Dave,

I wouldn't accept this as the final word.  As has been suggested, I
would seek not only a second opinion, but a third, a fourth and
perhaps a fifth.  And I would be very selective whom I consult -- not
just another uro out of the Yellow Pages.

First, I would go to BestDoctors.com, take out a membership (I believe
it's appx. $35 for one year) and enter your zip code and ask for best
urologist.  BestDoctors.com lists only the top four percent of
specialists in the various fields.  Unless you live in the New York or
Los Angeles areas, you'll likely find that there are only one or two
Best Doctors listed in your area, so you might have to expand your
search and be ready to travel a few hundred miles.

I would also include in your search for opinions some of the top PVP
uros who have been mentioned in this group over the last couple years.
One that comes to mind is Dr. Lin in St. Augustine, Florida, who has
done over a thousand PVP procedures and also a Dr. Laube in Santa
Barbara, California, who seems to enjoy a very fine reputation. I
assume you're Medicare eligible, so this won't cost you an arm and a
leg, excepting travel.

One key issue that is most often not understood by the average patient
is that not all urologists are created equal.  There are huge
differences among them as a consequence of such factors as skill in
using their equipment, knowledge, experience and use of good judgment.

Dave, you should not give up!  It will require both patience and
perseverance to line up these top experts and manage appointments,
travel, etc.  But, you've simply got too much at stake to toss in the
towel now.

Whatever, you decide to do, I wouldn't recommend going back to see any
of the urologists who have served you in the past.  They seem, from
what you've posted, as very bad news.  Avoid them.

And when you have lined up your appointments, be sure to take someone
with you -- a relative or friend -- who can run interference for you.
In other words, an advocate who can deal with the red tape, ask the
right questions and have some knowledge of how to deal with the
medical profession.

Finally, don't be tempted to make a decision after receiving only one
opinion.  To make the right choice, you need to have spoken with four
or five experts and reach a consensus.  Only then can you feel a level
of confidence that what you're choosing is the best and right choice
for you.

Good luck and please keep us posted!

Best,

Rob