Patricia: I am suburban Maryland referred to the urologist by a smaller but as I understand it, well-reputed local hospital for the kidney stone for which I presented to the emergency room originally. The urologist runs an outpatient clinic away from the hospital, where he performs cystoscopies and minor procedures under anaesthesia on the weekend when he can bring in a hospital anaesthetist.
My cystoscopy last weekend was performed under mild general anaethesia, and the TUR will be performed under the supervision of an anaesthetist as well. I don't know what his procedure will be. I'm still under the impression that this is not a complicated procedure. I have an appointment on Friday with the uro to discuss this in more detail.
The hospital has an inpatient cancer program but is not affiliated with a major university.
Am I not receiving the standard of care? If I want to postpone treatment (the uro in question wanted this done ASAP but I am willing to be suspicious), I can do so---only a total 5% risk of malignant transformation suggests that I have the time to seek other care despite the uro's warnings, but I should start calling urologists ASAP. We have other reputable clinics here.
Online searches from all the medical review web sites deliver little information about the uro except that he has approx 40 years of licensing and 1-2 sanctions, but I'm given to understand that many doctors of long career have sanctions.
The majority of the time polyps are benign. I've seen the numbers somewhere but can't find the stats right now.
"Benign" is not 5% cancer. Benign is not cancer unless they have recently starting coming up with new ways of categorizing things.
Kind of like being 5% pregnant. One is either pregnant or not pregnant. One either has cancer or doesn't.
Bladder polyps (urinary bladder papillomas) are most often harmless (benign), so individuals usually have an excellent prognosis following their removal; only 5% to 10% of bladder polyps will progress to cancer ("Bladder Tumors"). Bladder polyps vary greatly in their rate of recurrence, with some types returning infrequently (8.8% recurrence), and some types returning quickly (70% to 75% recurrence) (Cheng; "Bladder Tumors"). Consequently, follow-up bladder ultrasound or cystoscopy with urinalysis is recommended at regular intervals following treatment, usually every 6 months for up to 18 months and then annually.
Well not exactly the same. This procedure should be performed under anesthesia and the uro should be sure he gets all of the tumor and part of the muscle to rule out anything more devious. I would not want to be awake for this.
Where are you located? Are you with a top university or cancer hospital? If your uro does not do many of these which i suspect as he's doing it on the weekend so as not to interfere with his office hours..you may wish to seek a second opinion.
So the urologist just called and told me that I have a "benign" papilloma. Since I have been spending the past few days doing extensive reading about bladder growths, I know that this basically means that am 5% of a cancer patient, which is much better than being 100% of one, but still worrying.
Anyway, it's coming out by cystocopic TUR on the weekend. I'm given to understand that this is mostly just like the cystoscopy I just had.
I asked the urologist whether I should be looking forward to years of regular cystoscopies to verify nonrecurrence. He said while it depended on final pathology, probably not. This doesn't quite jive with what I've been reading so far, and I will probably see if I can get one anyway to make sure to my paranoid self that nothing comes back.
The doc says that I should be grateful that my kidney stone brought this incidentally to light and that this saga should all be over on the weekend. It's possible that the papilloma irritated my ureter and contributed to the kidney stone. I have no basis to evaluate the likelihood of this theory---since the kidney stone happened after an extended (and foolish) period of dehydration, which is definitely a condition that causes stones---but if so I may evade another stone as well.
Thanks. "Concern but not worry." I like that idea. I'm a somewhat anxious person by nature and have difficulty separating the two. I certainly hope it isn't cancer, and am reassured that you as a survivor seem to suspect so too. I guess I could deal with an annual cytoscopy...