Dismissed by urologist after he learned I had had a PAE and an FLA

Posted , 13 users are following.

So I am coming up on 2 years post FlA and 3 years post PAE? Neither of which done me me much if any good. Several months after the FlA I developed retro grade ejaculation, as well as difficulty maintaining erections.

I had another 3 T MRI performed and ordered by DR K earlier this year. DR Busch so no signs of cancer, and other than the large median lobe he saw no major obstructions.

When I ejaculate, or try to,it feels like there is a blockage of some type in the urethra. And the same feeling when I try to start my stream, which is very weak.

SO I read about a new urologist at TN Valley urology, who performs rezum. I thought well he is young and progressive and will st least be open minded.

I took all of my MRI results with me for him to,review, as well as other tests I had done. Also,when I scheduled the appointment I specifically stated I wanted a cystoscopy.

After listening to me for less than 5 minutes, and No physical exam at all, he stated I have no way of know what sort of laser was used in you, and most likely the nerve bundles were damaged. I told him DR Karamanian assures me he didnt get anywhere near the nerves or ejaculatory ducts. He basically shrugged and said well apparently something went wrong.

So I asked again about the scope, and he said sure we can do one but the physiology of,your prostate has been changed and other than showing the median lobe its not going to,tell us anything. So I said well it feels to me like the blockage is in the urethra and not the prostate so I would,prefer to have one. He said well you will need to make another appt for that.

As we were walking out the door I asked if the rezum could not be used to remove the middle lobe and he just said no. You would need a turp for that.

So the bottom line is if you have some of these newer procedures NOT done by urologists you can forget ever getting any help from them for future problems. My take is if you have some of these other procedures, and have problems later, you are better off not to even tell the urologist you have had them done.

I left feeling totally let down, and money and time wasted.

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  • Posted

    Find another uro. This one is a quack. They can certainly deal with the median lobe with Rezum, but unless there is something else going on , you may be stuck with RE. Do you take any alpha blockers? They usually cause RE.

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    • Posted

      No sir no alpha blockers for me, could never tolerate the side effects. I will go to another uro for the scope tho. I left with zero confidence in this guy.

      Thanks for the reply.

      JOE

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  • Posted

    Joe,

    I had a similar experience with a uro post FLA. Mine didn't turn out the best so I went to the local uro to see about a rezum procedure, but he wouldn't consider it, because I had laser work done on the prostate by Dr K prior. He wanted to refer me to a teaching hospital for any further work. He discussed with his other colleagues, and that is what they thought was best. He wouldn't even discuss my case with Dr K after telling me in the office he would call him. Dr K was more than helpful through all this, and offered to discuss everything with the Uro.

    I don't think not telling the Uro you had work done on the prostate is the best approach though. They could possibly do more damage thinking they have to clean more tissue out with the Rezum or TURP.

    I get retro when I am on Flomax, but when I stop taking that, everything is fine. My FLA was almost three years ago now. Some days are better than others, nights are the worst. And my urethra does feel like it has so e blockage, FYI.

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  • Posted

    Joe,

    Many Uros will not recommend any procedure besides the one they do. This Uro probably only does Turp, so will only recommend Turp , and not Rezum, FLA, or PAE.

    Flomax will certain;y cause RE, if you are taking it. especially the 0.8 mg dose.

    Thomas

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    • Posted

      No Flomax for me, didnt help and caused retro.

      And this new guy has a billboard up advertising he now does Rezum in the office. That was what caught my attention, I thought well this guy is young and progressive....

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    • Posted

      Joe,

      .

      You really do not want to chose your urologist based on passing a billboard along the highway. You do want to carefully research and chose your urologist. If you are hasty in choosing your urologist, and the results of your BPH treatment are not good, then you only have yourself to blame...

      .

      I saw 3 urologists until I chose the one who did my Rezum and was highly recommended on a Patient.info forum.

      .

      Steve

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  • Posted

    Thanks Joe and Motoman. This confirms what I've read that urologists don't want to do procedures on patients with Lazer done on them already. FLA is a lazer procedure.

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  • Posted

    The last time I saw my Uro.. about 4 months ago, he wanted to do a TURP. It surprised me because when I first saw him over two years ago, he was all about Green Light Laser. Back then, he spent about 10 min. with me, did a DRE, and sent me away with a DVD & little pamphlet touting the wonders of GL. Also scheduled me for pre-op in two weeks. I wasn't considering seriously doing either one, so I didn't ask him why he advocated TURP now and apparently decided it was better for me than the GL. I wonder if they've secretly been getting bad results; or possibly he knew I didn't go for GL so he thought he'd try TURP on me.

    I've never had a cystoscopy. I pointed this out to the Dr. last time I saw him and he and the PA said that this Dr. had done thousands of surgeries and he can tell what I need just with the DRE. On this board, I hear about people doing all sorts of procedures such as an MRI to determine which procedure to have done. It's a pretty stark contrast to what he is telling me. The truth is probably somewhere in the middle.

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    • Posted

      OH WOW Keith I would not even consider ANY procedure without at the very least having a 3 T MRI . Sounds like your Doc is just fishing trying to see which bait he can get you to take,

      Get a second and even a 3rd opinion.

      thanks JOE

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  • Posted

    No it isn't. No one in their right mind would either do or consent any procedure based on a DRE - which by definition can't diagnose ANYTHING regarding BPH. it only measures the outside of a prostate in a very rough way and can't determine what, if anything is impeding flow or by how much. I had severe BPH (IPSS in the 30s) and a 30 Gm (normal) sized prostate.

    This guy sounds like an incompetent a-hole. Find a doc who does scopes, urodynamics tests and Rezum/Greenlight. If your only problem is a large median lobe, either procedure will fix it. But there's no way to diagnose that with a DRE which is an almost useless test.

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  • Posted

    Thanks y'all. That concurs with what I thought and I really appreciate the affirmation.

    I live in a very small community North of Boise in Idaho. Not exactly the bastion of high tech here. Boise's better but I think there may be a shortage of good doctors - unless they like to hunt or something - I don't know. Anyway, my GP from here sent me to a different doctor than the one that I was directed to, because the original one was too busy. And I can believe that he is because a lot of baby-boomers are that age now and for some time to come.

    Anyway, I don't know if the way they are treating me is because I just seem real typical to him??? He says that a TURP would "make me feel SO much better" and was, I thought, really trying to sell it to me. I only went in there because he has written my prescription for catheters and when I called them to change it to a coude tip, they insisted on seeing me first. The clinic voices to me that they are fine with my continuing to do cic but they act like an operation is painless, uncomplicated, piece of cake. I don't know how they can come on like that when they haven't done anymore than a sonigram and a DRE.

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