Ablation possibly being held off for a radical… or…

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I finally had enough of this intermittent extreme pain that I was venting about a couple weeks ago. I saw the urologist yesterday to discuss it. He is as concerned as those people who commented on my previous post are. He did not have a quick fix but put me back on the Ditropan for now. He felt hesitant about postponing the ablation, but thinks an additional test needs done. I asked him what the timeframe would be for getting the test done since I am 10 days away from the scheduled ablation. His response was “It’s when Imaging” can get a slot…” I looked at him very frustrated because I know those tests are scheduled way out unless someone is “dying” in the ER. I continued to inquire what he was hoping to learn or how to proceed. He was very direct in saying that this could turn into needing a radical prostatectomy. I asked, “No cancer, and you are proposing a radical???” His response was that he is not sure that using a laser to remove only the inner part of the prostate is not the solution. There might be more going on with, and around, the prostate than believed. If I can get into Imaging this week, he might be able to still do the ablation if the test deems it the best option. Then, I was thrown for a loop when he said he might be able to rearrange his schedule to do the radical on the same day. That’s when I started rolling my eyes because I know that is not how things work in medicine… Did I go to another “quack”??? I guess I will see if the test can be done and it’s just “as planned”…

I hate to start all over with another urologist, since this has been a 3-4 month ordeal as it is.

 

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Hello,

Most doctors give their patients a printout of their visit, outlining what took place and the findings. If you didn't get this, ask for it and, take it to another doctor for a re-evaluation. Your present doc seems to be grasping at straws instead of giving a definitive evaluation and course of action. I know this is frustrating; but, unnecessary procedures are worse. Unless you live in a very rural area, imaging facilities shouldn't be that rare and impacted. Usually the insurance authorization is the culprit. I sure wish I could help. I really feel for your situation.

 

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MAM,

If I recall correctly you are still young and interested in having a family one day. That renders a RP as a last resort.

Of the options available the ablation seems to be the best outcome.

I am not a medical professional and will refrain from venturing into that domain. However, from a purely logic perspective the desired outcome is for you to have urinary control without pain and retain your reproductive capability.

An imagining consultation may bring additional insights or knowledge that isn’t available today.

My recommendation is to keep focused on how to achieve the desired outcome.

Greensleeves

 

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@Regina I have medical records for all of my urology visits (both doctors). We agreed upon a plan of action until the intermittent pain started.

 

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@Greensleeves351 I actually am single, and don’t foresee a family in my future since I am in my mid-40’s, approaching 50 “soon”. That being said, I hoped the ablation would be the solution… the visit just felt strange when he came back with the possibility of a RP. You normally don’t give a patient 10 days before acting; the journey to a RP has to be carefully discussed and discerned. If the test does happen and I am advised to consider a RP, I will insist on giving it thought instead of just going through with it without serious thought.

Although, when another urologist recommended a RP, and I sought the second opinion, I am beginning to wonder if this extra time beyond the time I was with the other urologist has been only causing more damage to my urethra. I have the records, as I explained to Regina, and nothing seems like a red flag… BUT this pain needs to stop!

 

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Imaging has an opening tomorrow for a MRI. I cannot believe that was able to be "pulled off"... It usually takes weeks to get a MRI approved. That being said, I have gone into freak out mode because of the quick scheduling; the urologist must be looking for something first undetected with other tests. My PSA is just below borderline, but we know the PSA is not the most important test. Could I be faced with a RP? Or is something else going on where the prostate does not need touched? The more I think about it, the more freaked I am getting.

 

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MAM,

It is hard to tell with the sketchy information provided what is going on. I agree it is very strange that an MRI can be arranged on such short notice.

I see no harm in getting the MRI, it will provide you another piece of information you didn't previously have.

Unless there is other information that would influence your decision I'd recommend continuing to get the ablation. You need some relief to able to urinate and empty your bladder.

Even if the MRI fills in a piece of missing information you will have some relief and time to figure out what to do next.

Greensleeves

 

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I show up to Imaging this morning... I asked the woman a check-in as to how it got scheduled so fast, and she said the doctor pushed to get it through ASAP!

Now, I have to wait for the technician to write up the report to send over to my urologist. The tech refused to say anything while conducting the test, so I am left in the dark except that my urethra is constricted. I would agree with you @Greensleeves351 that this seems sketchy. I just want this random voiding and pain to stop!

 

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Well, I am now on pre-op antibiotics 11 days out. A urinary analysis indicated that there was no infection but the MRI showed the prostate pushing up into the bladder; likely due to something as silly as riding my bicycle to get everywhere around town; so the doctor surmises. The antibiotics apparently are to minimize the potential of infection prior to and during the procedure… ablation still planned as of yesterday.