Gat Goren Method

Nice meeting you Andy. Thanks for your perseverance on informing others about an alternative to surgery. My brother had an emergency TURP after having had a hernia operation. He had difficulty in peeing. The TURP left him partially incontinent...with leakage everytime he got up from a sitting position. Now, at the age of 74, and a very active athlete, he talks about having to wear a pad..

You are right about Dr. Gat's knowledge of fluid dynamics and hydraulics. What differentiates him from others in the field is both his degree in mechanical engineering and his medical degree. And most of all, his ability to think out of the box...what most genius's do who excel in scientific discovery. The Gat-Goren team was actually able to measure the pressure of the blood flowing from the Internal Spermatics to the prostate. Here is a brief explanation to the best of my knowledge:

Normally, when the ISM's (right and left) are working properly, the free T (along with metabolic waste products) flow from the testes to the ISM"s to the inferior vena cava to the heart to the general blood stream. Average Pressure of blood near the testis (the pampiniform plexus and diferential vein) is about 6mmHg. The ISV's are long and have a length of about 35-40cm.

Now...When the valves of the internal spermatics fail, the blood instead of going upward to the ISV's, is forced downward by gravity (given the length of the ISM's) causing a gradient pressure of between +27mmHg to +32mmHg. This greater pressure forces the blood filled with free T from the testes to be diverted and detoured to the prostate via interconnecting veins. It then bathes the prostate with 130x as much Free T as normal....causing inflammation (Hypertrophy and Hyperplasia). Bernouli's (?) principle is involved here. I find it amazing that this inflammation can be reduced in most cases by 50% by sclerosing (glueing) the ISM's and allowing the prostate which is elastic to heal. Eventually, I understand the bladder follows suit. The bladder wall becomes less hardened allowing for greater flow of urine and more fluid retention. Healing, ...Much depends on the length of time one has had BPH, age, health of the urinary system, and whether one has had long term use of a catheter. The theory is that hyperplasia can cause changes in the DNA of the prostate resulting in prostate cancer. As I have stated previously, there are 3 other veins that provide an outlet for Free-T to get to the bloodstream even when the ISM's no longer function as a pathway.

Clap: The poster on this forum is Yoav: Go to viewing page 3.

"My name is Yoav and I live in Israel.
I have been suffering from BPH for about 10 years.
Tried few medications that helped but with some side effects.
My first visit to Gat Goren clinic was around January this year when I met with Dr. Gat who explained their research and procedure to overcome BPH.
To make sure I'm a candidate for the procedure Dr Gat asked me to ultrasound test for Varicocele which I did and found I did suffer from it.
May 30 2012 I have passed the procedure that took about 2 hours while I was fully awake and just had a simple local anesthesia.
Since then my free T went up 50% with some (10%) decrease later, PSA went down to around 2.8 and most promising, today I've been ultrasound tested for prostate size which showed remarkable shrinkage from around 75cc to around 43cc ! I'm still using Xtral XL and while doing so I have one night visit to the bathroom.
I'm only 4 month after the procedure and I understand it may take time to get better results.
I have also consulted with few urologists that did not believe this procedure may solve BPH problem. As I understand (told by one doctor), if Gat Goren procedure will be adopted some doctors will have to look for another job . . .

Let me know in case you need any clarifications.

Yoav.

Martin Victor. Yes. Thanks. I found the comment that I had missed before. Does sound like a success story.

But, please accept without reservations, I have no axe to grind. Why is there no statistical information available for a procedure that the good doctors say that they have been performing for 3 years now? If it is 100% successful, or even 75% successful, where are all the 'cured'. We have here Andy and Yoav. I accept them both as bona fide personalities who are sharing with us their own personal experience for our benefit. And I thank them for it.

BUT MY UROLOGIST is not satisfied. He doesn't do operations and, as far as I can determine, has no axe to grind either. My family doctor refers me to the urologist.

Pity to go all over it again. I will wait to see what statistical data Dr. GAT puts in the public arena.

As I have written before, IF the procedure is 'successful', various health funds will jump on it. Even with the initial cost, 15,000 dollars I believe, there is no hospitalization involved and, as with 'stents', very small likelihood of complications developing. The Health Funds would be falling over themselves to adopt it and the good doctors GG would almost certainly receive the Novel Prize for Medicine. The Health Funds would laugh any objecting urologist out of their fund if he objects. The 15,000 dollar cost would quickly drop to the level of the cost of an angiogram.

Surely, money is no problem here?

I am not a doctor and cannot be expected to gain the correct insights from statistical material pertaining to the GG results but I will wait and see and I suggest that you do too.

Clap, Martin.

The nitty gritty of it all is whether or not one feels the potential risks / benefits of the Gat Goren procedure at this point in time outweigh the risk / benefits of the other treatments available - and the patient would need to determine that after weighting up all the information he has obtained. As Martin points out, many urologists will have a vested interest in their own agendas - and some haven't heard of the G/G procedure and many are just not interested at this stage. However, if one underwent the G/G procedure and it failed and one's cash has been "wasted" then the fallback may be the other treatments. That's how I looked at it. Complications aside, if the G/G works, then it's worth every cent. YOU have to decide whether or not the risks outweigh the benefits!

This is a very good informative article for those in doubt:


http://www.medicalnewstoday.com/articles/174851.php

Martin Hi.

That article has been posted before and is from 2009. The thing is that it doesn't seem to have generated the interest that it should do. Which is surprising.

Now, I may be rather skeptical but I feel that there are urologists 'out there' who, on reading the article would have jumped on a plane to Israel to get more information from Gat/Goren on the procedure so that they can learn it themselves.

BUT THIS HAS NOT HAPPENED.

Now there may be a large number of urologists who have vested interest. But there are also a large number of urologists who don't and, if the claims were acceptable to qualified urologists, they would surely be looking to provide the same procedure to their patients.

If the claims were acceptable to qualified urologists, much bigger waves should have been generated within the profession by the above article.

Andy. Hi. As I have said before, I follow your emails and am happy for you. I hope that as winter comes to an end, you can report to us that you really feel well and see the procedure as a real success. Then I may discard my negative thoughts on the procedure and consider undergoing it myself.

Clap: A urologist cannot do the procedure. One must be trained as a radiologist and in the United States probably has to be board certified. And doing venography is probably even more of a detailed specialty leaving urologists out in the cold.

Andy, Martin, Clap and fellow bloggers,
Thanks for continuing posting your experience and thoughts.
I am going through the tests in preparation for the Gat Goren procedure.
So far, I have not taken the final decision to make it now. I was told by several Urologists that as long as the medication works, why make any intervention. I intend to discuss the matter with Dr. gat and Goren once I have my tests ready. Will keep you posted.

martin,
I have posted some before and after results. All my tests were taken through th UK NHS, so they are independent. Sadly however, they seem to keep loosing samples or messing up the tests. i'd love you to comment on that data. So, if you wouldn't mind, please look back as it would take me too much time to fish them our of wherever they are. It sounds like you too are getting some positive improvements. I hope that
you get to the stage I have where you could live without the inconvenience of moderate to severe BPH. I must say that I don't think the stream wil lever be as strong again and once a night is tolerable. the major improvement for me is frequency has dropped dramatically and I no longer have to plan a wc stop every half hour or less.

Good for you Dj and bon voyage.... i'd say take what your urologist says with a pinch of salt because if what G/G say is correct and the cause is being treated with their procedure, the long term benefit to you - ie general improvement and more importantly, less potential for PCa, will make it worth every penny. Please give my regards to the team out there if you go.

Clap: In interventional radiology there are radiologists whose specialty is venography...or the study of veins. When the Gat Goren radiologist inserts a fine catheter into the femoral artery, he must "thread" it into the proper veins which lead to the internal spermatic. This is much more complicated than threading a catheter for an angiogram. You need a specialist who is trained specifically for this task as the veins are exceedingly small.

A radiologist uses a dye which appears on a fluoroscope machine (which emits radiation) to see where the catheter is going. Urologists are NOT radiologists. They do not have the training which is probably extensive. Urologists stand to lose a major portion of their business doing TURPS...moocho money! A radiologist trying to explain this procedure to a group of urologists is equivalent to going into a "lions den." They will not be happy campers to see a major part of their business go out the wall. On another subject...It is now 3 1/2 months since my procedure. I go to the bathroom at night just once. Lately, 5 hours pass before I need to pee. My goal is to get a restful 8 hours sleep without waking up...and sex life is fine for this 70 year old.

NHS Survey...

Perhaps they will endorse Gat Goren method.


http://www.nice.org.uk/guidance/index.jsp?action=article&o=61500

Hiya chaps and you too Uk New member.

Uk, I'm an essex man who has undergone the G/g treatment. The local doctor and his staff were totally unsupportive and incompetent, the urologist was unsupportive with regards the treatment, the NHS keep loosing my blood samples or ignoring some of the blood tests requested on the form - despite having paid privately for them. (Cost around £80 for NHS to do the battery of blood tests). My, private health care not interested, however I was able to get the urologists to undertake the flow tests etc and this was covered by the Private plan. you will have to pay the NHS for your tests. Whr r you in the UK?

PS, I don't think you will find many men in the UK have had the G/g procedure for prostate. I was the first Uk man for prostate and that was 9 months ago. I'm not aware of any others.

To everyone else.... 9 months in. still OFF diffundox and finasteride. Have come OFF flomax three weeks ago but I still have the flomax on standby. Night time visits reduced compared to pre treatment - 1- 2 max but I do like a few cups of green tea between 7 - 11pm. When I cut back the drinks, I can sleep through the night.

First pee of the morning... slow, very slow... but after that the rest of the day as I get moving, no problem and flow is quite steady and although not strong like a teenager, its significantly improved over pre treatment. I always double void just to make sure it's all out. Frequency normal- ish and I don't have to plan loo stops every 20 mins as I did pre treatment. There is still a strong urge when I do want to go though!

Still of the opinion, that the G/G was worth every penny.

Victor, Yoav, how are you getting on? Are you experiencing improvements?