Thank you Warren...all one needs to do is check out the metastatic area to find dilligent patients and not so dilligent uro's who felt the naked eye was all they needed to access the grade of tumor/tumors. Not enough of a sample taken or no sample taken and fulgeration done.
I think the biopsy/electrofulguration in the office is a great thing, unless the pathology report happens to come back high grade, like my last one did. Since the office biopsy is very superficial and doesn't get the lamina propria or any muscle in the specimen, I now still have to go to the operating room for more biopsies.
Well, I guess that would be part of my point. Since understaging is a big concern, and I don't believe it's a given that anything under G3 is always superficial, just how good is that in office biopsy to be worth the pain? Can an in office biopsy adequately evaluate CIS?
Now my experience may be different from others. We all tolerate different things differently. When I had my one in office biopsy which I refused to repeat, I had no tumors - just erythema. And the specimen was inadequate - probably because one can't go too deep without anesthesia. Maybe I just have a sensitive bladder. I always have urinary symptoms after a cystoscopy and take, on average, 1½ weeks to fully recover. But since each cystoscopy I have does require a urethral dilation, which I do willingly although not happily wide awake without sedatives, I don't think I'm a wimp. I still say I'll pass on in office biopsies.
TaG3 + CIS 12/2000. TURB + Mitomycin C (No BCG)
Urethral stricture, urethroplasty 10/2009
CIS 11/2010 treated with BCG. CIS 5/2012 treated with BCG/interferon
T1G3 1/2013. Radical Cystectomy 3/5/2013, No invasive cancer. CIS in right ureter.
Incontinent. AUS implant 2/2014. AUS explant...
Last year and again this year I've had biopsies done in the office by my urologist. After the tumor or tumors were biopsied, electrofulguration was used to remove the tumors. This is done with no anesthetic whatsoever. The biopsies were simply a pinch, nothing more. The electrofulguration was more painful. And it consists of being zapped numerous times. I do take .5 mg of Xanax before these things to keep myself relaxed; otherwise, I honestly don't know how I'd get through it.
I think the biopsy/electrofulguration in the office is a great thing, unless the pathology report happens to come back high grade, like my last one did. Since the office biopsy is very superficial and doesn't get the lamina propria or any muscle in the specimen, I now still have to go to the operating room for more biopsies. But last year when the pathology report came back benign, I was so glad it could all be done in the office.
oops forgot to reply to Pat's comment. I pictured that fetus "silent scream" when you said that. ooooooeeee. Private practice urology groups are most apt to offer in-office procedures as they are not limitied by hospital boards, protocol and tradition. If anyone prefers that more expedient albeit possibly more painful office-service they only need call various private urological group practises and ask if they have that capability. I don't know of any hospital based urologists that offer in-office treatment, but there may be. Rosie
Ian, I guess "free" medical care in GB does cost in other ways. Yes, we in US can go to whatever hospital or doctor we want if we don't mind paying if that doctor or hospital is not within our health insurance plan. Once people here are covered by medicare they usually have many more choices of where to go and still be covered with not much additional out of pocket expense. Rosie
ooooh Rosie...i remember those "Now you'll just feel a pinch".....Now maybe i have a low tolerance for pain but when my OB/GYN said that to me when he decided to do an ablation on my uterus for excessive bleeding...i was in silent scream shock. In no way was that a "pinch".
And there are no uro's in my city who do an in office procedure ...they're not equipped nor are they talented enough. But thats my situation or anyone elses who's unlucky enough to live here and have BC.
Anyway i'm getting hungry with all this Turkey Talk...Is it thanksgiving yet?