My disappointing Urologist visit.

There are a lot more urologists than Interventional Radiologists so PAE will always be more difficult to have done. I'm surprised at the attitude of John Hopkins. In the UK a urology nurse practitioner is now most likely the first person you will see. .

Hi Vig, I am interested in who ordered the MRI for you, and who paid for it. Hank

Inova Hospital in Alexandria, VA ordered the MRI for evaluation for a PAE procedure.  My insurance paid for it. (Medicare and supplimental)

I was surprised at Hopkins also.  They used to be considered tops for prostate and urology issues.  When I went there, there was only one other person in the waiting room.  It seemed like a ghost town.  Years ago - about 15 years ago, I had a prostate biopsy done there so I was already in the system.  The doctor I saw back then is no longer there.

He retired rich or with a bad back ??

Glenn, my uro would not give me a cystoscopy unless i have a Urolift with him. Hank

Right on, Bobby.  I couldn't switch docs fast enough.

Thanks Bobby. I think this problem of "money first, patients last" is more prominent in the US than in UK. I think some US doctors are allowed to charge and keep too much  money is the main cause.

I think I will change medical group. Hank

Yeah I did look it up. Trus can be used for estimating prostate size. But I doubt it that my uro will give me that. Hank 

I'm surprised that GL has not got to your country. It was even in Turkey before it was in most parts of the UK.

How long did it take you to achieve that kind of retention.   I am not close to that yet but am only 4 weeks on this side of the GL procedure.   Am still getting up 3 or 4 times a night and do not yet have normal 'wiggle' room after the urge.

What country? Are you in France? Because France has GL.

USA   We have Green Light   (GL)

Good to hear your good result. How long ago did you have TURP ? Hank

".. 4 weeks on this side of the GL procedure."

What do you mean ? Did you have GL 4 weeks ago ? Hank

I wish GL had stayed in Turkey, given my awful outcome.

glenn, did you have a bad experience with GL ? Please share. Thanks. Hank

Yes, I've posted about it before.  It was 18 months ago.  Total leakage afterwards.  Doctor did a cystoscopy 6 weeks afterwards, and it looked like a mass of tree roots in a river.  He sort of groaned and scheduled Gyrus Turp that was only 2 months after the GL.  New doctor found strictures that are very complex and right at the external sphincter.  I've seen a top specialist in CA, and repair would be risky and dicey.  So I continue to survive in either a diaper, heavy pad or a condom catheters and a collection bag strapped to the leg.   At this point, I've had a bunch of procedures, with four of them requiring anesthesia in the last 18 months.

Thanks for sharing, Glenn. I remember your post now. I am still following it. I did consider GL at one point but thanks to you and several others, I am now ruling it out. Hank

I would have GL any time it was needed in the future. Unfortunately Forums like this are populated by patients who had problems and it seems Uro's with limited experience and ones who look at cheaper options as the GL laser equipment and rods are expensive. TURP is cheap and profitable for them. 

All of these procedures (GL, TURP) access the prostate up through the penis, How does that not do irrepairable harm to the urethra?  Does the lining of the urethra just grow back?  Can anyone answer that question?  Is there actually any lining for the urethra or is there just a channel?  Does the prostate actually stick through the wall of the urethra or is it sort of bulging into the opening?  

The prostate suffers trauma during the procedure from the instruments and a lot of the post operative blood is from there as it soaks it up like a sponge.

Bulging I imagine. A growing prostate presses against all it touches.

You should go to Youtube and watch videos of the various procedures. There are hundred of them and very informative. Any procedure you are interested in you need only ask the equipment makers and they will either send you a DVD give you a link to download the procedure.   

Have you read this?https://patient.info/health/prostate-gland-enlargement

https://patient.info/health/prostate-gland-enlargement

 

"All of these procedures (GL, TURP) access the prostate up through the penis, How does that not do irrepairable harm to the urethra? .."

Good point Keith. It is one of the reasons I am interested in FLA, which is done via the rectum, if I remember it correctly. Less trauma to the urethra. Hank

Derek, if you still have GL after all the negative posts on this forum, you are a brave man. I am not however, and I don't believe in taking chances either. Hank

Read my posts. I had a GL in 2004 and it worked. When it regrew I had Thulium/Holmium laser in 2013 it worked. It is now the preferred NHS procedure due to it's quick recovery time

I can do nothing to convince people here that it is the failures you are reading about. Sore losers in more ways than one:-)

I really don't know why I continue to read this Forum

 

Derek,

..."sore losers...."

I have to disagree with you. The people that ended posting bad results on GL started out at the start full with optimism. I can feel their pain and anguish day by day, when things turned bad for them. It is why I believe them and I owe them for their stories.

"I really don't know why I continue to read this Forum"

Maybe you have nothing better to do. 😀 Or maybe deep down inside you want to help others, spreading your experience. You have 2 successful procedures. No wonder you are so confident. Some people are not that lucky.

Hank

Sore losers was meant to be tongue in cheek.

I can only say that America has a lot of incompetent urologists. If the procedure were so bad in your country of litigation you would have heard of law suits against the manufacturers and the surgeons.

Remember the longer people put off a procedure the less likely they will have a good outcome.

I waited ten years and was fortunate not to stretch my bladder or harm my kidneys while I was retaining 400 to 600 mls.

Look at the posters here and many having been putting of treatment for years and flitting from Uro to Uro looking for the answer they want and not trusting the advice given. I've posted here for four years and the same old names keep asking the same questions. All the surgeries work for the vast majority even TURP but not for everyone's range of symptoms. 

 

No, I haven't.  Thanks for the link.  Can't get too much information.

 

Remember that this is a British site although most of the posters are American so some of the advice is based on British/European medical practice. We think here that the American medical system is better and more efficient but on this forum at least it is not.

https://patient.info/doctor/genitourinary-history-and-examination-male

https://patient.info/health/prostate-gland-enlargement

 

it was in late May 2017

I am in Sri Lanka..a developing country

My TURP was done just 4 months ago

four months ago..

Aie!

Hey Derek,

I moved to Australia, and the medical expenses are pretty low because it is similar to UK medicine. The insurance and drug companies are always trying to make it like the USA.

The USA spends 2x as much per patient. That doesn't include the out of pocket expenses.

We have a system of evaluating drugs to see if they are just hundred dollar aspirins.

Here is an example. I had some Dipiridimol for an ocular migraine to keep it from progressing into a stroke. Here the prescription was 6 dollars. I went over the the US and the same prescription was 600 dollars. Someone is cutting a fat hawg there.

Wow !!! 6 dollars -> 600 dollars. That alone describes how screwed up the US health care sysytem is. Hank

I'm not saying the U.S. Health Care system doesn't have problems, but from my limited familiarity both here and with friends, I'd take it any day over the British or Canadian system. 

Yes, Medicare has a monthly fee, however I can see practically any doctor I want, including specialists, often within a week or two, and without going through a "gate keeper". And if I don't happen to like for example the urologist I just saw, I can make another appointment with a different urologist the next day. No limit. 

What I see here, and from a couple of friends in Canada, are very long waiting times and very limited choice of doctors. And when you finally end up seeing a specialist, not so easy to change. Plus, you're very limited by what procedures, surgeries are offered, so if you want something not available, you can end up paying thousands of dollars for the surgery, which kind of defeats the purpose of free medicine. 

As to Rx costs, my Medicare Rx plan covers most meds with a fairly reasonable co-pay. It also covers up to 200 catheters a month for free, which is a big help. And I get to pick the catheters. 

Jim

What you say is true for Medicare, but not the private insurance market. Where I live, I have very limited options, regardless of price. I can either be covered at the largest hospital system, or all of the others, but not both. I cannot get ANY coverage at an out of state hospital at any price. If I needed to go to someplace like the Mayo Clinic or MD Anderson for a cure for something potentially fatal, I would be able to choose between going broke and dying.

Medicare for everyone would be the best solution IMO. For now, if I don't get a job before my COBRA runs out, I'll have to pray that neither my wife or I get anything serious prior to turning 65.

@OB: What you say is true for Medicare, but not the private insurance market.

------------------------

Yes, you are correct. My insurance before Medicare cost more and didn't give me access to as many doctors. I still think I would prefer the older coverage to what my friends in Canada are getting in terms of wating times and lack of choice in terms of doctors and difficulty of 2nd and 3rd opinions. 

That said, I'd take being 40 again and deal with today's private insurance market, as opposed to being over 65! Getting old doesn't have too many perks, but at least we have this one!

Jim

OB,

After re-reading your post, let me amend my comment a little. I didn't realize private insurance right now is as limited as you state. It was better for me five years ago. But if that is the case then now, then I could see why someone might prefer a single payer system like in Canada or GB. Medicare for all would be great, but I doubt the government could pay for it. In fact, I'm concerned that the benefits I have now may be cut in the future as I hear that more and more docs are starting to opt out of Medicare, not to mention what the government may due to the benefits. 

Jim

UK price:

Dipyridamole 100mg tablets (Alliance Healthcare (Distribution) Ltd)

84 tablet [Prescription only medicine]

NHS indicative price = £3.69

JJ,

What many do in GB/Canada is buy supplemental policies that give them access to other docs and faster service. But even without that, limited choice for free is a lot better than limited choice for #2.5K/month plus copays and deductibles.

As for Medicare, the reason it's on such poor footing is that everyone on it is either old or old and sick. It's one massive high risk pool. Put everyone in it, including healthy 18 year olds who pee with reckless abandon, build in the negotiating power of 300+ million, subtract the cut that insurance companies get and its hard to imagine that they wouldn't be able to comp docs fairly and do it all better and for less $ than the we do now.

I'm covered under traditional Medicare, and I also have a high deductible BC/BS policy.  I thought that would limit my potential out of pocket medical expenses in a year.  What I have discovered that in addition to the high deductible of the BC/BS policy,  if I have a procedure that Medicare declines to play, then BC/BS automatically declines to apply it against my deductible.  Consequently, I've had thousands of dollars of charges that were never applied to the deductible.  So, the BC/BS policy is about useless to me so far.  (I've had five rounds of surgery requiring anesthesia since March of last year, plus a bunch of other "procedures" related to my GL disaster for BPH.)  Also, my daily "survival gear" is lots of Depends pull ups, pads and condom catheters and bags, none of which Medicare or BS/BS pays a penny.

Hi Glenn,

I believe we're still in the yearly changeover/enrollment period where you can change your supplemental policy under traditional Medicare. You might want to compare estimated costs with your high deductible policy to a no deductible Plan F where you shouldn't have any additional costs as long as the doctors and labs participate in Medicare, which most do. You will also get 200 free catheters a month with Medicare plus the Plan F. Supplemental. Don't know about the rest of your survival gear but you could ask.

Jim

I beleive the way it works is that when one turns 65 and picks a supplemental plan such as Plan F, High deductible, one has 6 months to switch.  After that, you still can switch even after the 6 months because they let me do it.  The way I understand it though, the insurance companies don't have to let you switch until the new enrollment period.  I had a high F plan with a $2400 deductible.  When I started self-cathing I was afraid the old policy wouldn't cover my co-pay (20%) for the Part B medicare that covered medical devices and physician services.  You know, the one most people use.  They let me switch to a Part N which should cover it after the yearly Part B deductible.  Actually, I've never gotten a bill from the insurance company yet; the one that had the high D.  I called them when I was thinking about switching. They said that I WOULD be getting a bill for my 20% so don't know about that.  All I know is that mainly the Republicans (and some of the corporate Dems) want to completely privatize everything they can.  Medicare has about a 2 or 3% overhead.  The ACA specified that health care providers have to spend 80% of money that they take in on patient care.  Now I'm sure that can be "fudged" somewhat but these profiteers hate anyone restricting the profits, especially when they've been rubbing their chubby little hands together thinking about all the money they're going to make off of baby boomers as they work through the system.  Medicaid can't work as well because may of the Republican governors refused to expand medicaid through the ACA which, BTW, would have cost their states nothing but could have prevented thousands of people who make too much to get regular medicaid having to go to the emergency room for treatment.  

Yes, you can switch Medicare plans every year during the enrollment period. Enrollment period this year is Oct 15 to December 10th. 

Jim