Anyone Here (or Anyone's Dad) with Prostate Issue?

Is there no cheap way (or Free via Medicare) to get it fixed?

We don't mind waiting, so time is a non-deciding factor however $ is priority.

We went to GP yesterday and I've asked the permanent way to fix the prostate issue and was advised to consult with private specialist (which of course $$$) … 1st consultation, 2nd consultation and so on .. so it adds up :(

By permanent way of fix is by surgery.

We don't have Private Health insurance.

Comments

  • Ask your GP to refer you to a public hospital.

    • I did that; I've asked and he made a quick call to Blacktown Hospital and they said Prostate is not yet 'public listed' … whatever that means ..
      And the GP seems to know for the fact that Westmead Hospital doesn't do one .. hence he didn't make that phone call.
      However, knowing that prostate is quite common problem in male, I find it hard to believe that Australian Government (Medicare) hasn't got it covered.

      • My GP has referred me to public hospitals for prostate issues three times over the past few years. The first was to the Royal Melbourne Hospital for a prostate biopsy. The second time, a year or two later, was to the Peter MacCallum Cancer Centre, for a template biopsy. I am currently on the waiting list for an MRI at the Royal Melbourne Hospital, which I expect to happen within the next few weeks. If they ever find something that requires prostate surgery, that surgery will happen at the public hospital that conducted the tests.

        I don't know what your GP/hospital means by saying that "Prostate is not yet 'public listed'", but all my prostate care has been and will be in a public hospital. I do not have private health insurance. Yes, there is a waiting list. How long you wait depends on exactly what is wrong - the wait for my MRI will be two to three months. I don't know how long the wait for actual prostate surgery is, and I hope I don't need to find out!

        Perhaps the issue is that whatever you have wrong with you is different to what they think might be wrong with me. I think you need to ask more questions of your GP, and/or consult a different GP.

        • and/or consult a different GP.

          I'm leaning towards this, thanks for your input.

        • My GP has referred me to public hospitals for prostate issues three times over the past few years. The first was to the Royal Melbourne Hospital for a prostate biopsy. The second time, a year or two later, was to the Peter MacCallum Cancer Centre, for a template biopsy. I am currently on the waiting list for an MRI at the Royal Melbourne Hospital, which I expect to happen within the next few weeks.

          I presume you didn't fork out cents for all the above?

          If they ever find something that requires prostate surgery

          I presume with the surgery, you're yet to know, so I won't ask

          • @tempura:

            I presume you didn't fork out cents for all the above?

            Zero dollars and zero cents. Actually, that's not entirely accurate - I had to pay to park my car at the hospitals.

            I presume with the surgery, you're yet to know, so I won't ask

            No-one thinks I have prostate cancer at this point. My prostate is enlarged, though, and my PSA levels seem to go up and down all over the place. The MRI might reveal something, but most likely not.

            • @pjetson: Good luck :)

            • @pjetson: My dad aged 80 is in the exact same situation. Had all the tests done and the doctors recommendations where to reduce caffeinated drinks or to reduce the consumption of the said drinks.

              Not a diagnosis, but something to try well you're waiting.

  • Permanent "fix" is called a T.U.R.P (Trans Urethal Resection of the Prostate) operation which, like all operations, is performed by a specialist.
    I do not know whether it is performed in the public system but I cannot see why not.
    With private health cover my out of pocket was still just over $3,500.
    It is one of the most common operations on men over 60.

    • Do you mind me asking, which Private Health Insurance that you have as I intend to purchase a cover and I do understand about the 12 months waiting period for any pre-existing client.

      • I was with G.M.H.B.A.

      • You might want to double check with the provider. In many cases pre existing is not covered, period..

        • not true! not sure where you are getting your information from, but all the large, well known PHI's cover Australian residents (with a medicare card, so not overseas visitors type cover) for pre-existing conditions after a 12 month waiting period.

    • TURP is done in public. However, you'll need to get onto the waiting list. I think how it works is surgeons have private rooms where they see both public and private patients. Then, if you don't have insurance, they will put your on their public waiting list. If that person doesn't work in the public, he/she refers you to someone who does.

    • TURP Iis the open surgery. Laser surgery was being performed in the early 1990’s as day patient procedures - but only by 1 Doctor - people were coming from interstate for the surgery. I believe it is more advanced nowadays but I worked at another hospital in the same town and we would get the occasional complications admissions.

  • What do you mean by prostate issue? I had prostate cancer, had it removed in public hospital. It cost me nothing apart from the specialists consultation fees and MRI etc. Don't muck around, get it checked.

    • So if i got this right, there's no public specialist hence all need to go via private specialist?

      • That would be correct unfortunately.

        • Ok, i'm getting contradicting information here … my GP seems to have the same thinking as your GP .. hence the private specialist … however ozbargainer in the above post (in Melbourne mind you) he went straight to public, so nothing private whatsoever. I need to do further research on this.

          • @tempura: You are gambling with your health over a $250 or so specialist fee?

            • +3 votes

              @brendanm: Well, no, OP is gambling with their health over an unknown but almost certainly large amount of money involving at least a specialist's fee, but most likely multiple specialists' fees, MRI fees, etc. Example cost for someone with vaguely similar issues that ended up doing this TURP thing (see (Ocker's post)[https://www.ozbargain.com.au/comment/6935766/redir]) was $3,500 out of pocked with insurance - and OP does not have insurance.

              So gambling, yeah, but likely for much more than $250, and they've presumably being paying their taxes and so already paid for their treatment under Medicare if this is actually covered (and there are claims here that it is).

              • @ely: Why would you even think about gambling on your health for $250 or even more. I bet he has enough money to buy a car or spend money on items etc, but anything with spending on health which you aren't getting a physical item from, people become tight wads as theres no physical return. Mate it's your health, just pay for a specialist and see what they say! It's that simple. Money or no money you don't muck around with health. This will be a lesson also to get private health insurance. You would be able to go wherever you want and see the top specialist and surgeon and it's covered, unlike seeing an average surgeon in public which you get zero choice..

              • @ely: To tell you a story so you can decide it's a gambling or not. A guy I worked with got to emergency for bloody urine, they performed emergency surgery and later test showed it a form of aggressive one and he had to quit his job to focus on treatment but sadly passed away in less than 2 years, just when he was about to reach retirement age.
                But statistically speaking most prostate issues are benign, my in law has one, he had a few panic period when notified and after couple of consultations and testing doctor gave him an ok, he just had to live with it for the rest of his life. The guy above just really unfortunate to get the hit, despite being super careful about his diet and lifestyle (no smoking, drinking, no eating junk etc.)

                • +1 vote

                  @lgacb08: I'm not sure what point you're trying to make. I'm not arguing that OP should or should not pony up for a specialist, I'm only pointing out that the costs of going private are likely to be significantly more than the $250 that brendanm mentioned.

                  • @ely: I'm trying to say an unknown diagnosis can have very different outcome and it's not worth it to gamble your life over the small saving. There are 2 scenario when someone in OP's situation: it's either uncertain and GP want him to go specialist to get more definite answer or it's just an inconvenience that OP find not worth spending thousand of dollar on and trying to get it fixed on the cheap via medicare. In his first few post he was being very vague so that's my guess. But over the length of the topic it seems that OP is just one of those many old fellas having that inconvenience. I can tell you that if after that first $250 consultation the specialist think that you're not gonna make it within a year or less then he'll find you a priority ticket in a public hospital.

                    You might criticise Medicare on whatever issues but almost all the case if your problem is not funded by medicare or having to wait 12+ months then it's not an emergency and you're not gonna die for it, if you want it fixed then pay up.

                    The fact that OP lives in NSW isn't gonna help him because that state was known to be among the worst on non-emergency waiting list. Sometimes it worth considering relocation ;)

                    • @lgacb08: That's fine and all - I'm not making any statement about whether it's worth it or not, I'm just saying it's not $250 :) Perhaps you should have been replying to OP instead of me?

              • @ely: At least the specialist can just tell you what is happening, without a 12 month wait. Judging by ops posts on here, he has $2k+ in a camera and a tonne of other crap, pretty sure health is far more important than any of that.

                If the specialist says it's not urgent, great, wait for Medicare. If it is urgent then go from there.

                Seems pretty silly to just wait if it's something that needs doing asap.

                • @brendanm: I think it is the other way around. If it is urgent, you will be prioritized by medicare and wait time will be shorter. If it is non-urgent, as in not life-threatening, but most certainly very inconveniencing, that's when you need private insurance to get your quality of life back to normal in the shortest possible time.

                  • @leiiv: My point was to get to a specialist so they can actually tell you if it is urgent or not. At this point op doesn't even know what is wrong.

                  • @leiiv: leiiv you don't know the exact issue and extent hence why its referred to a specialist! you go to the specialist to find out what is exactly wrong and what procedure to take next and they can refer you to a surgeon, where a GP can't and GP can only really tell you what the report has said which is written by a specialist. You're not going to wait 12-24 months to see a specialist in a public hospital to save a dollar. You don't go tight with your health bud

                • @brendanm: That seems like a pretty reasonable approach, and probably what I would personally do as well.

          • @tempura: The specialist can diagnose and advise the correct treatment/procedure. Then you can look at going to private or public hospital as referred by the specialist. This was the process for my son's tonsils; GP referred to specialist, then option to be referred by specialist to public hospital for treatment, or go private for treatment with the same specialist.

  • I admire your insaitable appetite for bargain hunting. Maybe look for a hospital or specialist that is affiliated with cashrewards?

  • I was once strongly advised by a relative that I get my prostate checked out due to a family history of enlarged prostates.

    …despite the fact that I am female. ¯_(ツ)_/¯

    I don't have any advice for you OP but I hope you find a solution and wish you well.

    • But did you have it checked? :-)

    • …despite the fact that I am female.

      Honestly, I'd be more concerned about the fact that you're missing a forearm and you have a hand floating independently of your body.

  • The Australian prostate centre deals with everything related to the prostate. They bulk bill patients (=no out of pocket expenses) as long as you have a GP referral.

    https://australianprostatecentre.org.au/

  • As some have pointed out - what sort of prostate "issue" is involved?

    • We had an ultrasound done; so the process was done 2 steps:
      * full bladder
      * then empty the bladder

      So it was diagnosed as follow:
      * the inability to empty the bladder, so only partial went out but majority remains inside, hence the frequent need to go to toilet.
      * the prostate was also enlarged.

      • A common next step for that kind of bladder issue is a flexible cystoscopy. I'm having one tomorrow, at the Royal Melbourne Hospital, as a public patient. My ultrasound was also done at a hospital.

      • So it was diagnosed observed as follow:

        The inability to empty the bladder is the symptom. They've just confirmed the symptom.

        The prostate being enlarged can be caused by several different things. Is it just swollen, is it inflamed (which is medically different to just being enlarged)? Is there a growth? Is it malignant or benign?

        Go to a specialist and get an actual diagnosis.

        • This.

          BPH is the most common, but you need to distinguish between that, cancer, or stricture. Treatments are different.

      • My father has similar symptoms, they noticed an anomaly on his bladder ultrasound (which looked a bit like a darker band if I remember right) which they wanted to test further by cystoscopy (internal inspection) as they suspected bladder cancer but he wasnt super keen so he ended up paying for his own MRI scan instead of the internal. This scan actually revealed a prostate cancer although it is just being monitored at present.

        He then decided it was probably best to also get the bladder internal inspection done after all. It showed no cancer of the bladder however what it did show was a "fold" in the bladder which resulted in incomplete drainage.

        There is a Hospital in Newcastle that also offers another type of scan which can apparently show up any signs of prostate related cancer anywhere within the body. A friend had this done after getting prostate cancer and it showed a related cancer inside a rib for instance. I can find out more if you want?

  • What is the actual issue, is it BPH or something more serious?

    I had mine done about 12 years ago, we went semi private and it cost about $1000. I was reading recently they are using a new unique now using some kind of steam injection rather than laser which results in quicker healing so you might want to look into that also. No reason you can't go fully public except for the wait times. But if it is BPH, don't put it off for too long. Dad did that for years and then eventually it blocked up completely…on a flight to London. It then became an emergency situation, had the ambos there waiting for the plane to land…..

  • Exactly my symptoms.
    There are tablets that you can get by prescription that will ease the problem, but that is generally only good for a few years.
    Eventually the prostate will enlarge to the stage where it will completely block the urine flow and then it is a trip to the emergency ward to have a catheter inserted to drain the bladder. Again, only a short term fix and eventually a TURP will be required (not a nice operation!!)

    • There are tablets

      The GP said 3 options for us:
      1. Do nothing
      2. Tablets … now I know what he's talking about ….
      3. See specialist and get it done for good

      With these tablets, I presume you haven't taken them before? If you did, will that helps with emptying full bladder (hence no frequent visit to the toilet)? I do understand your point that it's only good for a few years.

    • I don't think they still do TURP (i.e. with a blade), they either use a laser or that new steam technique I mentioned. The OP is OK, let's face, the OP will be unconscious, then you go home with a tube hanging out of your dick for a week, then they yank it out and you're good to go. Well, you're good to start recovering. Though the Rezum (steam) seems to be better in that regard.

      Here's some info for the OP to chase up with his doc.

      https://www.youtube.com/watch?v=bpuXaeOUB1s

      https://prostate.net/articles/rezum-therapy-uses-steam-treat...

      • The Greenlight laser is less effective than a traditional TURP and is usually reserved for patients who are on anticoagulation and cannot stop them or those with bleeding tendencies (less bleeding with the laser)

    • Common side effects after TURP surgery include:

      bleeding after the operation – this usually reduces over time and should stop after four weeks
      retrograde ejaculation – most men are able to have erections and orgasms after surgery to treat an enlarged prostate. However, they may not ejaculate because the bladder neck is removed along with prostate tissue. This causes the ejaculate to collect with urine and pass out of the body in the next urination.
      

      Less common unwanted effects of surgery include:

      urinary symptoms do not change – sometimes surgery does not cure your urinary problems. Even though the blockage has been cleared, the bladder irritability may continue and you may still have symptoms such as being unable to empty your bladder completely, and nocturia (passing urine more than twice during the night)
      erectile dysfunction (impotence) – some men are unable to get or maintain an erection sufficient for sexual intercourse after surgery. This is more of a problem for men who had erectile difficulties before their operation. This problem may be treated by medication
      urethral strictures – when scarring occurs in and around the urinary tract, it can cause further blockage to urine flow. Strictures may need to be dilated or need further surgery
      urinary incontinence – sometimes surgery results in being unable to hold or control the flow of urine. This may be due to continuing bladder problems or, less often, to sphincter muscle damage
      infertility – retrograde ejaculation is not harmful, but it can result in infertility. It causes the seminal fluid to collect with the urine and it doesn't come out as ejaculate. This makes 'natural' insemination impossible. However, in vitro fertilisation (IVF) may be used to achieve a pregnancy. The sperm can be removed from the urine and injected into the woman’s harvested eggs.
      

      I can't wait till I get even older and have to have such an operation :(

  • Have you consulted with a urologist yet? I think this is the first step to at least get the full picture of your situation. Ask the urologist how long you can wait before doing the procedure, if it can be managed medically (without surgery), the costs involved etc. Don't be scared to ask questions and also tell them that you can't afford surgery right away. Then you can decide what you want to do once you have the information. An initial consult might be around $250 (minus medicare) but specialists sometimes exercise discretionary pricing if they recognise your financial situation. They might even bulk bill the intial consult.

  • Another option is a Urolift. https://urolift.com.au/urolift-system/ Apparently a minimal invasiive operation. My urologist keeps giving me brochures on the subject. Some of the pills aren’t cheap as they are not on the PBS although there are a couple that are. Most have some side affects until your body adjusts.

    • Some of the pills aren’t cheap as they are not on the PBS although there are a couple that are.

      Are you referring to those 'tablets' which assist in relieving the prostate?

    • Be careful; urolift is likely not as good as the brochures suggest, and some urologists have a vested interest in the product/company

      • Yes I’m a bit wary of it and it difficult to find anyone that that has had it done to comment on the pros and cons.

  • Yes, they relieve the symptoms by relaxing the muscles to allow flow and reduce urgency. They are taken every day and are either tablets or capsules.

    As others have said you need to see a urologist for a correct diagnosis and suitable treatment. There is a questionnaire that gives a score on how you’re affected by the condition.

    • As others have said you need to see a urologist for a correct diagnosis and suitable treatment.

      agree and will do

    • Yeah I see a lot scripts for Duodart (dutasteride and tamsulosin). Dutasteride decreases the production of testosterone which would otherwise stimulate your prostate to grow. Tamsulosin helps relax the urinary smooth muscle so it's easier to pee.

      The risk with prostate surgery is that it's an important structural component of the penis. Removing all or part of it can cause erectile dysfunction and urinary incontinence.

  • Best thing would be to Google nearby public hospitals, identify which of them have a urology service, then seek a subsequent referral from your GP. The wait, however, could be many months and up to 2 years before being seen.

    You may also be able to see a private urologist (best to see one who works at a nearby public hospital too) who, with the relevant investigation results (i.e. urinary tract ultrasound with prostate size/volume and PSA) should be able to promptly diagnose the issue. If surgical treatment is required but you do not have private health insurance, the surgeon will often refer you to the public hospital they work at and have you put onto a surgical waiting list. This may be better than waiting months to see the urologist in the public system for initial consultation, then waiting weeks-months for further investigations, then waiting even more months for surgery if indicated.

  • My husband had his first Pristste MRI at a private hospital costing around $800. Last year he had it at the public hospital because they now had the technology to do them. Previously private was the only option.

    However the ounlic MRI was fine on an old nmachine refurbished to go the prostate job. The report was less extensive.

    Perhaps this is what your GP means.

    As an RN years ago there was plenty if prostate surgery in public hospitals. However thinking on prostate issues has changed a lot. A lot of malignant rumours are not removed. Enlarged prostates were being removed even when men were not having symptoms years ago. So perhaps the criteria for surgery has changed with that too.

  • I have the same symptoms as OP - I have an moderately enlarged prostate -and had all the usual prostate/bladder checks/analyses mentioned above by a urologist who monitored the symptoms over a few years. About three years ago he said it was time for me to have a TURP.
    Because I didn’t fancy the likely side effects (look them up), I thought I’d get a second opinion from a second urologist who said he wasn’t convinced my enlarged prostate but an over-sensitive bladder was causing my symptoms and that a TURP would not cure the symptoms. He referred me on to a third urologist who concurred and suggested a different procedure to deal with an over sensitive bladder, which I turned down, at least for the time being, despite having private health cover.
    I treat surgery as a last resort, and because I can manage my current bladder symptoms, I’m living with them, and they haven’t got much worse over the past few years.
    OP is going to have to see a urologist for a proper diagnosis, but as with all invasive surgery, my advice would be to ALWAYS GET AT LEAST ONE SECOND OPINION before deciding on what you want to do.
    My advice to the OP would be if he can manage the symptoms for the time being, take out private health insurance and sit out the 12-month waiting period. But it sounds like he doesn’t even want to pay private health premiums for a year even if it will save him thousands and allow him to choose his own urologist/surgeon.
    In any case, the symptoms of an enlarged prostate are usually just a nuisance/inconvenience (sometimes embarrassment), and there would be no serious health consequences in simply joining that dreaded public hospital queue.

  • Have a look at this website- It appears that if your Dad is having acute urological problems,say unable to pass urine he could go to the Emergency Dept and ask them at some stage in his visit to be referred to this clinic( no outside referrals allowed) http://www.wslhd.directory/australia/westmead/westmead-hospital/westmead-hospital-university-clinics-urology-service!

  • Prostate cancer is a huge killer. Don't play life and death over dollars and cents.

    Health is wealth, don't get that confused with being a tightass and leaving your family earlier than needed to save some cash (if you can afford it)

  • Hilde Hemmes has helped thousands of men with prostate problems
    https://www.herbalsupplies.com.au/index.php/conditions/prost...

    The man responsible for creating the prostate test spoke about how it is being abused in the medical system, I wouldn't negate it totally but know it comes with problems.

    https://www.medscape.com/viewarticle/828854
    https://www.smh.com.au/national/prostate-test-creator-labels...

  • I'm wondering if the gp might have misunderstood or misexplained?
    From what yr saying, a problem exists. You asked for a permanent solution. Whether this takes place or not, it requires a referall to a specialist. All specialists are 'private' in the sense that very few bulk bill but private health would not cover this either.
    Seeing the specialists would then result in a booking for surgery;this is where the private vs public would take place.
    So ideally yr looking for a referral to a low-fee specialist who can then either do the procedure or arrange for it to take place in a public health facility?

  • That's not right - there's public urology clinics. And there's also medications in the interm that your Dad can try if he hasn't already (assuming it's just a big prostate).

  • Hubby just had the robotic prostatectomy on medicare, 3 weeks ago. All free, from blood test, biopsy, mri & scan and surgery, including consultation with the urology specialist, also treatment post-surgery is free. He only had to wait about 2 months from when he got the diagnose. Are you only diagnosed with prostate enlargement or prostate cancer?

    • Sounds like my dad's situation maybe 3 years ago (Melbourne). Was treated at Peter Mac.

      Pretty much free through public even though have private health insurance.

    • Where was he treated and who referred him?

  • I've read a bit of this and just to summarise first:

    the background work was done and doesn't seem like its cancer, but now you want a surgical fix to the problem and you want it fast & cheap?

    few things I would say:
    - tablets work and have a good chance of dealing with the urinary issues
    - is there a reason why you are insisting of the surgical route?
    - are you aware of the complications related with the surgical option?
    - unfortunately not having private insurance for matters like this will likely mean a fast surgical option is almost definitely impossible, unless its life threatening like cancer

  • +1 vote

    Hi Tempura
    Been there done that.
    Loose weight
    Funny how loosing 20% of weight has improved the problem put up with it for 2 or 3 years.
    Still losing weight
    It is like Diabetes , Diabetes 2 is not a dieseas but a life style ( i think worlds number 1 disease )

    No money in it to be healthy! if your Father is healthy ,
    Increase iodine, selenium, zinc, increase testosterone ( exercise) which is is the opposite of Dr's and fat is good not the BS that is feed for the last 30 years.

    Go to a Compounding Chemist get some Lugols iodine 5% drink it at a few drops aday and he can splash on the Balls for increased absorbtion, may feel burning , balls increase in size and Boron Also increases in size.

    Bottom line been there done that and would run from a specialist that has never had the problem.

    •  

      Iodine RDA ,all rda is stupid recommended daily allowance is a measurement not to die, not about being healthy, do you think a person that is sick needs more vitamin C than a healthy person? Xxxx time even hundreds?.

      The USA RDA for iodine for adults is quite small, 150 micro grams.
      Yet Japanese take 12.5mg and have the lowest prostate

      Also

      https://www.health.harvard.edu/newsletter_article/selenium-a...

      Believe what you want .

      Good luck

  •  

    You will need to do some research on your own
    Junk in the trunk (fat) i believe is a huge problem, even a slim person that is not exercising could build up fat around the bum, eating fat is fine just a sedentary life style, go jogging.
    Squat for toilet, buy or build a squatty potty
    http://www.livealigned.ca/wp-content/uploads/2013/08/potty-b...

    Start low and build up
    Take selenium with iodine Tablets, Pepitas, Brazil nuts. Iherb.com ships to au,

    Dr. Brownstein who has written on iodine
    Check youtube
    Iodine gets rid of other toxins so yes you can get a detox reaction , so start low, I personally have taken large amounts, without problems
    https://drsircus.com/detox/iodine-and-detoxification/

    Iodine transdermal
    https://drsircus.com/cancer/prostate-cancer-treatment-choice...

    Prostate Problems: Why it is Rare Among Chinese, Indian and Japanese Men?
    https://www.toilet-related-ailments.com/prostate-problems.ht...

    3 ways exercise helps the prostate (yes, the prostate)
    https://www.health.harvard.edu/mens-health/3-ways-exercise-h...
    Good luck

  •  

    Should also say, Alcohol / coffee depletes Vitamin B and Magnessium so keep them up