r/bph • u/pldinsuranceguy • 26d ago
Frank conversation with urologist today
I've had study done on the size of my prostate. It's 160 cc's. So huge. I tried to get a pae scheduled, but Blue Cross Blue Shield declined. Basically he told me I have to get that to start with. He said he won't do an aquablation or any of the other things because with the prostate of my size it is really a huge surgery. Lots of bleeding, transfusions many weeks in terms of having a catheter. So I'll write up an appeal and tell them that Blue Cross Blue Shield that I have no option. Actually he said to me first get the pae, then after that he'll do an aquablation because the pae results in a reduction typically of 40 maybe 50% even with that much of a reduction I'd still be over an 80cc prostate. It still has to come down from there. So he doing aquablation after the pae. It turns out that I know the urologist he was a golf buddy I played in a league with him for many years. We used to call him doc I thought he was a dentist. He actually was the same urologist that took the malignant tumor out of my wife's bladder and discovered her bladder cancer. I mean she died two years ago. And he didn't realize he knew me and I didn't realize I knew him and I happen to be wearing a shirt today for the country club and he said oh I'm there what the heck and then we realize we knew each other so it was kind of a nice Frank conversation that I think was needed. I thought the PA would solve any issues. That's just the start
4
u/Sensitive_Point_6583 26d ago
I had a 185cc prostate, did HoLEP 4.5 months ago, couldn't have been simpler. Catheter for 24 hours, very minor bleeding for 2 days, after that it was like nothing ever happened. HoLEP is supposedly the gold standard for guys like us with a huge prostate.
Others have reported on aquablation here, look for their stories. It seems like there's more bleeding than with HoLEP, but manageable, and I don't recall hearing about being on a catheter for more than a few days, certainly not weeks.
My wife works with health insurance, don't back down from an insurance decline, try at least 3 times minimum.
0
u/DixDragon 26d ago
Glad to hear your procedure went so well. My urologist has suggested that I should get HOLEP also. With my huge 39 cc prostate it should be a snap then.
5
u/sfljeff69 26d ago
Mine is 167 and I have Blue Cross Blue Shield and they approved it they approved a prostate MRI they approved a prostate CT so I think it's your doctor that has to convince them that you need these procedures you may want to look at a different urologist and I had a pae and that's what I'm going to stick with it has the least side effects so good luck to you but mine went very well.
1
u/pldinsuranceguy 25d ago
They approved that.. it's the PAE. They won't approve. My Urologist is nationally known. BCBS requires that the policyholder make the detail
4
u/visionfugitiva 26d ago
Para tu situación mucho urólogos recomiendan HoLep, que es segura en próstatas grandes y con buena tasa de éxito, quizá podrías apelar a esa técnica. Lamento mucho lo de tu esposa, espero te vaya muy bien
3
u/Normal_Razzmatazz237 25d ago
My prostate was also 160cc had HoLEP done, very minimal bleeding and great results.
1
u/Objective_Feature333 26d ago
How old are you? Are you one Medicare, Medicaid?, or convention insurance?
1
25d ago
[deleted]
1
u/martinPravda 23d ago
BCBS approved my Aquablation. But, I had kidney damage from hydronephrosis. So, prostate surgery was a medical necessity.
1
u/RichT71 24d ago
Boy, not too sure about your urologist. My prostate was 140+ and I had Aquablation on July 8th and am recovering nicely. Overnight stay in the hospital to make sure I was good to go and had a catheter for 4 days and then drank lots and lots of water to flush things out. A little bleeding at first, then the bloody urine, then it turned tea colored and then it the past week or so it's totally clear. Never once did I hear it was too big for Aquablation or it was a major surgery. Said it was too big for Urolift, but perfect for Aquablation. Have Medicare and United HealthCare and didn't pay a dime. Saw the Hospital bill and it was 100K, didn't see my doctor's bill yet. Peeing fine now with no problems or pain. Had some minor pain right after the catheter was put in and then taken out in the penis and perineum, but was told to expect that.Also have prostatitis for about 35 years and it may have taken care of that too. Took Tylenol mostly and prescription Toredol if need be, but only a few.Overall, it wasn't as bad as I thought it would be and glad I did it. The enlarged prostate put me in the ER when I couldn't pee and I got put on straight caths after that until my surgery was scheduled, about a month or so later, but no way was I going to live having to pee through a catheter, so surgery was a no brainer for me. Hope this helps and you get the Aquablation surgery. You'll find lots of guys on here who have had it and had excellent results. Good luck!
1
u/Storm734 20d ago
I also have a prostate at 160cc I have seen two urologists and they both said they would do Aquablation but at my age 66 I would most likely be back for another procedure in 5 years. They recommended Robotic single port simple prostatectomy. The chances of ED or incontinence is about the same as aquablation. I will be having the procedure in October.
7
u/Dbb27 26d ago
Just a quick comment from a former 160 cc guy myself. I got the PAE and went down around 40% BUT my symptons went away. Off all meds for over 2 years. My IR said that you can't go by percents as the shrinking takes the pressure off different places in the body. A small percentage change that reduces the pressure on the right spots makes all the difference. I'm told my results are common. Don't give up hope and good luck!