Like some of the others have alluded to, Dr. Figert also performed my inguinal hernia repair a few months ago. I too found out, after the fact, that she had ordered a bladder catheter placed after I was anesthesized. So I go online to research the entire procedure and also Figerts backround, what I found was enlightening and surprising. Laprascopic hernia repair is relatively new, only gaining popularity since the mid 1990's. Early on Dr. Figert realized the many benefits of the new procedure over the old 'open' style where mesh was simply placed on 'top' of defect. So Dr. Figert honed her skills with special training and undertook the exceptionally long learning curve (100 plus surgeries) to become an expert using the superior Laprascopic TEP approach. (Totally Extraperitoneal) considered more difficult but better than the more invasive TAPP method (Transabdominal). Dr. Figert also wisely chose the best polypropylene mesh and the highly regarded titanium helical devices for securing the mesh. So where am I going with all of this? With all of the very wise decisions made by Dr. Figert (my surgeon) why would she cling to the outdated bladder catheterization protocol developed in the 1990's when this laprascopic surgery was in it's infancy? The assumption then was that surgeons were slow and clumsy with these new fangled, long instruments operated while viewing a monitor. And during these early, rather protracted laprascopic hernia repairs, the bladder would become distended (full) with urine and become more vunerable to injury by the surgeon. But that was 20 years ago and many thousands of hernia repairs ago. Now most experienced general surgeons perform the laprascopic procedure in 45 minutes to one hour. And simply having the patient to empty their bladders completely during the hour or two in the pre-op area will suffice. Thus a patient with a nearly empty bladder undergoing a laprascopic hernia repair by an experienced surgeon has no medical reason to receive a bladder catheter. This is where the paradox comes into play. Why would a surgeon like Dr. Figert who was very progressive on techique (TEP) and materials (correct mesh and fixation) still INSIST on ordering a relic from the past ( Foley indwelling baldder catheters) ? A Foley catheter is a foot long and about 6mm in diameter (1/4" or about the size of a pencil) and is forced into the urethra by the nurses hand using some lubricant. They always carry urethra bacteria back into the bladder (even while using sterile method) and usually cause trauma to the urethra, especially in males. On some occasions the urethra tears or is punctured or the inflatable balloon causes permanent damage to the urinary tract. Those events could affect a persons ability to self-urinate forever. So while Dr. Figert is unquestionably a qualified surgeon for the reasons mentioned, her absolute insistence on ordering painful and risky bladder catheters before ANY surgery may be enough of a reason to seek out a surgeon who does not expose patients to such archaic methods. Most general surgeons do NOT order bladder catheters for surgery's lasting under three hours. So just check with other surgeons and you'll find others who are confident and skilled and don't intentionally expose patients to unnecessary cath's. Good Luck to you.
One would like to believe that an experienced (20 plus years) general surgeon would know the medical indications (reasons) to order bladder catheterization. And they are; Acute urinary retention, need for uncontaminated urine for tests, patient immobility and urine blockage, and finally bladder catheters are medically indicated before urinary tract & prostate surgery. Also any long duration surgery (more than 3 hours) to prevent bladder filling. So it is very surprising that this surgeon, Dr. Patricia Figert MD, would order bladder cath's for her surgery patients NOT in any of those catagories. And even for 45min. to 1 hour routine surgeries. For those who don't know, a bladder catheter, also known as an indwelling Foley catheter, is a large ( 6mm or 1/4" diameter, pencil-sized ) 15" long plastic tube that a nurse forces into the patients urethra with her hand. Its implied that it's a 'sterile' procedure, but actually the bacteria within the urethra naturally is carried back into the bladder contaminating it and sometimes causing urinary tract infections. After the plastic tip of the tube is pushed in all of the way to the bladder, the nurse uses a syringe of water to fill a balloon to secure the catheter tubing from slipping out on its own. Even after removal, these catheters have nearly always caused trauma to the urethra from extreme 'stretching' of the lining. Due to this urethra damage the ammonia in the urine causes days of urinary burning. But first you may experience many hours of induced urinary retention, another very common side effect of bladder catheterization. Occasionally severe urethra damage results from the catheterization and then surgery must then be performed for that repair (hopefully by a more caring surgeon).Dr. Figert attempts to justify 'cath' orders by claiming that she might inadvertantly puncture a slightly distended bladder during surgery (statistically an extremely low occurance). And only intern (novice) and inexperienced general surgeons can claim that excuse. For any routine surgery of less than 3 hours, simply having the patient to empty their own bladder pre-op will suffice. The surgeon could also use a bladder scanner (ultra-sound) to confirm the bladders empty status before surgery. But Dr. Figert (and some other old-school surgeons) just have old, bad habits and willingly expose their patients to the many serious risks of bladder catheters. It may be easier to find another surgeon who does not 'cath 'em all' . Good Luck, Chris T. May, 2015
George Conway Juhl & Stephens
I've read with interest these patient reviews of the general surgeon Dr. Patricia Figert. It seems that Dr. Figert has a personal preference to order bladder catheters on virtually all of her patients. Years ago bladder catheters were considered a normal and routine pre-operative practice. Much has changed but Dr. Figert has not. Research and disturbing statistics now reveal that Foley indwelling cathetization (Dr. Figerts choice) is responsible for urethra damage, bladder and kidney infections and worse. They are supposedly inserted a 'sterile' fashion. BUT, bacteria already residing in the urethra gets pushed back into the bladder initiating infections in many patients. The catheter is a large tube (nearly 1/4" diameter) and is so long (14 to 16") that it curls up inside the bladder because the nurses are told to keep pushing it till it will go no farther.But here's the thing. Patients who simply empty on their own need no catheter. The only reason bladder catheters are ever needed before surgery is if the patient can not self-void beforehand or it the surgery will be extended (several hours or more). This should not be just the patients opinion against the surgeons opinion or personal prefernce. This should be about the best and safest course of action for the patient! Here are the federal (National Institute of Helath) guidelines for laparoscopic hernia repair (TEP/TAPP). But the cautions given about limiting bladder catheterization apply to most surgerys.See Chapters 2 & 11 - see 'Statements and Recommendation' boxes, copy and paste into your browser-www.ncbi.nlm.nih.gov/pmc/articles/PMC3160575/#Sec6titleand also more of the same from the very respected site, emedicinehttp://emedicine.medscape.com/article/1534321-periprocedure#aw2aab6b3b2Congrats to you on researching your surgeon before just blindly choosing one. You deserve a general surgeon who will provide you with the best care. And NOT subject you the many risks of bladder catheteriztion simply because she (or he) has developed bad habits which exposes patients to those complications unnecessarily.S.M. June, 2015
Dr. Reyes is the only doc I have met, who will take the time to get to know you, and familiarize himself with your specific issues. You are not rushed. His bedside manner is impeccable. You will receive the most thorough work up. I can not say enough good stuff. The downside, expect to wait to see him. He gives everyone his time, so when it's your turn it's worth it. The staff is, 'relaxed', but kind. This is not your average uppity-money making office. I believe he cares about his patients. Bottom line. He is worth the wait time. If you go, block out at least 3.5 hours. Usually only takes 2.5 though.
Pearl Medical Care Center
Good Dr and NP. Most office staff is good, however if you need a referral to anything else you either won't get it because the girl that should be doing them doesn't, or you will have to call them endless times to get it done. Even after the new girl took over, they still aren't getting done unless you have your insurance company call to get it done for you. Moral of the story, if you're fairly healthy and just need routine medical care and no referrals, this is the office for you- at least until they find someone who will actually do the referrals in a timely manner.