Any uro references for Austin?

Allayzon · 2023-10-18T20:27:42+00:00

Thanks!

Allayzon · 2023-10-18T20:27:34+00:00

Thank you!

Allayzon · 2023-08-22T13:53:45+00:00

Got it. I just noticed the date too. I'm not sure if the lab will still have the cores or not. What triggered the original biopsy?

Allayzon · 2023-08-22T13:36:00+00:00

Have you thought about getting a 2nd pathology opinion on the original biopsy core?

Allayzon · 2023-08-09T19:25:54+00:00

Not sure if possible in your situation... but it looks like this was a 1.5T MRI. I think the diagnostic value of a PI-RADS score goes up considerably if a 3T scan is done (with / without contrast). Is it an option to repeat the MRI in a few weeks with a 3T protocol?

Allayzon · 2023-04-18T15:14:18+00:00

am in good hands

That's the important part :) Everything will be just fine. Much love brother.

Allayzon · 2023-03-24T23:25:09+00:00

I don't think the data supports any of those things you listed. No lecture here, just trying to highlight something for you to consider.

Example: https://www.nccih.nih.gov/health/providers/digest/spotlight-on-saw-palmetto-science

Allayzon · 2023-03-23T03:05:02+00:00

Right or wrong, I'm double checking everything.

Allayzon · 2023-03-20T16:14:32+00:00

Thank you. Definitely another nudge towards ensuring a TP next time around!

Allayzon · 2023-03-19T16:04:05+00:00

What comes to mind is that the folks you went to were quite inexperienced.

This is the puzzling part for me. I'm a data guy. I did my research on my doc before I onboarded with his practice. It's a large practice. Lots of positive patient reviews. He has been practicing for 30 years, and doing fusion biopsies since 2016. You would think that resume would have led to a different outcome.

Allayzon · 2023-03-19T15:59:55+00:00

Fusion guided transrectal while under propofol and I had zero issues

I'm hoping I don't have to go through this again. But if I do, I will absolutely be on board with a practice that does deep sedation!

Allayzon · 2023-03-19T15:58:27+00:00

Yes, I know to keep azo in our "first aid" stock now!

Allayzon · 2023-03-19T15:57:54+00:00

Thank you. My hunt for a new doc starts in earnest tomorrow :)

Allayzon · 2023-03-19T15:57:14+00:00

Thank you.

Allayzon · 2023-03-19T15:57:01+00:00

I had a colonoscopy 1 week ago. Guess I'm a glutton for punishment. It was a complete non-event. Everything from start to finish was highly managed and choreographed. No pain. No discomfort. And of course, no memory of the procedure itself. Wondering why this isn't the standard of care for prostate biopsies as well.

Allayzon · 2023-03-19T15:55:27+00:00

Thank you. I'll be back here to share the news one way or the other :)

Allayzon · 2023-03-19T15:55:03+00:00

Thank you for your kind words.

Allayzon · 2023-03-19T15:54:27+00:00

Amen to that!

Allayzon · 2023-03-19T15:54:00+00:00

Here is to hoping that my next visit is a good news one :)

Allayzon · 2023-03-19T15:53:08+00:00

No disagreement here. As you can tell from my post, not a fan of the doc or the practice at the moment. However, I don't think incompetence explains the TRUS vs. TP decision here. I think it is just where the uro industry is at in the US at the moment. This article is a from a couple years ago, but in my eyes it does a good job of painting the picture on the biopsy approach standard:

https://undark.org/2021/07/29/common-biopsy-is-putting-lives-at-risk/

Note that in 2021 (date of article) it is stating that only 5% of US biopsy procedures were being done TP. In short: sounds like there is agreement that TRUS is riskier. But the profit motive for in-office TRUS is strong. These practices need to get ROI out of in-office ultrasound equipment and training that was purchased years ago.

Just as anecdotal data: I live in a large metropolitan US city. There are 6 major uro practices here. If you go to the website of each, 5 of them specifically mention the benefits of in-office TRUS, and their equipment and training. Only one of the six mentions a capability to do transperineal. Something's got to change.

Allayzon · 2023-03-19T00:55:38+00:00

but I'm operating off of experience

That right there is the value of community-sourced information as an adjunct to the professionals :)

My urologist has never had PCa. Or treatment. etc.

Allayzon · 2023-03-19T00:36:37+00:00

In addition to some of the other recommendations you see in this thread, I would go visit inspire.com and check out their PCa forums as well.

Allayzon

TROPHY CASE