Issues with Urologist

[tomcat]

Hi all

I am concerned regarding my Urologist who is a professor at my local hospital hence no one is higher than him.

2nd appointment (which was a teleconference with my support worker and carer at the time) He first stated there wasn't any solution then he wanted me to self Indwell Catherise (he stated this on the phone with my support worker or get support worker to do it) without any training or knowing exact size.

3rd Appointment (Dec) He stated he doesn't want me to be Indwelled catherised due to uti risks and have Botox to the Urethal Spinctor and prostate (but wrote to GP COPY AND PASTED "Botox injections to the pelvic floor and bladder neck given that he does have longstanding voiding dysfunction".) I signed relevant paperwork that day and was told have the procedure in February.

4th Appointment (28th Feb)Urologist never showed up nor communicated this with his staff as he was flying to London (I am in Sydney, Australia) and was not notified this until 30mins after the appointment and had to wait an additional hour for a different urologist who made me sign the same paperwork as didn't know if it was sent to Admissions back in December (thankfully as after the appointment
I went to hospital admissions and found out my urologist never submitted the paperwork in December and refused to allow me to make a written complaint due to all the issues with the urologist.


I forgot to mention he flat out refuses to communicate with my Continence Nurse (who is private and the urologist is public public system refused my a public Continence nurse) my continence Nurse is a Doctorate with a PHD and I requested him to do this numerous times.

My question is

Is Botox to the Urethal Spinctor and prostate and "Botox injections to the pelvic floor and bladder neck given that he does have longstanding voiding dysfunction the same? If so what are peoples experiences as I have a letter from admissions that I should have the procedure in about 3 months? And would people trust this behavior from their specialists? Many thanks

 

[SparkyDog]

First I would see a new urologist.

Caths are the worst and UTI's are almost a sure thing.

Botox is hit and miss. My urologist said 50-50
i said well might as well try I guess
He stated no no not 50-50 it works or doesn't work. 50-50 it works or becomes worse than what you are dealing with now.

But I would definitely get a new urologist

 

[mickdl]

Hi Tomcat,
The way I see it, different doctors have different opinions.

The way I see it, different doctors have different opinions. To make things very clear: The indication for such a treatment would be the endangerment of the upper urinary tract as it can occur, for example, with a detrusor sphincter dissynergy. In such a case, either a spincterotomy or this Botox treatment can be considered if self-catheterization is not possible.

How the doctor then comes up with the idea of offering ISC and then _this_ Botox treatment at the same time I don't know and it seems illogical to me (as a layman). What is normally done in a DSD with urinary retention is to dampen the detrusor and not the sphincter muscle with Botox to keep the pressure low and then to empty with ISC. If there‘s no residual urine ISC is not needed. If ISC ist not possible and the pressure gets to high you can think over option one to the price of a purer continence. But to be very clear on this here - you will not find a doctor doing that without a clear diagnostic indication. Normaly the better choice would be a suprapubic catherter.

As far as the cooperation between nurses and doctors is concerned, I have not quite understood the problem. Why shouldn't he discuss this with the nurses - after all, in the end they - or the company that supplies the catheters (at least that's how it is in Germany) - have to do the instruction and choose the right catheter. For support workers and carers it‘s also important to know…

 

[Edgewater]

Yes, select another Urologist. Just because he is the head of the section does not mean he is the best choice for you!
It would make sense to have your support staff there and hearing what options are being considered.
The Doctor not seeing your private Continent Nurse is not professional on his part and supports your need to find a Urologist that is a much better fit for you!

 

[Lethdale]

Hi all

I am concerned regarding my Urologist who is a professor at my local hospital hence no one is higher than him.

2nd appointment (which was a teleconference with my support worker and carer at the time) He first stated there wasn't any solution then he wanted me to self Indwell Catherise (he stated this on the phone with my support worker or get support worker to do it) without any training or knowing exact size.

3rd Appointment (Dec) He stated he doesn't want me to be Indwelled catherised due to uti risks and have Botox to the Urethal Spinctor and prostate (but wrote to GP COPY AND PASTED "Botox injections to the pelvic floor and bladder neck given that he does have longstanding voiding dysfunction".) I signed relevant paperwork that day and was told have the procedure in February.

4th Appointment (28th Feb)Urologist never showed up nor communicated this with his staff as he was flying to London (I am in Sydney, Australia) and was not notified this until 30mins after the appointment and had to wait an additional hour for a different urologist who made me sign the same paperwork as didn't know if it was sent to Admissions back in December (thankfully as after the appointment
I went to hospital admissions and found out my urologist never submitted the paperwork in December and refused to allow me to make a written complaint due to all the issues with the urologist.


I forgot to mention he flat out refuses to communicate with my Continence Nurse (who is private and the urologist is public public system refused my a public Continence nurse) my continence Nurse is a Doctorate with a PHD and I requested him to do this numerous times.

My question is

Is Botox to the Urethal Spinctor and prostate and "Botox injections to the pelvic floor and bladder neck given that he does have longstanding voiding dysfunction the same? If so what are peoples experiences as I have a letter from admissions that I should have the procedure in about 3 months? And would people trust this behavior from their specialists? Many thanks

He sounds like an ass. Get a new urologist.

 

[Babybub]

Agree with other. Find a new Urologist.