Confused completely after second uro appointment with conflicting info.. what would you do?

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Had uro appointment .. she booked MRI (on my insistence on a non-invasive test first) and a second PSA test .. now she said that my prostate "has lobes"  but my previous understanding is that lobes cannot be felt by rectal finger exam  (is this right?) . .

Did research..my hospital MRI only 1.5T resolution at best, not 3T .. so should I look for other hospitals?

oddly, my uro now says i could have cancer and now she is suggesting a biopsy (painful) whereas in her first rectal exam, she said "no nodules, no cancer"

..also earlier she said my PSA then at 13 was NOT "elevated" because at the time i suffered urinary wounding, cathing, and Cipro antibiotics;  at that first appointment, she said that only a 40 pt. PSA reading would be  "of concern" --  that's just 10 days ago...

so, I'm confused by her sudden turn around.

also, at the end of the appointment, she asked if I wanted to have her remove my Foley today.  i said, 'no thanks' because i've only had 4 days of peace;  last Friday, I was on my way to ER because of bloody in the urine returned and I couldn't pee despite the new Foley -- luckily the rough ride thru potholes evidently released the logjam in my bladder/Foley, and the new urine didn't have blood or blood clots any longer

Did some online research on ultrasound imaging for prostate cancer/size/lobes.  There are new articles and studies proclaiming, "We're (the ultrasounders) back in business" - new types of sonography with Doppler, etc etc.  however, i suggested this three times today, but my uro was completely unresponsive - if you've had the new ultrasound imagers, which appear to be less invasive than 3T or 1.5T MRI, what were your results?

what would you do, in my shoes?

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  • Posted

    Bob  I am sorry that you are having a problem.  I think she is jumping around to much .  For your own safety I would go get a second opinion before you have any biopsy.  The prostate is made up of lobes.  Just be careful Take care  Ken
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    • Posted

      Just heard from a relative who administers a clinic in another jurisdiction in Canada.  She says that "second opinions" are forbidden.  What the patient sees is an apparent "brush off" or "no appointment made".  Reason?  Government budgets.

      I was also told to "go MRI" only, and forget the ultrasound test.  That's not what I want to do.  So, we'll see, if there's a work-around.

      I already asked my uro for the paperwork for the private ultrasound test.  Haven't heard any reply.

      What would you do?

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    • Posted

      To me that does not sound right.  You should be able to get a second opinion.  That should be your right if you don't agree.  I would keep going and keep asking.  Good luck  Ken

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    • Posted

      Thanks, Ken.

      Last night, I used a diagnostic website.  Apprently, what I have is called Sudden Onset Urinary Retention - 8 or more causes, and an enlarged prostate is just one.

      Visited a Chinese chronic disease hospital site.  It also listed many causes.  This hospital uses ultrasound not MRI.

      Also found a very revealing NCBI - PMC (shows NIH at the top left) titled, Various treatment options for benign prostatic hyperplasia: A current update

       

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  • Posted

    Hi Bob:

    For your own peace of mind, get a second opinion and maybe a new urologist as she doesn't seem to be able to make up her mind on her own diagnosis.

    The difference between the 3T and 1.5T MRI is the strength of the magnets which equates back to better pictures. The 3T has stronger magnets in it than the 1.5T machine therefore you'll get a picture with more detail on a 3T machine.

    Regards,

    Raffie

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  • Posted

    Hi - do you have the actual MRI report?
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  • Posted

    Personally, I would seek another opinion. The 'lobe' comment may be referring to what is commonly referred to as a middle lobe, which occurs in some men when the prostate is enlarged and a portion of it on the 'top' extends towards the bladder. Ultrasound and MRI are two very different devices using different technology and used for different diagnostics. 

    Depending on the area of the country you are in, if you want a 3T MRI with contrast performed by one of the radiologists that specialize in prostate cancer diagnostics and treatments, consider seeing Dr. Karamanian in Houston TX or Dr Busch in Chattanooga, TN. There are others, but those are just the two I have personally seen. I am going back for my 7th MRI mid Oct. If you want any other details, send me a personal message (click on my userID). I will be glad to help you anyway I can.

    -Tim

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  • Posted

    Sounds like second opinion time. Heard this story before. She's gonna try to cut on you next. I wouldn't let her do a thing til you get some solid test results, consistent test results, ALL your questions answered. Avoiding your questions , in my opinion and experience, is a doctor either guessing or lying. Either way you don't need more issues. She's gonna do a MRI that is inconclusive and use it to treat you? Why? She won't know any more after it then she does now.

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  • Posted

    Tell her to go back to school and go to another hospital E/R.
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