My disappointing Urologist visit.
Posted , 19 users are following.
Last year, I went to see a urologist for the first time after a kidney scan revealed that I was retaining urine. At the uro office, a catheter was used by a nurse to measure the retention and it was 250ml.
My uro walked in, and he immediately offered TURP, no exam, no test. I told him I'll think about it. He gave me a DRE, told me he felt a nodule, and suggested biopsy. Again, I told him I'll think about it. He told me to come back every 3 months. I left, and never came back.
This year, arming with an incredible amount of knowledge 
accumulated from this forum mainly, I went to see another uro, from the same medical group. This time I know what to ask for: my prostate nodule, more information on my prostate, especially my prostate size, whether or not it has a median lobe, and an MRI.
Nodule: After performing DRE, he said that he can not be sure that there was a nodule, maybe it's just felt a little tighter than normal. (Maybe it just went away, I hope ) . After looking through my PSA history, he said that if he were I, he would not worry about it. Which I consider a good news.
MRI: I then asked for an order for a 3T MRI, for my BPH as well as cancer diagnosis. His answer was not how it works. You can only get an MRI if you go to Cancer Center and only there, they will decide whether or not to give you a biopsy or a MRI-assisted biopsy. I told him my friends told me you can have an MRI without a biopsy. He said "your friends don't know what they are talking about."
Prostate size: He then offered me a Urolift. He already knew I don't like TURP because of too much bleeding. I told him I'd like to know my prostate size. He said the only way is through a prostate scan. I asked if I can have one. He said you can have one when I do the Urolift.
Median lobe: I asked if I have a median lobe. His answer is you can find out only by having a camera in your bladder, and you can only have it if you have a Urolift.
Overall, it was a dissappointing visit. It seems like I can not get the information to make informed decisions on selecting a good procedure, without subjecting myself in one of the procedures first.
Is it similar to what happened to you ?
Hank
1 like, 97 replies
john15876 hank1953
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hank1953 john15876
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john15876 hank1953
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Where do you live? Heath in lifestyle is very important weight yada good food exercise, keep looking for a good dr, you sure as hell don't want to suffer the hell i have caused myself by not listening to my dr no going to the Dr An not taking my meds I paid s very high price for being a scary cat not anymore I have had three major surgeries An have learned my lesson on follow through keep taking your meds hope all works out for u sounds like you are doing tie right things
derek76 hank1953
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hank1953 john15876
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richp21 hank1953
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Boy, sounds like you should find another medical group. Are you in the US? I had just a 3T MRI and there are several other men on this forum who have had that also. In my case I opted for a follow up biopsy as my PIRADS score was 4/5, but if the MRI had come back clean, I would not have had a biospy. And I have gotten prostate size measurements from the MRI and from and Ulstrasound without dosing any procedures. I'm kind of shocked at what the uros you saw are telling you.
Rich
hank1953 richp21
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glenn54030 hank1953
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hank1953 glenn54030
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richp21 hank1953
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I don't have an explanation for their opinions, but if it was me I'd just say '"don't bother to get up, l'll show myself out".
I've had similar experiences with docs and uro docs in particular, where I've gotten advice that would have been potentially extremely harmful. I suspect that some of the reason is due the pressure of having to see too many patients in too short a time. One uro doc even told me that after his group was purchased by a larger group, he was then scheduled for 10 mns with each patient. Incredible! And when he investigated starting a smaller group on his own, the insurance reimbursements would have killed him. The other reason is that uros may have spent years and decades learning and performing one or two procedures, and are only passingly familiar with the many other procedures, so when you have a hammer, everything starts to look like a nail. Whatever the reason or reasons, this is our health and our bodies. In my opinion, it's up to us to thoroughly research all our options and to use uro docs as resources and helpers, but not necessarily experts with the final word.
Rich
hank1953 richp21
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I have a feeling they are pushing us for procedures so they can make money. I am glad I am informed so I will not be pushed. Hank
nealpros hank1953
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Neal
derek76 hank1953
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Any competent GP can tell your prostate size by doing a DRE. A cystoscopy would show if there is a nodule.
All prostates have a median lobe.
The median lobe is found just posterior to the urethra along the midline of the prostate. The median lobe contains the ejaculatory ducts of the prostate. The posterior lobe forms a thin layer of tissue posterior to the median lobe and the lateral lobes.
hank1953 derek76
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Thanks Derek. I asked my URO about the size. He said "Without an ultrasound, all I can say is that it is not large."
About the nodule, it was felt during a DRE, which means it on the outsside of the prostate (actual note: right lateral lobe). I don't see how you can see it from a cystoscopy, which would look at the inside).
Median lobe: Perhaps I should use a more correct term :"large median lobe". I am referring to the part of the prostate that is protruding into the bladder neck.
Hank
derek76 hank1953
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At the last cystoscopy I had two years ago the Uro said that I had a nodule on my median lobe and pointed it out to me on the screen.
Every DRE I've had over the years whether by a GP, Uro or urology nurse has been accurate and confirmed by a TRUSS or Cystoscopy later. The last DRE stimulated my vagal nerve and put me into AF. .
zdzislaw derek76
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derek76 zdzislaw
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