Recent Urologist Visit - I know I should not be surprised

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johnt

Member
So I went to urologist for vasectomy consultation (still not sure whether I am going to do it). Prior to doc coming in the Intake nurse asked me questions about my medical history and medications, which I had listed Testosterone and Anastrozole (0.25mg once per week). She looked completely perplexed as to why I was taking Anastrozole. She even asked me to spell it twice. I got the impression she never heard of Anastrozole.

During the consultation the doc asked me about my TRT protocol. The doc asked when was the last time I ran my blood work. I said about 12 weeks ago. Doc explained that it was important to run every 12 weeks or so to monitor hematocrit. I mentioned the doc that I use for TRT is an hour drive away and that I pay for my own bloodwork. The doc inquired as the why I was paying out-of-pocket for the blood work and not going through my insurance. I explained my concerns of insurance denying payment then me getting stuck with a large bill so I prefer to use sites that Discountedlabs. Doc said that they order labs all the time and never have an issue. Doc then wrote script for me to get blood work done and to return in a couple of weeks. I do not plan on switching from my current doctor that is very knowledgeable to my Urologist but figure if I can get labs paid through insurance why not at least get that done.

So today I am about to schedule my blood work and notice that doc did not list estradiol so I call the office and leave a message to see if they can add estradiol sensitive test to my blood panel. Docs nurse calls me back and says "why do you need estradiol labs? We do not order estradiol blood work for those going considering TRT or for current patients on TRT". I told her that I take Anastrozole and recently stopped so I want to make sure estradiol is not too high. Nurse responded "Anastrozole? Why are you taking Anastrozole?". She went on to tell me that she would ask doc about adding estradiol test to labs but unlikely they would. She said if I want to get that tested then I may want to do that through my doctor that is monitoring my TRT.

I know I should not be shocked but it is still shocking that there are doctors prescribing TRT that really don't have a good understanding.

Side Note: When I went to my primary for physical my primary doc recommended I talk to my TRT doctor about changing my protocol from 1 injection per week to 1 injection every 10 to 14 days. Primary doc said 180MG every week is probably not necessary. LOL!!!!!!!!
 
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Saxon

Member
Side Note: When I went to my primary for physical my primary doc recommended I talk to my TRT doctor about changing my protocol from 1 injection per week to 1 injection every 10 to 14 days. Primary doc said 180MG every week is probably not necessary. LOL!!!!!!!!

The next time someone's doctor says something stupid like this, I'd love for one of us to say: "Why? Why 10-14 days Doc? Why not 21 days? Why not 30 days to make it nice and easy? Why not once a year doc?"

These doctors are insanely uneducated.
 

keigwin

Member
On the subject of vasectomy - I had one shortly after our second kid was born. It was easy and sooo convenient because my wife couldn't take oral contraceptives and this solved our problem.

Some years later I found a lump on my left testicle and it was tender. Got an ultrasound and the urologist said "I don't know what it is, but we should take it out in case it's cancer." Scared the sh** out of me, so I said by all means, do it. (What he did was remove the epididymis where the lump was.) Turned out to be benign, a sperm granuloma or something like that. These things can result from vasectomy, turns out. Also turns out that, according to a different urologist, the chances of it being cancer of the epididymis were really small. Wish I had known that then.

So, because he was concerned about possible cancer, the doctor did a more invasive surgery. This resulted in scar tissue that permanently left my testicle "up". It's not inside me, but it doesn't hang down anymore either. Guess it doesn't matter since it's more of an aesthetic thing, but it bugs the sh** out of me every time I see it in the mirror.

Not trying to scare you off of vasectomy, but you should be aware that there can be complications you'll have to deal with down the road.
 
So I went to urologist for vasectomy consultation (still not sure whether I am going to do it). Prior to doc coming in the Intake nurse asked me questions about my medical history and medications, which I had listed Testosterone and Anastrozole (0.25mg once per week). She looked completely perplexed as to why I was taking Anastrozole. She even asked me to spell it twice. I got the impression she never heard of Anastrozole.

During the consultation the doc asked me about my TRT protocol. The doc asked when was the last time I ran my blood work. I said about 12 weeks ago. Doc explained that it was important to run every 12 weeks or so to monitor hematocrit. I mentioned the doc that I use for TRT is an hour drive away and that I pay for my own bloodwork. The doc inquired as the why I was paying out-of-pocket for the blood work and not going through my insurance. I explained my concerns of insurance denying payment then me getting stuck with a large bill so I prefer to use sites that Discountedlabs. Doc said that they order labs all the time and never have an issue. Doc then wrote script for me to get blood work done and to return in a couple of weeks. I do not plan on switching from my current doctor that is very knowledgeable to my Urologist but figure if I can get labs paid through insurance why not at least get that done.

So today I am about to schedule my blood work and notice that doc did not list estradiol so I call the office and leave a message to see if they can add estradiol sensitive test to my blood panel. Docs nurse calls me back and says "why do you need estradiol labs? We do not order estradiol blood work for those going considering TRT or for current patients on TRT". I told her that I take Anastrozole and recently stopped so I want to make sure estradiol is not too high. Nurse responded "Anastrozole? Why are you taking Anastrozole?". She went on to tell me that she would ask doc about adding estradiol test to labs but unlikely they would. She said if I want to get that tested then I may want to do that through my doctor that is monitoring my TRT.

I know I should not be shocked but it is still shocking that there are doctors prescribing TRT that really don't have a good understanding.

Side Note: When I went to my primary for physical my primary doc recommended I talk to my TRT doctor about changing my protocol from 1 injection per week to 1 injection every 10 to 14 days. Primary doc said 180MG every week is probably not necessary. LOL!!!!!!!!

It's insane how little is known about male hormones, or really, hormones in general.

I guess in the grand scheme of things the average doctor sees, this is not that serious. I figure the average patient is Type II diabetic, HTN, morbidly obese and with at least another major illness. Not to mention the folks with serious illnesses, and these doctors just have a whole new perspective of what "sick" is.
 
On the subject of vasectomy - I had one shortly after our second kid was born. It was easy and sooo convenient because my wife couldn't take oral contraceptives and this solved our problem.

Some years later I found a lump on my left testicle and it was tender. Got an ultrasound and the urologist said "I don't know what it is, but we should take it out in case it's cancer." Scared the sh** out of me, so I said by all means, do it. (What he did was remove the epididymis where the lump was.) Turned out to be benign, a sperm granuloma or something like that. These things can result from vasectomy, turns out. Also turns out that, according to a different urologist, the chances of it being cancer of the epididymis were really small. Wish I had known that then.

So, because he was concerned about possible cancer, the doctor did a more invasive surgery. This resulted in scar tissue that permanently left my testicle "up". It's not inside me, but it doesn't hang down anymore either. Guess it doesn't matter since it's more of an aesthetic thing, but it bugs the sh** out of me every time I see it in the mirror.

Not trying to scare you off of vasectomy, but you should be aware that there can be complications you'll have to deal with down the road.


I had a Kidney Stone a few months back, the pain was shooting into my left testicle. Never felt pain like this in my life! Went to the ER, the Dr orders a Ultrasound of the testies, looking for testicular torsion. Ultrasound shows no torsion, but there is a small lump on the epididymis. Lucky for me they told me these are somewhat common and are very rarely cancerous. After the Ultrasound, they found blood in my urine, and did a CT scan. Kidney stone was working its way down into the bladder. My God I pray I never get another, that pain was the worse pain I have ever felt!!!
 

johnt

Member
@Saxon he has good rep for vasectomy but definitely not going to go to him for TRT. I'll take advantage of him running updated blood work for me, which will save me a couple hundred dollars.

@kiegwin thanks for sharing your V story with me. I know complications are rare but they do happen as you noted. At this point I'm on the fence but more in the NO camp on the V. I've never needed to be cut open, thank God, and don't want to start with a vasectomy.

@Vince Carter I was thinking of doing the same but thought it would be good for doc to know. The primary and Urologist did not say anything negative about me being on TRT but it was clear from their comments that they should not be treating people on TRT.
 
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