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My disappointing Urologist visit.

Posted , 19 users are following.

hank1953
hank1953

  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

1 like, 97 replies

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  • stebrunner
    stebrunner hank1953

    Posted

    Hi, Hank,

    You sound disappointed, and rightfully so. One would expect a teaching hospital in a large metro area to have better doctors. Maybe you can find a better doc in that medical group. Then again the docs in that clinic may tend to back each other up. And they may be under pressure to keep revenues up.

    I live in Idaho, and my BPH journey started a little over a year and a half ago. My first 2 uros were from a clinic associated with one of our largest hospital systems. After disappointing experiences with those 2, a friend told me I should open my horizons and look for expertise out of state. That was excellent advice! I've now seen 8 uros, including 2 at the Mayo Clinic in AZ, and I've had procedures done in Denver and Seattle. You may want to expand your search for a good uro beyond UCSD.

    Early on I had a CT scan done, and none of the urologists could tell me how large my prostate is. They would only say it's large. It wasn't until I saw an interventional radiologist that I learned my prostate size is 90cc. That's also when I learned more about my large median lobe. Knowledge of your exact prostate size and it's anatomy is important when figuring out your treatment options.

    Thankfully, I found this forum and mastered CIC. It's giving me time to see if better BPH treatment options come along. FLA looks like a promising option for me. I'm waiting to see more results on it before I decide.

    BTW, the last uro I saw was with the Kidney Stone Center in Seattle. She is a fairly new doctor and seemed very knowledgeable about newer treatments. My local uro is in his mid 50s and keeps trying to push a series of TURPS on me. In future, I think I'll stay away from uros who've been practicing 10 years or more, as they seem stuck in their ways.

    Stebrunner

    • hank1953
      hank1953 stebrunner

      Posted

      Hi Steb, I was congratulated by many in having access to UCSD but so far I have been mostly dissapointed. I start to think that they have lost their standards, just renting out their name and spaces to any one that can pay. I am planning to change to another medical group. Just wondering whether or not to file a complaint to UCSD first.

      I am ruling out everything that can cause excessive bleeding and long/painful recovery. TURP is therefore a definite no. Like you, I am highly interested in FLA. I am also interested in iTind. But not until I find out more about my anatomy.

      Hank

    • mike87311
      mike87311 hank1953

      Posted

      Hank,

       I think my previous post may be blocked  because I put a link in but what I said was have you investigated Bipolar Turp  (Google is your friend)

      It is supposed to be less invasive and less "bloody" as it vaporizes the prostate rather than cuts it .

      I am on the list to have one later this year as I have a three lobe prostate (“which looked occlusive”) so a Urolift was a no go.

      Good Luck... Mike

    • hank1953
      hank1953 mike87311

      Posted

      Hi Mike, I looked into bipolar TURP. Yes, it is much less invasive than TURP. Good luck with your coming procedure. Hank
  • eddie06613
    eddie06613 hank1953

    Posted

    Hi Hank, thank you for the very informative reply. I Think it is very important to get as much information about your problem before you go see a doctor. I'm in the process of learning as much as possible before I decide to have a second surgery, The thing that bothers me the must is the burning feeling when I pee, I don't know how longer I can put up with this and more important what any other damage I may be causing to my prostate.  Thanks again.

    • hank1953
      hank1953 eddie06613

      Posted

      Hi eddie, if learning is what you want, you are at the right place (this forum). It's what I have been doing, BTW. The best way for your situation, I think, would be for you open a new discussion, stating as much info as you can about your problem, its history. There are many more qualified people than me on this forum and I believe they will help you. 

      For now, with the only input you gave me: burning during peeing. The only answer I can think of is UTI. Good luck.

      Hank

  • jimjames
    jimjames hank1953

    Posted

    I would have walked out of the office as soon as he suggested a catheter to determine bladder volume. Doesn't he have a bladder scanner in the office? Catheterization, something I am familiar with and practice, should not be part of a typical office exam for a number of reasons. I've been to maybe 10 uros over the years, and while far from perfect, none of them were this bad. 

    Jim

    • hank1953
      hank1953 jimjames

      Posted

      Hi Jim, they did scan my bladder but didn't tell me anything and I was too ignorant to ask. Hank

    • jimjames
      jimjames hank1953

      Posted

      Makes even less sense (scan and cath) unless maybe they thought your urine culture was contaminated and wanted a sterile sample, but even that seems a bit extreme in most cases. The problem is, in a lot of cases like this, by the time you learn what is what, it's too late!

      Jim

    • hank1953
      hank1953 jimjames

      Posted

      "Make even less sense ..."

      You'd make a good detective. The truth is the cath was for the nurse to teach me how to self cath, which turned out to be a bad and bloody experience for me since she did it incorrectly. Hank

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