Gat Goren Method

UK: I had none of the complications noted by a previous poster:

"What I did have is a lot of is black/blue type of bruising from the groin and all around my testis and nearly all of my penis, that is now starting to fade. "

I am sure the procedure the Israeli doctors use is somewhat different than that of the Portuguese. I would prefer a doctor like Dr. Gat, a mechanical engineer, medical doctor and researcher at the Weitzman Institute and his radiologist ...Dr. Goren, a Harvard trained doctor.

But of course...one has to weigh the money factor.

Hi Martin,

I got the info from the link you posted in your post of 11/26/2012 6:06 PM

NHS Survey...

Perhaps they will endorse Gat Goren method.

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

....

On the bottom of the linked page there is a section 2.4 on Safety. The anectodal events are in section 2.4.4 as follows:

2.4 Safety
2.4.1 Ischaemia of a small area of bladder wall was reported in 1 patient in the case series of 15 patients: treatment was by surgical excision of the affected area.
2.4.2 Urinary tract infection was reported in 2 patients in the case series of 15 patients: these were treated with antibiotics.
2.4.3 Acute urinary retention after the procedure needing catheterisation was reported in 1 patient in the case series of 15 patients.
2.4.4 The Specialist Advisers listed additional anecdotal adverse events as inadvertent embolisation and subsequent infarction (and possibly gangrene) of adjacent organs, such as the bladder and possibly the rectum. In addition, they listed transient rectal bleeding, retro-pubic pain, haematuria, haemospermia, proctalgia and balanoprostatitis. They listed theoretical adverse events as damage to the cavernosal artery and erectile dysfunction, damage to the external urethral sphincter and incontinence, arterial pseudo-aneurysm, urinary fistula, prostatic abscess, haematomas, dysuria, and worsening benign prostatic hyperplasia symptoms.

......

That said, one of the adverse events reported to our National Institutes of Health website on the TUMT (Transurethral Microwave Thermotherapy) procedure I underwent several years ago was incineration of the penis when the microwave rod malfunctioned. That was a very rare outcome, but I was thinking of it before and during the treatment! I'm not sure how long it would take for the possible adverse effect of a GG procedure to show up, but I would think it would be fairly soon after the procedure.

Bob

martin victor said...
>>>"My feeling about the GG is that I feel uneasy about the possibility of bladder necrosis or even artery necrosis that is listed as a possible (one report said an anecdotal) side effect."<<<

Bob: Please advise the source (one report said an anecdotal) for this possible side effect. Thanks.

My first question to the NHS survey is what doctor did the 15 embolizations. The Portuguese process seems in many respects different including the sclerosing agent. In conversations with Dr. Gat, I was assured they have had no complications...maybe there were some minor complications but the Doctor exuded confidence. Dr. Gat and his team have done 200 prostatic embolizations and several thousand more in treating fertility problems where again, the internal spermatics are occluded. I wonder if the British surveyors ever heard of a complaint from Gat/Goren.

Complications to the femoral artery, during the Gat procedure may not be the same as using a stent. The distance is shorter and the catheter is probably much much smaller. Gat uses minor anesthesia. Less pain than a simple blood test. I have not yet done a rectal ultrasound to see if the size of my prostate decreased. Generally it takes 4-5 months for it to possibly shrink 30-50%. I am disappointed however with the flow, having not seen much improvement. Perhaps it takes time for the bladder to improve facing less resistance. Also as of yet...5 months out...I have seen no increase in testosterone levels. I was told by Dr. Gat, that one must have patience as the body is adjusting to the greater oxygenation in the area. We shall see!

Martin Victor. 'I was told by Dr. Gat, that one must have patience as the body is adjusting to the greater oxygenation in the area. We shall see!'

I'm crossing my fingers for you Martin.

I was with my GP last week. He has a patient who underwent the Gat Goren procedure 6 weeks ago and will possibly update me on the progress of this patient. I will keep everyone posted.

Any medical invasive procedure has its risks. Blue discoloring in my privates is not a worry. Penis incineration is.

Hi all-
Have been following the G/G discussion with interest.
Have been some distance down the road with my BPH and have been discussing with G/G folks; actually had an appointment for the procedure in December until hostilities in Israel broke out and I put on hold. Will likely re-schedule in the next 60 days.

Martin and Andy, I am curious about which of the personnel actually did your procedure. I have been advised that either G/G or Dr. Perlow would perform the procedure, although I do not have information on Dr. Perlow and at this point am more likely to request G/G. I will follow with voice/voice discussion with Gat or Goren before I re-schedule.
If you have an opinion along these lines would like to get your input; or message me privately if you prefer.

Best

Bob_NJ - 'In my own case, 6 months after the GL laser which I have recounted in several posts here, I am regressing.'

Sorry to hear about that Bob. But thanks for taking the trouble to update us.

I wish you the best. I am waiting a little while longer and see if the ISAR MRI clinic in Munchen takes up the procedure. Gat Goren visited last year here in Munchen. My prostate ia over 100, but I don't seem to have problems peeing. However, I am having some success with the Herbs and IP-6 which seems to reduce the inflammation. I hope you keep us all informed as you progress.

marsh.

Franck,

Dr Goren undertook the procedure. Dr Gat was looking on and possibly involved from another from an adjoining area -

frank T: Dr. Perlow did my procedure with Dr. Levenger at a control in another room. Dr. Perlow is from South Africa and according to Dr. Gat is one of the finest radiologists in Israel. I believe Dr. Perlow was chief resident at Jackson Memorial here in Miami, one of the best rated hospitals. Dr. Levenger has a medical degree in internal medicine.

Here is Dr. Perlow's Background:

Alain Perlow, MD
Dr. Perlow received his undergraduate and medical degrees from the University of the Wi***ersrand in South Africa. He completed his Residency in Radiology at the University of the Wi***ersrand, a Fellowship in Neuroradiology at the University of Michigan Medical Center and a Fellowship in Interventional Neuroradiology at Jackson Memorial Hospital, University of Miami in Florida.Dr. Perlow is a member of several professional organizations including the Radiological Society of North America and is a Fellow of the Royal College of Radiology in the United Kingdom.
Dr. Perlow is certified by the American Board of Radiology.

Andy: Glad to hear of your continued progress. Clap, I wish you well and hope you eventually see improvement.

It has been 5 1/2 months since my procedure. With exception of one time, I have never taken drugs to control BPH...or any drugs. I tried flomax just once but after 3 days, I did not like having retrograde ejaculation. My prostate size of 45 grams is considered small compared to many. I am down to one bathroom visit a night, compared to 2-3 prior to the procedure. Urgency is considerably less but urinary stream is still weak. I am disappointed with testosterone levels. Prior to the procedure serum testosterone was in the 700ng/dL area. Today my reading is 479. One positive: it is up 20 points since the last test. Free T has gone from 8.3 pg/ml to 5.9. But libido is quite strong. What is strange is that 40 days after the procedure, free T went up to 9.6 and then steadily went down. My conclusion is the body has its own timetable. We cannot second guess its wisdom. I was told by Dr. Gat that free T increases take longer with the elderly. Young people with fertility problems who undergo the same/similar embolization improve t levels at a very rapid rate to the extent with an 85% success rate.

I have read that the elasticity of the bladder improves with the TURP procedure due to less resistance. But of course, about 25% of the time, the cause of prostate enlargement is not eliminated and a second operation is necessary. Patience is necessary with Gat/Goren ...as the prostate size recedes, the bladder needs less effort to void and if one is in good health, the bladder lining thins rather than thickens just like any muscle or organ that becomes less overworked.

Hansi writes|: I absolutely can recommend to do this to everybody!!! I will keep you posted.

I wish you a complete recovery which in this framework, means less visits to the pissoir and a better flow. And a really good night's rest.

I'm sure that we will all be very interested about how you feel after 4 to 6 months.

I suggest you to read Andy's comments from the start of this thread.

Frank: Thanks for the information. I was curious as to when testosterone levels were highest. According to this website from Livestrong: "Circadian rhythms can have an impact on many bodily functions, and testosterone levels are no exception. Normally, they are highest in the morning, usually at about 8 a.m. A man's testosterone levels then decline throughout the rest of the day, reaching a low point before bedtime--the theory being that he does not need testosterone while he sleeps. The day's events can change this pattern, however. "

Prior to the procedure, I had hormone levels tested on a fasting basis, no later than 10AM. My most recent testing in the last 6 months was on a non fasting basis around 12PM. So, perhaps this might account for some lower numbers.

I was under the impression that saliva testing for hormones was the most accurate for most sexual hormones. I have added DHEA (25mg) to see if this has any effect on free T levels.

Hi everyone:
Newbie question: What is the difference between the Gat Goren method and prostatic artery embolization?

Thank you.