I definitely understand about wanting questioning practitioners. I actually had one Urologist for about 15 years. I was first seeing him for fertility as we tried to have another child. He is a well known urologist, specializing in for male infertility. He didn't see women. After a year or two there, one day at a visit I mentioned urinary problems (straining/hesitancy) and he performed some tests he didn't usually do and diagnosed me with BPH. So from a relatively young age (early 40s) I was being treated for BPH. He always mentioned at some point we may want to do something more drastic than medication, but given my age, it wasn't necessary yet. Somewhere along the line he gave me info about Urolift. I looked at the pamphlets and than even went online and read more information about it. Was even able to watch videos of the procedure online. The procedure didn't concern me too much - meaning it didn't frighten me - how they performed it. What worried me was that it didn't seem like a very good solution and seemed pretty invasive to the tissue. So I held off and would come across new options and would research them, like Rezum. Finally about 2 years ago as things got worse, I decided lets do something about this and went through all the tests to make sure I was a good candidate (which involved TRUS, cystoscopy and another extremely invasive test including all kinds of electrodes and a catheter).

Anyway, back to the point. After all the tests I went home and started looking into Urolift again, because it had been a few years and I was still apprehensive about. What I was reading was that the results were not great and only lasted a year or two. (But now you had these clips in you permanently) Within days my social media feeds started popping up all different stuff about BPH and procedures including Urolift as well as multiple clinical trials. So when I went to my follow-up with my Urologist, I asked about some of these procedures that were in clinical trials. He got kind of dismissive and angry, (my urologist of 15 years) like "none of those are very good and besides we're not participating in any trials at this time". Basically scolded me. So he went over all of my results and said I was a good candidate for Urolift and sent someone in to schedule the procedure.

Since I was still had my doubts about Urolift because it seemed traumatic to the tissue and everything I read basically said it didn't last very long I decided to do a little more research. With all these new options that kept popping up in my feeds (one or two on the streets) as well as clinical trials. The trials in particular looked like elegant design solutions to the BPH problem. So I cancelled my Urolift by phone - called and said I had a conflict and needed to reschedule. I never called back to reschedule. I reached out to the office of one of the doctors who was doing a couple of the trials, in my city. Made an appointment with no commitment and did all the tests and after I cleared the bar, became a clinical trial patient. A device was put into my urethra in the prostate area (via cystoscopy) for 3 months and then removed. I am now almost 2 years from starting that, and over a year and half since removal. It was very effective, the procedure wasn't too painful and best of all, it did not traumatically pierce the tissue. (Although one time while it was still in, I received quite the friendly inspection of my groin from a TSA agent.) The device worked really well, at least for a year. I do feel like I am getting more hesitancy again and retaining more again, but not straining like before. Since nothing was permanently put in me, or gouged out of me, I don't mind - it gives me the opportunity to try other options in the future as those options get better. All of that to say, because my urologist of many years got angry and wouldn't even discuss other options with me, I moved on. The future of my genitourinary system to function for all of its intended purposes deserved better than my long time doctor getting angry at me for asking questions.

Now one could wonder why I didn't go to the urologist heading the clinical trial who did the BPH device. I actually would have, he has one of the best bed side manners of any doctor I have ever been the patient of. However, at one of my visits while talking to him, he told me he only deals in urinary incontinence issues (which includes BPH) and between clinical trials and his patient load, he doesn't have time to treat anything else. He would have seen me if made an appointment to see him, but it would have taken several weeks to get in because he is at a large medical provider. He probably would have tested my PSA again and done a DRE, but then he would have referred me to someone else at the organization, which would require another wait of several weeks and it would still be a doctor I didn't know. So I opted to find someone within the medical group where my PCP is.

Also, as a final note since some might say, "your PSA is probably elevated by BPH" - I was diagnosed with BPH 12 or 13 years ago and my PSA was consistently 0.9-1.1 for all those years until 2023 when it doubled to 2.2 and this year when it jumped to 5.

Sorry for another long post. 😐