Need HELP dealing with urologist... - Page 2

[AnnMarie]

Originally posted by Frankly Speaking
Somebody please tell me if I'm wrong. I seem to remember reading somewhere that an undescended testicle that is not repaired is a risk factor for cancer later in life. Do I remember that correctly or am I all wet?




Frank

Not true. The risk of cancer is the same for those that don't have the surgery (The risk of cancer is higher with this condition, but surgery doesn't change the risk.), it's just harder to detect. And, like circumcision, the child can decide on the surgery himself when he's older. It's mostly cosmetic. They didn't do surgery for this long ago. It's not a life or death thing.

[Dragonfly]

Originally posted by Hilary
I couldn't find any decent links to illustrate what I found out when I talked to my doc.

He was surprised that they would advocate surgery for a descended testicle. After all, lots of people have lived long and rich lives with only one descended testicle. Sure, it means that that testicle isn't fertile. But unless a disaster occurs, your son could populate the rest of the world with the other one

Definitely true . There is, though, a fairly significant risk factor for cancer in the undescended testicle. My understanding is that the risk is still present once the testicle is brought down through surgery, but it is less than if it remains in the abdomen.

As far as the hernia, he did say that it felt as though he did have a hernia and that he appears to have fluid in the scrotal sac (which apparently is indicative of a hernia? Have to look for more information about that).

My doc won't do adenoids at that age. Adenoids are the "factory" that makes immunoglobin and complement, and other immune factors that help protect both the intestinal tract and the lungs he would be reluctant to touch them.

I feel like I'm between a rock and a hard place on this one. Generally, the adenoids don't began to shrink again (if they do at all, that is) until around age 5-7. Meanwhile, he can't breathe through his nose, he has apnea (which is really affecting his disposition at this point and I'm concerned about the long term ramifications of this), and he doesn't eat well (presumably because he can't breathe when his mouth is full of food) which is incredibly disturbing for a growing boy. So, we can leave his adenoids in and he can continue on this course for the next few years, which may affect his growth and his personality. Or we can have them out and most likely fix all of that but affect his immune function in the process. I'm leaning toward the second option partly because his immune system is quite strong as is (because it hasn't been disturbed in other ways) and partly because my reading tells me that adenoids get less and less important for immune function as a child gets older and sometimes even disappear completely in their teens. That said, I'm still not entirely comfortable with removing any part of his body. I'm just facing a very difficult balancing process here.

Were I in your position, the only thing I would consider, would be the testicle and hernia issue. And that would be very reluctantly.

Would you feel the same in light of what I've told you in the previous paragraphs? It just doesn't seem that simple to me (I guess because I'm the one faced with the decision). It's not a simple instance of, "Don't remove them and everything will be hunky-dory." He's really incredibly uncomfortable right now and frome every indication will continue to be for quite some time.

In terms of dealing with an obnoxious prat like this person, seems to me you are well on the way to sorting that out.

: I'd be over him like a chronic measles rash...

:LOL Yeah, I've got that part covered. And thanks for the reminder about the homeopathics.

The more I think about it, the more I'm convinced that I can't have this person operating on my baby.... I just don't trust him. The only way I might change my mind on that is if his ped does observe.

Crud. You know, sometimes it really sucks to be a thinking parent. This just gets harder and harder.

[BowenTherapist]

i haven't read all the posts, so i am not sure iuf someone already mentioned this, but also make sure he doesn't forceble retract the foreskin while under anestethisia.

also i just wanted to add that bowen therapy is amazing and may be able to deal with the undescended testicle, hernia and maybe the adnoid issue. here is a link talking about bowen...
www.bowtech.com

good luck with this idgit! it is great you are sticking up for your son so well

i wanted to edit to add:
did you remove ALL forms of dairy from his diet. .. basically all processed food since they put casin or whey in everything!

[Dragonfly]

I've had some time to look through the links that you all provided and just wanted to offer a heartfelt "Thank you!" once again. It's clear to me now that there is absolutely no need for a steroid cream whatsoever - that even if he "should" be retracting at this point and he does have some degree of pathological phimosis (both of which I think are unlikely) it does not warrant intervention, as yet.

And, furthermore, I'm convinced that this doctor is even more of a twit than I initially thought. Here he is recommending circumcision as a *first* resort when prevailing knowledge and opinion indicates that it should be the very last resort after all other measures have been taken. I feel sorry for every little intact boy who has walked into his office.

Grrrr...

[somemama]

Originally posted by Dragonfly

Yeah, unfortunately I'm not rich and it's looking like with my insurance it's either this guy, or the last one (who was worse), or no one at all.

I'm not rich, either. But this guy still wouldn't be touching my son.

[Dragonfly]

You know, I'm really not interested in this becoming a pissing match.

Let's keep in mind that it's very easy to say what you would and wouldn't do when you're not in the middle of a situation.

[somemama]

I know, but some choices are just bigger than money. (Even if I had to go to the extreme of running up a lot of credit and declaring bankruptcy, which normally I would be opposed to doing.)


Of course I'd have to fight my dh, who'd be saying, "No, let's just go with this guy anyway, since the insurance will pay for it."


If the ENT is going to be there, operating at the same time, can you talk to him/her about making sure that a circ doesn't occur?

I'd also talk to the urologist again, and explain in no uncertain terms that a circ will not be happening, or else a lawsuit will be happening.

Best wishes to you and your son.

[Frankly Speaking]

Originally posted by Dragonfly
Crud. You know, sometimes it really sucks to be a thinking parent. This just gets harder and harder.

Ya know, I think that is true of most aspects of life. Thinking about all of the rammifications of daily actions in life can certainly avoid a lot of bad outcomes but it is difficult at best. There are so many ways we can get tripped up it is almost overwhelming sometimes. I don't think it is getting any easier either. I think there are many more people willing to take advantage of you now than at any time in our history. I know there are many people who are not armed and don't have the ability to defend themselves and I really feel sorry for them. They walk through a minefield daily.



Frank

[madrone]

My DH had an undecended testicle and that waited until he was 11 to do the surgery. maybe i'm wrong, but i thought they were hoping it would end up descending on its own. BTW, the urologist circumcised him just for the heck of it during the surgery. His foreskin was retracting.

[Quirky]

What about the catheter??

Are catheters routine during surgery under general anesthesia? If so, you need to be careful about specifying that they don't retract him to put in the catheter. Or isn't there an outside-the-ureter catheter (like a baggie) they can do? Frank, what's the deal here with what Dragonfly needs to know about this?

[Frankly Speaking]

Good point! Thanks for bringing that up Jane.

Cathertization has been used as an excuse for circumcising men. As a matter of fact, a man in his late 50's was circumcised in New Jersey during abdominal surgery a few years ago without his consent. He sued and won a paltry amount. The doctor said he couldn't be cathertized unless he was circumcised. Of course, this is a crock of you-know-what!

It is a little more difficult to catheterize an intact child but not much more. There are also external male catheters that are essentially a condom with a tube coming out the end. They are simply slipped over the penis and taped in place. As a matter of fact, I would demand an external catheter. The standard catheter can introduce bacteria into the urethra or bladder causing a UTI and this would not happen in the case of an external catheter. The only reason that I can see for using an internal catheter is if they are taking a urine specimen and need to avoid contamination or if they are preforming surgery on the penis. (Such as hypospaidius repair) Most hospitals will probably not stock external catheters and will need to order them. Dragonfly, I would bring this to the surgeon's attention at least a couple of weeks before the surgery and make them show you one before the surgery begins. This is one of those things that can be "convienietly forgotten" and would not be used and you would probably be told that it was and had been used when in fact, it had not.

Of course, the doctor is going to say "You just don't understand these things. You need to just let us do our job."




Frank

[AutumnMoonfire]

Re: What about the catheter??

Originally posted by Jane
Are catheters routine during surgery under general anesthesia? If so, you need to be careful about specifying that they don't retract him to put in the catheter. Or isn't there an outside-the-ureter catheter (like a baggie) they can do? Frank, what's the deal here with what Dragonfly needs to know about this?

It is my understanding that at this point his foreskin can be partly retracted...if so, when it is partly retracted can you se the opening of his urethra? If so the insertion of a foley would not be a huge issue to a sensitive nurse...if s/he can expose the urethera s/he can insert the foley. they may fuss about it because it is suposed to be a sterile proceedure and the foreskin is supposed to be fully retracted for it...but those rules were set out in the"bad ol' days" and if you consider women don't need any major remodel for a sterile cath to be inserted....

a baggy cath, known as a "texas catherter" is likely to cause objection for getting in the way of the operative field. the main use is to collect urine samples in diaper wearing children.

I wish you luck dealind with this...I hope your pedi is willing and able to go into the OR to advocate for your son, otherwise I am really worried...landmines in every stinking proceedure!

[Gitti]

I just talked to my son (dr.) and he said here is what you should ask very specifically:

1. about the benefits or the procedure or surgery

2. all or any aternative therapy (this should be elaborated and examined thoroughly; don't accept a vague explanation)

3. what exactly is the expected outcome

4. have the surgeon explain exactly the procedure in detail

My son is a surgeon and he always shows a video while at the same time explaining the procedure. He spends about 2 hrs. or loger with each patient before doing any surgery.

[Xenogenesis]

Originally posted by madrone
BTW, the urologist circumcised him just for the heck of it during the surgery. His foreskin was retracting.

I'm so sorry some folks think that since they've gone to school "longer" than others they are therefore so much more intelligent than those others. :

[ThomasL]

Madrone,thats horrible that your dh was circed by the urologust with no consent involved.I hope he eventually sued the jerk.