Urologist

[Spargano]

As you may have read in my other thread, my primary care physician asked me if I wanted to pursue anything with my OAB and when I said no, he let it go and then told me he would not put it in my chart so that others could see since I confided I did not want it getting out.

[Spargano]

I should clarify, I am pursuing incontinence. That is not to say there might not be something going on with my prostate or cancer (God forbid), but I know there is nothing wrong. I don't really feel I need it other than for the doctors to feel I am safe. But he did not seem concerned (something that does concern me, not because I need it, but because he should want to rule out dangerous causes).

[kevindhca]

The doctor can only do what you consent to, you said no, so he cannot go any further in this area.

It really doesn't matter if you see an urologist, other than the information you might get about the state of you urological system.

My MD wants me to see an urologist too, with my consent of course, but it will probably be many months before I am able to get an appointment to see him.

I am interested in the the results of whatever tests he might decide to do.

I suspect he will try to measure bladder size and holding pressure.

He can test all he wants, but treatment is up to me, I will be asking many questions and considering all effects of any meds he might suggest.

Medical science does not have a really good understanding on how to cure urolological problems in a lot of patients, and in many cases, the doctor is just trying stuff that MAY help.

The only person that really knows if you can be continent, is you.

There are no tests to say you are incontinent, that condition is totally self reported.

Even if all tests come back normal, that will just give the doc fewer options to try and treat.

You can say no to treatment at any time, the doc might not like it, but there's nothing he can do about it.

[Spargano]

which is fine. Just seems odd because I always read don't lie to your doctor (not outright). I only brought it up now that I have progressed to the stage where it is believable given the symptoms. I know there is nothing they can force me to do, and I know that most tests would report me as normal, probably with a weakened bladder and sphincter.

[kevindhca]

The doctor didn't test for serious illness, because the symptoms you described don't seem to indicate a serious medical condition.

Medical science always says there is and underlying condition to cause incontinence, but there may not be any treatment to correct it.

As for getting a different doc in the future, I would just say, I was extremely concerned about that info getting out, so the doc just discussed different things I should try without writing it in my file.

Fear of discovery, ya no one will understand that. Lol

If you are ever admitted to a hospital, you will be under the care of a physician, you can get the doc to diagnose incontinence at that time, and the insurance should be no problem.

[babyleanna75]

I wouldn't mention your goal of becomming incontinent personally.

[ut8ft]

Certain meds may cause urinary problems

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[babyleanna75]

I wouldn't mention your goal of becomming incontinent personally.

And like your doctor said just tell the hospitals and other docs that you are IC if you are having OAB problems. And it looks like your achieving your goal of being IC congrats the only reason t would need to be on record that you are IC is if you were to get diapers prescribed for insurance purposes. But DO NOT tell the doctor you are purposely tring to be IC doctors already dont understand why an IC person dosent want to treat their IC and just wear diapers and would not understand why someone is trying to become IC. I used the 12 month program to worsen my OAB and Urge Incontince and would never tell my doctor that I did it. Since I becamepartially IC 3 years ago I started the 12 month program and dont pee in the toilet unless I pee while pooping and dont think I could make it to the toilet if I tried to now.

[Spargano]

I wouldn't mention your goal of becomming incontinent personally.

I couldn't agree with you more. This would be exceptionally stupid.

Spargano

[kevindhca]

Urologists generally treat issues that produce what most people consider reduced quality of life.

I am seeing an urologist in a month, and the new patient info forms amount to six pages.

One page of general info, two pages of medical condition, a page of prostate condition questions, a page of erectile function questions, and a voiding page to track voiding for three days.

Most people would consider leaking all the time to be a very severe reduced quality of life problem, and an urologist will suggest it be treated.

Complete loss of control day and night will probably result in advice to have an artificial sphincter implanted. To an urologist, the risk from surgery to improve quality of life is well worth it.

If the leakage is only at night and situations where it's been a longer time since you were able to get to a bathroom, then risk from surgery may not be worthwhile.

A small problem with limited impact on quality of life (as viewed by others) is the hardest for a urologist to try and treat.

Extreme treatments will not be medically indicated, especially if you are not mentally distressed by the condition.

When the condition is mild, the doc has to be careful he doesn't make it worse, so his treatment options are more limited.

[Spargano]

So if you were to indicate your quality of life is not horrible with this condition then he would be obligated to say, ok? Given that I have pushed my average over the past three days to 20-36 wetting a a day I think I am definitely in the over active bladder condition. I use urobladderdiary to track and it is incredible how it is helping/teaching me on my journey.

All I would want, if I was referred is a diagnosis and a clear bill regarding prostate issues and cancer. My management is fine, and given what I read on incontinencesupport.org I am not out of line at all.

Spargano

[kevindhca]

Actually that's one of questions on the prostate condition page.

Quote:

How would you feel if you had to live with your urinary condition the way it is now, no better, no worse, for the rest of your life?

1) Delighted

2) Pleased

3) Mostly Satisfied

4) Mixed

5) Mostly Dissatisfied

6) Unhappy

7) Terrible

The answer to this question will tell the doc how much risk and medical intervention the patient is willing to take for possible improvement.

I'm going with Mostly Satisfied for me.

The problem doesn't have a big impact on quality of life, and any treatment carries the possibility of side effects worse than the condition, or treatment could worsen the situation.

[ut8ft]

I went to the urologist earlier this month and they are saying that my estimated bladder capacity is 1 liter and they cant figure out why it is so large and why i am not voiding all of the urine. They checked my prostate and it is normal.

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[kevindhca]

Wow, 1 liter is a lot, twice the average amount.

Do you have a history of holding it a long time?

A bladder that distended could lose it's ability to contract, resulting in a requirement to cath just to go.

My bladder will not hold more than 400 ml. I feel the need to go at around 200 ml. At around 350 ml I feel like I can't hold it any more.

[ut8ft]

Ya i do. I never liked to go to the restroom when i was in school and my first bladder infection was in 3rd (grade i later found out that the are considered uti's) the strange thing is if i werent holding that much urine i would probably weigh 133 the Drs. are considering some type of delimitating disease since i have scaring on my brain and my insurance just approved ensure plus 3x daily for a year to get me to gain weight and every test they have run comes back fine even though i snack through out the day and eat 2 hearty meals a day.

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