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 smile 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 smile ) . 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

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  • Posted

    Hank there is no perfect test, no damn perfect surgery, if I had listened to half these know it all here some, I would be totally screwed, of course my Turp was a toughie, I had a huge prostate, I have suffered for many many years, locking up using cold meds, did not know back then, getting up all nite having to pee, always having to know where the bathroom was every place I went, look listen to a specialist, ask a lot of questions, some procedures are short term fixes, my dr has preformed all of the procedures that are out there, he says thousands , he told me flat out, we can try this or that but you have had and have a huge prostate for years, if I preform Turp on you I guarantee it to not retry another procedure in my lifetime, it gives my patients the best results, now look do as your please, you mirth not need anything yet but meds and a change of lifestyle like what you eat and drink, and when you drink, how long before bed yada, so listen to your dr ad make a decision not from forms, but informed
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    • Posted

      Thanks John for the advice. You are lucky to find a good doctor for your situation. I am not lucky so far so I am still looking. In the mean time I am taking meds and I already have a very healthy lifestyle. Hank

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    • Posted

      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 

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    • Posted

      I live in San Diego, US. I am in almost perfect health. smile Good lifestyle. No bad habits. The only problem is either bladder bad or prostate bad, or both. Hank

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  • Posted

    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

     

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    • Posted

      Hi Rick, I am in the US and my medical group is UCSD in San Diego, not a small outfit. I wonder if they are falling behind or my uros are just snowing me. Hank
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    • Posted

      I am not sure how much bad information you have from your group but since any cystoscopy puts a camera into your bladder, I find what you are saying you were told by your urologist suspect.  Dump them!
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    • Posted

      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

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    • Posted

      Thanks Rich, I did not have the feeling that this uro is rushing at all. In fact, he lingered and chatted with me for a long time, which I appreciated. And the fact that he booked me (without my knowledge, BTW) for a procedure (urolift I guess) 2 weeks after means he is not that busy. 

      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

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  • Posted

    You can sure pick your urologists :-)

    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.

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    • Posted

      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

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    • Posted

      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. .  

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    • Posted

      I had AF after heart surgery but was back in NSR for 15 months after cardioversion and then had a colonoscopy that stimulated my vagal nerve and put me back into AF.  The next cardioversion put me back in NSR until over a year later when I had the DRE.
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