Lack of NHS consultants Urologists in UK to treat NHS patients.
Posted , 11 users are following.
I have had BHP for twelve years and have been taking tamulosin and Dutasterided individually and now both together. during the last 12 months my condition has got worse and getting up 5 or 6 times a night is almost the norm now. I saw a consultant and had MRI images and psa 4.4 and was told he would put me forward for green light surgery. After 6 weeks I saw the consultant who does the laser and he treated me like someone who had just started with BPH and not taken any notice of the investigating consultant who said I was suitable for laser treatment. He put me on Noqdirna at night to stop p roducing urine at night { treating a symtom and not the cause} and then said come back in 6 weeks for more tests. A few weeks later I complained to the first consultant who said he would speak with the 'stalling' consultant and said he would let me know the outcome. THey didnt get back to me but instead a few weeks later got another referral for a third consultant. At this point I told the urologist department I didnt want anything to do with them and am now trying to get referred elsewhere.
I would suggest too many Urologists are favouring private patients at the expense of
NHS patients and its a bloody disgrace. These people are trained and paid for by tax paying citizens and if they want to do private work they should fund their own training and not use NHS facilities. It makes my blood boil. And, I dont agree with the people who say that private patients help pay for the NHS. No it doesn't it mainly rewards private patients and the consultants and nurses., It's a nice little earner for them but they should not be allowed to practise in NHS hospitals at all.
Does anyone else think the same or is it just my local hospital which is in south Yorkshire? Can any recommend a consultate in South or West Yorkshire who treats BHP patients reasonable quickly on the NHS.
I note there is a nation prostate cancer uk association and I think there should be the same for the endemic BHP problem as well.
1 like, 35 replies
Grunthos breeze61
Posted
Hi breeze,
I'ts familiar to me. I was referred to the urology department at the Lister Hospital in Stevenage (East and North Herts NHS Trust) in September 2016 after taking tamsulosin for over five years. I had a cystoscopy within a month (3rd Oct 2016) but since then two thirds of four fifth of sod all has happened in the way of progress. I had a flow test one week later (10th Oct 2016) then a Urodynamics procedure which left me with a urinary tract infection, which took five weeks to clear up, on 15th June 2017. I had another flow test on 28th October 2017 and the "consultant" then wrote to my GP asking him to put me on Noqdirna (under-the-tongue desmopressin) until my next appointment in March 2018. I'm going round in circles!
breeze61 Grunthos
Posted
Grunthos, It makes one wonder if the NHS accountants and some consultants are using delay tactics on purpose to force us to take out loans to pay for private treatment. One of the main problems is that the same operating theatres are used for a multitude of different uses within a hospital and thus consultants only get use of the op theatre for short periods of time. That's why I say that centres of excellence should be set up through out the country.. The long and short of it is that the NHS is extremely inefficient and wasteful and the end result is choas and provides a system that is generally v good for private patients and not for anyone else. Some parts of the NHS are good in more main stream disciplines but us older men are being put out to seed.
derek76 breeze61
Posted
I then wrote a letter of complaint to the head of urology. Two days later I had a phone call where he started shouting down the phone. He then found that I could shout louder than him:-)
Supertractorman breeze61
Posted
In this area they are intending to use one Hospital for all elective surgery in order to make better use of Operating Theatres to save interruption of emergency patients causing chaos to lists which sounds good. Unfortunately there is uproar in the community as they will be losing some / all A&E facilities at this hospital in order that they can concentrate them elsewhere, and people are concerned about having to travel further. Can they win ?.
Grunthos derek76
Posted
Hi derek,
I have to agree with you about ageism in any urology department. The doctors all seem to think that if you're over fifty you don't need a sex life. All the medication from Tamsulosin, Finasteride, Dutasteride etc render you infertile either by causing retrograde ejaculation (Tamsulosin) or partial chemical castration (Finasteride & Dutasteride).
derek76 Grunthos
Posted
I did not take Finasteride for long as I was growing breasts. Tamsulosin, the nurse at our surgery said is the most complained about drug. By men I said. No by their wife's she answered.
I did not take that for long either
breeze61
Posted
There are still some altruistic consultants around but the accountants are ruling the show.
The majority of the working classes have paid into it all their working life only to be fobbed off in older age when the need the system most.
derek76 breeze61
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Supertractorman derek76
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You are right there Derek, that is why I am paying Private next week for Implants as I cannot keep the NHS dentures in my mouth and my teeth don't even meet now to chew.
derek76 Supertractorman
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We had previously been spoilt as when we lived in Scotland the practice we went to believed in the NHS and did all necessary treatments that they subsidised by doing cosmetic dentistry.
Did you consider going abroad for your implants ? A friend went to Hungary at a fraction of the UK price. He had an initial appointment in London and then two visits to Budapest for the treatment. His UK dentist was surprised at the quality of the work. The Company is called Smiles.
Supertractorman breeze61
Posted
I did look at treatment abroad, but with my other problems ruled it out in case of health problems, plus almost all were only giving warranty if you went back to them on a regular basis for check ups which I reckoned could start to be expensive in travel costs. The practices advertising made them look of high standards but I did wonder if you could be blacklisted if you had a problem back here in later years. Was concerned by one Dentist who quoted to do the work here and wanted £500 spent with their Hygienist as my teeth were in such a bad state that I would need injections to have my teeth cleaned !. A visit to another Dentist and there Hygienist said " If everyone kept their mouth to your standard I would be out of work ". Dentistry is very much down to trust, and the Dentist I have chosen for the work also lectures at Dental sections of Universities and only does implants now, but also has registration to carry out sedation etc., so must work to a good standard.
derek76 Supertractorman
Posted
My friend did not have to go back there for his check-ups. His first visit included travel and hotel costs for his wife. I expect she could have gone with him the next time but she had work commitments. On his second visit they gave him an apartment for the week he was there.
I can't imagine £500 of hygiene treatment. I was told last week by the hygienist that my teeth are in excellent condition for my age (83) They would have been in a much better state were it not for an Irish dentist in London who said when I was 20 that I should have everything needed doing before I was 21 and had to pay for treatment. She promptly filled fourteen teeth. I will always remember Miss Cleary on Wandsworth Hill.
barrie62598 breeze61
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Life expectancy keeps rising and most men will suffer BPH or PCa if they live long enough. This creates a greater Budget problem year by year. Urologists and Politicians are as trustworthy as one another and both have an influence on how we are treated. 5ARI drugs are supposed to “MOSTLY” REDUCE PROSTATE SIZE. Ponder on what ELSE they do when they DON’T.
I was treated for Benign Prostate Hyperplasia/Hypertrophy (BPH) since 1990. In 2006 I was prescribed Alpha-blockers (Flomaxtra then Prazosin) 4mg a day. They still left some voiding difficulty and overnight necessities. Bladder capacity was shrinking. There was no consideration of the impact 9 years of Alpha altering of bladder neck/urethra muscles and nerves might have if a prostatectomy were to follow. I did not know that since 1995 urologists had known Prazosin would need an increase in its 4mg dosage beyond 2 years. By 2015 still no one had bothered to do the research. Pharmaceutical companies do all the research and they don’t if there’s no billion dollar benefit in it for them. In 2013 when I advised that Prazosin was becoming less effective and requested an increase to 6mg a day a 5ARI drug was prescribed March 2013 to March 2014. Gleason Score 3+4=7 and Open Radical Prostatectomy followed in November 2015(at 72 years). A long and hard partial recovery and so far 2 years of incontinence followed. An emergency hospital botched blockage treatment then causing possible permanent bladder neck damage and months of self catheterising. My 25 years of PSAs never went above 3.8 (Apl 2009) and it was 2.41 (f/t38%) in July 2015 long after 5ARI affect on IT had ceased.
My 5ARI contained the active ingredients Dutasteride and Tamsulosin Hydrochloride (Flomaxtra). Dutasteride manipulates testosterone, altering prostate cell structure to mostly reduce prostate size. I was told side effects could include headaches and dizziness as well as affect sexual stimulation and ejaculation. There was no mention of the possibility of initiating high grade Prostate Cancer (PCa). This was a factor in the drug’s pre-release trials but Prostate Cancer is still not listed as a “side effect” in Australia.
The drug’s Australian supplier has since reported 5 de-identified suspected Adverse Drug Reaction (ADR) of PCa to our Therapeutic Goods Administration’s (TGA) Database of Adverse Events Notifications (DAEN). Reports omit age, other medications and Gleason Score. This makes the supplier’s nominated submission date the only identifying factor. Their 5 could be just the “tip of the iceberg”. The number of this drug’s Australian users would be vast so to come up with just 5 they would have to have some way of isolating Cancers suspected of being caused by the drug and those that were not.
The drug supplier says the drug reduces the risk of low-grade PCa and allays a risk of increased high-grade cancer as pre-release study design. The trials did prove a high percentage of men taking the drug would progress to PCa even if the drug was not complicent. Drug suppliers are bound to report “serious” adverse events. To do this they must have feedback which could only come from Urologists or patients. My suspect adverse PCa reaction failed to reach the DAEN via the company even though they told me they had created a report for it. It seems they breached their legal responsibility yet our government does not care.
I believe men in the USA have an opportunity to make their “risk vs benefits” decisions after evaluating this risk. The only way Australian men could learn of the drug companies own 5 suspected cases would be to access the DAEN then write to TGA.
Barrie Heslop
derek76 barrie62598
Posted
I refused TURP in 1995 and stuck it out until GL PVP got to the UK around 2004. Prior to them there was holmium Laser that I rejected and Gyrus Laser that I would have accepted but few hospitals did. One surgeon in England had done over a thousand by that time. And it was being done at a Scottish hospital in Ayr but the waiting time was over a year.
As soon as trials started for GL PVP I applied to get one and was accepted but it took about six months after being accepted before the area health authority in Scotland agreed to fund it over the border in England.
breeze61 barrie62598
Posted
Hi Barrie, You have certainly been through the mill. I dont think anyone knows or documents the long term effects of taking the two main type of pills. And of course the people making the decisions on our behalf can all get the best treatments with their all inclusive health plans so can get an op quickly and not need the pills. I remember when green laser first came out in UK , some 10 years ago and lo and behold that top man Peter Mandleson got his green laser on the NHS. I bet he didnt have to take the pills for years or do endless tests p*****g into flow meters and the like. The majority of men are between a rock and a hard place., take the pills with unknown end effects of pay a not so small sum to get the better of the ops going off at the time.
I was reading about Rezum last night on this sight and I was impressed with the simplicity and supposedly good results with out backwords ejeculation or incontenance. It seems to be too good to be true and is as far as I know is only being practised in London and Hamshire. It's being going for two years in USA in a few places and looks good going forward. It's so simple to perform that the private price should be within the reach of a lot of men. I certainly would pay £3000 to get it done but no doubt the prices would be bumped up in rip off UK. I just hope it will turn out to be as good as present reports say and that it will be rolled out quickly within the UK and Europe because at the moment it looks like the answer to all my prayers. No doubt something will turn up to spoil the party.
Most readers on here will probably know about Rezum already but I just found out about it last night.
derek76 breeze61
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breeze61 derek76
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barrie62598 derek76
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I unfortunately blindly followed GP and Urologist’s directions all the way. Had I previously done the hundreds of hours post-PCa surgery research my treatments would have been different. We trust Urologists much more than we should. The Australian government favours cheaper medication treatment of BPH over more costly TURPs. There was no mention by GP or Urologists of the other, better procedures I now find about.
The Australian government favoured useless ultrasound guided biopsies for fluctuating PSA treatment. Along the way I had a 6 hit negative biopsy. My Urologist simply said “some people just have fluctuating PSA’s”. My eventual PCa was identified by MRI suggested by GP over Urologist’s “keep monitoring via PSA”. It located 2 suspect cancers and a 20 hit biopsy confirmed these as 3+4=7 PCa. The other 18 were again clear. My choice for RP on a 3+4 is now a concern for me. The last 2 years have not been worth living and for much of it I was incapacitated. I ponder what radiation/hormone treatment might have left me with.
An article questioning Dutasteride’s capacity to cause PCa led me to many hours of research. I became concerned when I learned the pharmaceutical manufacturer/sponsor of my Dutasteride product had reported 5 suspect PCas attributed to the drug to our Therapeutic Goods Administration’s (TGA) Database of Adverse Event Notifications (DAEN). There was no mention of age, other medications or Gleason Score. They could have been anybody. The company told me they reported mine, which TGA says they were legally bound to do, but submission dates appear to suggest they did not. Again no one cares about this
I have written or emailed hundreds of Departments, Ministers, MPs, Senators, Urologists etc. attempting to get PCa listed as a “side effect” in the products consumer information. The Commonwealth Ombudsman says only adverse effects detected in pre-release trials are eligible for consumer’s knowledge. Subsequent adversities suspected by the manufacturer are supposed to be hidden. Urologists then don’t have to inform their patients of this serious cancer risk. The Health Department/Minister says people prescribed Dutasteride should read the 4 page CMI, the 26 page PI and research the DAEN. If they did all this they still would not know the most important issue. That the pharmaceutical supplier suspects Dutasteride causes PCa. No one else has a real opinion. I now have a new GP and a new Urologist and I endeavour to believe nothing they tell or recommend without a lot of research. It’s a pity this has to be so as like our politicians and financial advisors we should be able to believe what our healthcare professionals tell us. We are paying their substantial wages.
Barrie 62598
breeze61 barrie62598
Posted
Barrie,
Same old, same old, fed on mushrooms and kept in the dark. It's so sad but there it is.