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Thread: Does this seem like good advice from my Urologist?

  1. #1

    Does this seem like good advice from my Urologist?

    I went to see him the other day (had a appointment for a couple weeks) and my main concern is I learned recently I cannot pass either a foley cath or a intermittant cath into my bladder which is concerning. The reason is because I had a sphincterotomy a couple years back by this same Dr. and I believe there is a lot of scar tissue there now. Normally I have no reason to do a cath because I drain with a neurogenic bladder but what worries me is what if I stop draining for some reason and become distended? He claims the risk of going in there with a cystoscope is not worth it and if I do have a problem most er's have a Urologist on call. What if I'm way out in the woods fishing or something though? I dunno, maybe I should just risk it, I hate the thought of opening up a whole can of worms so to speak. I'm really thinking of just getting another Doctor, this guys has a bigtime dont care type of attitude which really bothers me. When I get back up North I have some lofric caths (thin and hydrophilic) I'm going to try, that might just work. He did not even offer me one to try, I'm sure they must have had something like that at his office. I get the feeling he just wanted to just get rid of me because he can make more money off other people with private insurance, I just have medicare.
    "Life is about how you
    respond to not only the
    challenges you're dealt but
    the challenges you seek...If
    you have no goals, no
    mountains to climb, your
    soul dies".~Liz Fordred

  2. #2
    I agree with you. I don't like his attitude, and dismissiveness.

    And you certainly don't want to rely on any random ER to help you if you hit a crisis. As we all know, ER's are often useless and dangerous places for us.

    I agree with you that I would get a second opinion.

  3. #3
    Yes, I would begin looking for another urologist and another opinion. Your instincts are right.

    all the best,
    GJ

  4. #4
    Senior Member Foolish Old's Avatar
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    Once you lose confidence in a doc, it's time to move on.

    Curt, I'm sure you know this trick, but it was new to me when I learned it not so awful long ago, When the cath meets the point of resistance at the sphincter, don't push hard but maintain steady pressure. When the sphincter fatigues and relaxes, you may be able to insert the cath.
    Foolish

    "We have met the enemy and he is us."-POGO.

    "I have great faith in fools; self-confidence my friends call it."~Edgar Allan Poe

    "Dream big, you might never wake up!"- Snoop Dogg

  5. #5
    Quote Originally Posted by Foolish Old View Post
    Once you lose confidence in a doc, it's time to move on.

    Curt, I'm sure you know this trick, but it was new to me when I learned it not so awful long ago, When the cath meets the point of resistance at the sphincter, don't push hard but maintain steady pressure. When the sphincter fatigues and relaxes, you may be able to insert the cath.
    Thanks FO, that was the first thing I tried and no luck. Definatly think I need a new Doc, this guy does not inspire much confidence in me at all. I did have a complication after he operated on me a couple years ago with bleeding. It really makes me think he did something wrong at this point especially the way he acted the other day, It's like "no lets not take a look in there, not a good idea".
    "Life is about how you
    respond to not only the
    challenges you're dealt but
    the challenges you seek...If
    you have no goals, no
    mountains to climb, your
    soul dies".~Liz Fordred

  6. #6
    Quote Originally Posted by smashms View Post
    do you mean you have a diversion like a suprapubic cath?
    Nope, just straight drainage through a external cath had my first Sphincterotomy done around 28 years ago, it scarred over and had another done a couple years ago.
    "Life is about how you
    respond to not only the
    challenges you're dealt but
    the challenges you seek...If
    you have no goals, no
    mountains to climb, your
    soul dies".~Liz Fordred

  7. #7
    I would definitely find another urologist. If you can't cath well and are voiding with lots of bladder pressure, you can back urine up into your kidneys. You may need to get an in dwelling Foley catheter until a new urologist is found. Then hopefully a plan of action can be found.

  8. #8

    Post urologist

    Dear Curt
    It is not uncommon for a sphincterotomy to scar over and need to be completed again. Lofric catheters are very good in decreasing the resistance with strictures or scarring with intermittent self catheterization.

    In my practice, I had a patient who got a new cushion that positioned his bladder retrograde so that he didn't drain properly using his external condom catheter. He did get a severe infection and had to temporarily catheterize. Once his infection cleared, he worked with the seating/cushion vendor to cut his cushion more effectively so that he could drain better again and use his ext condom catheter for his bladder management.

    It is discouraging to lose faith in a provider. I hope you were able to express that to this urologist so that he is aware of his communication skills and how his explanation did not instill confidence.
    pbr

  9. #9
    Thanks pbr, I really did not talk with him about it, it kinda hit me after seeing him that this should probably be investigated at some point. I do seem to be draining great though, so that's the good news. I don't think I'm running excess pressures or anything because I'm very sensitive to A/D and I'm not getting very much of it when I void, only if I drink too much fluid too fast like guzzling beer or something which I don't do very often.
    "Life is about how you
    respond to not only the
    challenges you're dealt but
    the challenges you seek...If
    you have no goals, no
    mountains to climb, your
    soul dies".~Liz Fordred

  10. #10
    You stay strong Curt. You have 6 batteries on that Powerpod you have to wear out going 30 milees an hour.

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