Not Good News after prostate biospy when MRI didn't look too bad

@stldadof4
I had it removed in Topeka on April 30th and then they cut me open again on May 1 at 2AM as an artery was bleeding. Two surgeries in less than 12 hours. Then about a week later they said I had a TIA. Kind of a rough time. Then when he was removing the prostate the surgeon fixed an inguinal hernia that I had since late 1980s and didn't bother me and I didn't want messed with, but they didn't ask- he just put in a mesh. I did all kinds of heavy weight lifting, never bother me prior to surgery. I knew about it, myself and PCP said if not bothering me leave alone, it wasn't that bad. Now the mesh he put in seems to have come loose and I have a bulge in groin. Looks like another surgery in near future?

I did try KUMC at first and the urology surgeon just would not answer my questions, so after a couple weeks I came back to Topeka. The Topeka surgeon has lots of experience with robotic, was responsible for bringing it to Topeka. He had done a urolift on me a long time ago. Has done over 1,000 radical prostatectomy with the Da Vinci system. I was a little disappointed with KUMC as 2 years ago I had an aquablation and found out after surgery a resident did surgery- not my doctor! Also, it didn't work and the doctor who was suppose to do surgery in first place said I needed a revision, I just said no and used Flomax. So I wasn't too happy with the urology department at KUMC. The doctor that was suppose to do the aquablation and the cancer doctor that wouldn't communicate were 2 different doctors.
Now they did wonderful with my wife's breast surgery care, couldn't have been better. But that was a different section of hospital.

@diverjer wow. You’ve really been through a lot. I misunderstood your original post and thought you were evaluating initial treatment options. Sounds like you are well traveled down that road. Very glad to hear that you have such capable care in Topeka, in light of so many other things you had to go through at the time of your PC surgery. Sorry to hear that KUMC wasn’t responsive to your needs.

@stldadof4

I should add that I don't mind the drive to KUMC, they have several clinics and all easy to get to. In late 60s I went out to LA and lived for 5 years, so used to traffic and still doesn't bother me. Straight shot down I70. Yes KUMC was also great with an ankle replacement I had done as well great with wife's breast cancer. Also the RO I worked with at the urology cancer center was great and always answered questions within hours. Somehow, I just got 2 bad draws on the urology surgeons and thrown in the dumpster for resident doing aquablation.

@diverjer - At teaching hospitals, it’s pretty common practice that a resident will perform parts (all?) of a surgery, but the attending surgeon is always available to keep the resident on the right path.

I can read through my surgical notes, and those detail which bits were done by the resident (whom I met just before the surgery), and which parts my attending surgeon did.

My notes just say the surgeon was there and collect specimens. All other notes were from resident. Also, when the real surgeon scoped me later when things weren't going well, he said lots of junk left in and I need a revision surgery. I asked was it new growth and he said no. He actually seemed angry or in a real hurry to get me out of there. He didn't spend two minutes with me after finishing scope and saying I needed a revision and it wasn't new growth. This is what he put in notes, not exactly what was said.

A/P: 78 y.o. male with recurrent LUTS, history of Aquablation 2/12/2024. Does have persistent obstructive tissue at apical gland in veru preserveration zone. No stricture/BNC. Reviewed options including revision surgery versus medications. Recommended trial tamsulosin 0.4mg. RTC 3 months.

I should show you notes from prostate removal on 4 30 2026 what the aquablation look liked, the word dirty was used.

We get yelp reviews, google reviews, medical websites reviews of all the Surgeons and Physicians we want to see before going, yet at the most important time that you go into surgery, you have nothing on the resident who may be performing a significant role in that surgery. I guess you just have to accept that is going to happen at most cancer Centers of Excellence which are part of the Medical school university’s. We are constantly told to learn how many procedures that your surgeon has done. It would be nice to know whether you are going to be the resident’s first patient, whether he is an A student or barely passing his courses. We also hear it is always under the supervision of the surgeon. I would rather be under the hands of the surgeon. There is nothing wrong not wanting to be treated by a resident. We are outspoken we don’t want to be a real surgeon’s first patient. Typically most surgeons that I have been around all seem to downplay the role of residents. I was at a dermatologist appointment to get a curettage and Electrodesiccation (C&D)of a squamous cell carcinoma when the Doctor walked in with a resident and asked whether it was all right for the resident to perform it. I was in their prepped and ready to go, what am I going to say. The Doctor afterwards said not bad, but I was obviously awake for this and you are hearing the Doctor say no don’t do that, you better go over this area again. All the instructions, I can only imagine in a major surgery, oops we didn’t want to do that. Diverjer’s experience with the resident’s work being dirty and junk left in I think is problematic. I think more transparency needs made by these surgeons and really what role the resident will actually play in surgery and the residents experience.

Went to Express Care Clinic Wednesday just to see what they thought of swollen area prior to seeing urologist on Thursday. Doctor at Express Care didn’t think it was from a detached hernia mesh, wasn’t sure what it was. Felt all around and did the old cough test and said be sure to check with urologist. She didn’t think it was from the inguinal mesh coming loose, but she has seen swelling a few weeks or month after that inguinal surgery.
Urologist was not very helpful Thursday. He just poked and checked it out and said mesh is fine, it’s something else. See you later and I am sending in a referral for your pelvic therapy to help with incontinence. I kept asking what do you think that swelling is and he didn’t have answer, just kept saying not mesh coming loose. Said not all that much bigger than other side and I said other side not sore and it is noticeable bigger. He was in a big hurry, had been called into hospital for emergency surgery and was still in scrubs with an office full of people backed up.
May go to my PCP who isn't ever much more help and takes a month. Sure miss my old PCP that retired! The swollen area hasn't got worse, but is sore after some of my walks, but not for long. Maybe I am overreacting, but having that area swell up after surgery in groin does cause me to be concerned, but medical folks don't seem concerned. I thought they would at least do x-ray or one of those echo things.

Could it be swollen inguinal lymphnodes? Obviously a ultrasound scan would identify that.

@diverjer
I am surprised the doctor didn’t want to do a scan. @wheel1 Definitely has a good point. At least they could look inside a little bit and see if there is something going on. Time to speak to another doctor to see if you can get that done. Of course you could wait another day or two to see if the swelling goes away.

@diverjer
I can not believe nobody offered ultrasound or a CT (if not MRI ) to check what is going on : (.
Just madness all around ...How can doctor say "I am not sure what it is" and than not order further testing ?
Wishing you super fast healing and "heaven's intervention" since obviously in 21.st century in KS one can not have proper and thorough examination - I do not know what else to say : (((.
Sending you healing vibes ✨✨...