystoscopies and a PAE. For each cystoscopy they had me in twilight before starting the procedure. I don't recall ever having pain or discomfort. My first one was 40 years ago and they were able to make it painless even then.

    With my PAE they got as far as opening my paper gown before I fell asleep. Last thing I remember is two cute young nurses looking at my bishop, putting a towel over it and saying 'there, thats a little more modest'. But I was drifting away, thinking that it was ok for them to look. If they found it interesting all the better. (note: I'm a pretty modest guy but at that moment)

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    • Posted

      Second time around, I asked for "twilight" but was essentially told it was not necessary. I will never again have a cystoscopy unless equipped with a chemically-induced no-pain smile on my face.

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  • Posted

    BobbyT:

    Ostrich’s don’t bury their head in the sand but the AMA has their head buried so deep in the sand on the issue of male dignity that an earthquake measuring 10.0 on the Richter scale couldn’t shake it loose.

    It’s time they un-bury their heads and join the human race. Men are human beings first, patients second.

    Regards,

    Raffie

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  • Posted

    I have had a couple dozen cystoscopies as follow-up for bladder cancer. None have been painful at all. My complaint is that virtually no urologists ever hire any male staff. It doesn't matter how polite or well trained the female staff are, it is still an assault on my dignity. To those females who work in healthcare who say they are professionals and gender shouldn't matter I say male mammographers would be just as polite and just as well trained as female mammographers but I doubt many of those female nurses, doctors etc would ever allow a man to do their mammogram. There is nothing about a mammogram that can be considered any more intimate than a male's cystoscopy, so why same gender for women but not men?

    For all those many cystoscopies there has never been any extra people in the room nor intrusions into the room for any reason once I am exposed, nor have any of the nurses doing the prep ever done anything overtly wrong, but I did leave that practice a couple cystoscopies ago when I found a urologist in a large practice that has a couple male nurses. So yes, staff gender does matter.

    Under no circumstances will I tolerate any extra people in the room with my express consent. For example, I did not allow a female scribe and female LPN to be in the room when I had a full skin exam. Men need to understand that they can speak up.

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