It sure seems you have had to take a difficult route to get proper
attention.

Naturally I am wondering why he had surgery scheduled before getting a
close look at the prostate.   It seems to me that an ultrasound in the
office would have detected the abnormal size prostate.

On the other hand that should have been done long ago by other UROs.

I just did a little searching on the procedure.  It seems to have a
good track record for curing the problem.

Michael,

Thanks for sharing this with us! And I am sorry that your condition
has not already been resolved.

Did they say anything about how big your prostate was?

I thought Malloy was a pretty hot uro, and that he did large
prostates, up to 174 mL as implied by his joint paper with Dr Te and
others. See
http://www.blackwell-synergy.com/doi/abs/10.1111/j.1464-410X.2006.06197.x
(or http://tinyurl.com/2zjwrc).
(If anyone wants the full text article and has any difficulty getting
it, just say so and I will post it somewhere.)

For large prostates, the method of choice is open prostatectomy.
That's serious surgery, but the longterm outcome is excellent, better
than for TURP.

So, here's hoping that all goes well and that you'll be peeing like a
champ before too long.

Let us know what happens, please!

Ed

So sorry Michael...my heart goes out to you, and it sounds like a form of
incompetence to me.  Not only for not having the ultrasound beforehand, but
for not having  a pre-op cystoscopy which I feel is the right way to go
regardless of who the uro is or what country.  I have made references to
this many times in here, and I had a cysto before both my TUIP and TURP,
which I think is more the norm than not, although others in here have said
they went directly to pvp just based on history and a digital and maybe an
ultrasound.  I guess since you were in such a bad way Malloy thought he
would just get on with it.  I will say that was damn nice of him to get you
in to see him so quickly, and to schedule the procedure so quickly (almost
unheard of).  But......

Let me ask you something - is this a teaching hospital or university you are
going to in Penna, and will this "great" Dr. Malloy be actually doing the
surgery, or just supervising one of the residents or fellows.  Generally in
teaching hospitals you NEVER get operated on by the actual expert in the
field, but one of his residents or fellows under him (or several
doctors/assistants for more serious procedures) does the surgery (especially
in a hospital like Johns Hopkins or the Mayo Clinic).  So the question of
asking a doctor how many surgeries he has done (which is always mentioned in
here) goes out the window as far as the experience factor.  The pvp is not
major surgery and is ambulatory in nature (the open prostatectomy is more
serious), but my statement is still valid, and it is even worse for the real
major surgeries.  So I wonder when people talk about Dr. Te and Dr. Lin and
Dr. Laub, if these doctors are actually doing the surgeries, or are they
overseeing residents and fellows.  If they are at a teaching hospital and
part of a University or a hospital like Johns Hopkins, and are on the staff,
then I doubt they ever do the actually surgery, but are just in a supervisor
capacity.

This is a very interesting question that I just went through with a visit to
Johns Hopkins surgeon who specializes in MIS and GERD problems (he uses the
da Vinci robot also).  So the question is not just how many have you done
doc, and what is your success rate and the risks, etc (like we always ask
our surgeons) - but will YOU (ie the doctor you are talking to) be doing the
actually surgery, whether it is done manually or via a da Vinci robot.  In
the teaching hospitals the answer is usually no unless you happen to be one
of the lucky ones that the doc is using as part of the teaching process.

I was going to post this info in here as a separate post, so consider it
done.  I find it very interesting.  The bottom line is everyone says if you
have any serious and difficult to solve problem or condition (I am not
talking about the prostate, but in general for all disease processes), then
you should go to a university or hospital that is classified as a teaching
hospital.  They are also called tertiary care centers.  I have been to them
with not a lot of luck and have not been impressed,  and to me doctors are
the same all over, except they can do the more advanced technique major
procedures, that are not done in little red neck towns so to speak.

I will stop now, and I wish you the best with your open prostatectomy.  You
certainly deserve it.

Pete