How many of you who had a BPH procedure, had a cystoscopy firts?

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It is becoming increasingly clearer to me, that the procedure solution you are given is limited by which of the range of solutions (TURP, Rezum, HoLEP, FLA, PAE, Aquaablation, etc) your urologist performs. If they don't perform it they don't recommend it and sometimes don't even tell you that other options exist.

I have been frustrated by the lack of a consistent recommendation for me and the fact that they are making their recommendations without ever doing a cystoscopy or a 3D-MRI. How can they recommend a solution when they haven't even seen what the actual condition is inside my urethra and at the median lobe of my prostate.

Am I wrong to expect that they should want to know that before they recommend a solution? How many of you who have had a corrective procedure were offerred a cystoscopy or 3D-MRI first. If not, why not?

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  • Posted

    i had a cysto and rectal us before Rezum.

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  • Posted

    but you're right.... each doc recommends what they know, and there are so many possible interventions that it is truly mind boggling to try and figure out which one is right.

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  • Posted

    My urologist said THAT nothing can help me cause the prostate is not big enough for any procedure but I still have to pee so often that it is frustating

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  • Posted

    I was recommended TURP and Urolift by 2 separate uros without any tests other than a kidney scan that indicated that I had mild urinary retention. Luckily I learnt much from this forum so I declined both. Hank

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  • Posted

    Sadly my experience shows your comments are correct, all I was given(in our free public heath system) was a brief discussion, offered the finger inspection, had a few more discussions much to their disgust given thier busy schedual and told to take drugs until it got to the stage of turp surgery,I managed to talk them into an ultra sound which immediatly found an enlarged median lobe, I asked for a cystoscopy but was declined, I kept on trying until they finally did one but the urologist (who was going to do the surgery)rammed it in hard and fast without allowing sufficient time for the desensitizing cream to have affect and made me scream louder than ever before! he did not comment much on the result just that I needed turp, he said in his anger I will become incontinent and later admitted they do not know if after turp on a median lobe if the lower prostate valve will hold urine because it depends on the person. anyway very fortunately I found out about FLA in Houston Texas Dr K asked me to get a 3Tesla mp MRI so I paid for it he then did FLA whcih does not operate through the penis urethra but uses a tiny 1mm very accurate laser through the rectum so no injuries through the front and just a few drops of blood after the proceedure,done while you are in an MRI machine so they can see exactly where they are with absolute precision and simply deaden unnecessary median lobe tissue without harm to anything else it was painless during and after with excellent results and no harm to anything important it makes turp look barbarick to say the least! yes it was expensive but well worth it!

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  • Posted

    I had a cystoscopy before my PAE.

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  • Posted

    I had a cystoscopy - under general anesthetic - a bad experience , but necessary to look for cancer , kidney stones etc - this was done by urologist Dr.Mike Nicholls

    Then I had an MRI or CAT scan to see the blood vessels in my PG

    Then I had a PAE - it works very well, was done without an general anesthetic and has been effective (after about 8 months)

    I live in South Africa - it was done by radiologist Dr Gareth Bydewell

    Both Dr s are very professional and I am more than happy with the outcome

    Ciao

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  • Posted

    I had a cystoscopy - under general anesthetic - a bad experience , but necessary to look for cancer , kidney stones etc - this was done by urologist Dr.Mike Nicholls

    Then I had an MRI or CAT scan to see the blood vessels in my PG

    Then I had a PAE - it works very well, was done without an general anesthetic and has been effective (after about 8 months)

    I live in South Africa - it was done by radiologist Dr Gareth Bydewell

    Both Dr s are very professional and I am more than happy with the outcome

    Ciao

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  • Posted

    I had a cystoscopy - under general anesthetic - a bad experience , but necessary to look for cancer , kidney stones etc - this was done by urologist Dr.Mike Nicholls

    Then I had an MRI or CAT scan to see the blood vessels in my PG

    Then I had a PAE - it works very well, was done without an general anesthetic and has been effective (after about 8 months)

    I live in South Africa - it was done by radiologist Dr Gareth Bydewell

    Both Dr s are very professional and I am more than happy with the outcome

    Ciao

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  • Posted

    Perhaps I am lucky, but have had two cystoscopies ... I discussed the possibility of a Urolift with my Urologist and he said he would have to assess my viability for the procedure by doing a csytoscopy first...

    I go in on Friday for a Urolift... really hopeful it is going to relieve some of my symptoms

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  • Posted

    yes, each urologist will recommend the procedure he/she is most familiar with. I read a lot before taking a decision. My first uro even said, that I should have studied to become a doctor. Luckily I found a professional who cared and knew the right solution.

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  • Posted

    In Australia BPH isn’t taken as serious as in UK & US. From my many observations we appear to be only offered Alpha Blockers and Dutasteride or TURPs for BPH. I was treated for BPH since 1990(age 47). I was then scheduled for a biopsy from a shadowy Ultrasound (U/S) before they decided U/Ss were useless for PCa detection. Alphas were prescribed in 2006 and Dutasteride was added in 2013/14, 3+4 PCa and Open RP in 2015 (age 72). All the other BPH options I see on this site are not even mentioned here. My GP consultations and 5 minute Urology visits included a few DREs. I had a cystoscopy a short while after my RP to check for sphincter damage after botched blockage treatment at an Emergency Hospital. No Urologist was on duty and they didn’t want the expense of a call-out. Here Medicare is funded from an extra tax levy but private cover is necessary at some $5,000 pa per couple. These cover about half many costs but the $500m MRI that detected my cancer rebated nothing and the $611 biopsy refunded $311. I paid $781 towards RP Anaesthesia. If I had wanted RARP or other more advanced surgery I would have had to fund it all myself I believe. So for prostates you’re better off where you are I think.

    Barrie

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  • Posted

    I had my UroLift 8 weeks ago and had a Cysto, Pelvic st scan, and Kidney ultra sound prior to his recommendation

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    • Posted

      Billy: Are these things that they did when you went in for a pre-op appointment? My Uro did not mention doing a cystoscopy. The only appointment I had at this clinic where I saw him only involved a DRE and a very short consultation. He scheduled me for GL surgery in 3 weeks with a preop appointment in 2 weeks. He sent me home with a Green Light booklet and DVD to watch. Now 1 1/2 years later I still wonder if he was going to do some other procedures during the preop. It sure looked to me like he had already decided to use the GL laser on me before any other tests but I guess I'll never know.

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    • Posted

      Keith, at my first appointment with URO he scheduled me for a Cysto, that was to determine if I was a candidate for the Urolift. Then prior to the procedure I had the Ct scan and kidney ultrasound to be sure there were no stones. Bottom line the Urolift did NOT fix my problem as I have a uti as we speak and that is 8 weeks post surgery so I know it wasn't from the surgery. I go back in Jan and go from there. He agrees on a complete bladder work up. I don't think BPH has ever been my problem with recurring utis (prostatitis) as my retention is always 20-30 cc and has been almost 0. I believe it is bladder related. He did mention TURP but that ain't gonna happen. Bottom line is, why did he do the procedure with my minimal retention?!...........Billy

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