Gat Goren Method part 2

Martin,

Thunder read my mind and gave you my answer.

I think the main cause-effect relationship is: "ISV valve failure causes prostate problems." However, I also agree with Thunder that diet might also have an impact. At the very least, diet probably affects how and when the "BPH" problems MANIFEST after ISV valve failure. But it wouldn't surprise me if diet also had a direct impact on the health of the ISVs and ISV valves themselves.

-dave

Post Edited (Chicago Dave) : 8/19/2013 8:56:49 AM (GMT-6)

========= UPDATE! FOUR MONTHS OFF RAPAFLO =========

Look Ma! No meds!

On April 19, 2013--four months ago today--I did something that I thought I’d never be able to do: I stopped taking Rapaflo. I had been taking an 8-mg capsule of this powerful alpha-blocker once a day since mid-2010. But after tapering off of it for a few days, I took my last partial capsule on April 18. I’ve been off the Rapaflo wagon ever since—not even a single capsule in the last four months. I have not been taking any herbs or vitamins or anything else for this.

I had my G-G procedure on May 30, 2011. I’m approaching 27 months—2 years and 3 months—post procedure. The hallmark of my first year after G-G was the shrinkage of my prostate. It shrunk from about 51 g to about 22.3 g. (Its size was measured by different methods, which might exaggerate the improvement). There was a concomitant improvement in symptoms, but I still needed my drug crutch a year ago. The big improvement in the second year after G-G is the improvement of symptoms, so much so that I could discontinue meds.

Do I have the bladder of a young man? No, I don’t. I still have “mild” BPH symptoms as measured by the AUA’s BPH symptom checklist. It rates me a “7” now versus “8” a year ago. (That doesn’t sound like much improvement, but remember that last year’s rating was achieved with drugs.) I don’t particularly like the selection of items on this checklist—some items on the list aren’t important to me, whereas some omitted items are very important. Despite this, I accept as accurate its conclusion of “mild” BPH symptoms.

TMI on my CURRENT symptoms: Usually every 3 hours, but with little fluid intake, 5 hours or more. (My bladder is small.) I do sometimes feel some mild “pressure/urgency” symptoms during the day. I still squirm in my chair. And it’s not uncommon to me to heed the call of nature after just an hour—but this doesn’t go on continuously. I rarely get up at night to relieve myself. The pressure and urgency symptoms are made worse if I take water-soluble vitamins or guaifenesin. This was not the case 5 or 10 years ago. Also, the symptoms wax and wane even if I’m not taking vitamins.

TMI on my PAST symptoms: "BPH hell." Without Rapaflo or herbs--I liked cranberry extracts—up four times at night. During the day, I couldn’t sit still in my chair because of the cramping feeling in my lower abdomen. To the washroom every 45 minutes. I knew the locations of the bathrooms of almost every building I visited. I have really terrible memories of these times.

On my recent vacation, I went five-and-a-half hours without a washroom visit on an international flight back to the US. about an hour of this was spent waiting in line at US customs in Atlanta. I take guaifenesin when I fly to liquify the mucus in my inner ears and reduce the pressure symptoms during landing. I had Rapaflo capsules with me, and was tempted to use them on the flight as I was experiencing some mild urges. But I didn’t. And I survived US customs and TSA.

Martin: You have expressed doubt about Dr. Gat’s proposed etiology for BPH and its symptoms. I find it hard to accept your theories in view of my continuing improvement, which first became noticeable only 3.5 months after the G-G procedure. During the last two years, I have not changed my lifestyle in any way. I have not started new prescription medications—I still don’t take any. I have not lost weight (unfortunately); I’m still chubby. I have not given up my awful Standard American Diet of junky sugar products, junky processed foods and junky fatty foods. And I did not start taking new herbs and vitamins until the last six months. (I *have* been taking new herbs and vitamins in the past six months, but only for a few weeks at a time. I have not noticed any impact on my urinary symptoms other than the aggravation of water-soluble vitamins. My symptoms now are pretty comparable to how they were four months ago when I kicked the alpha-blocker habit. My usual vitamins are: D3, C, some B vitamins, and E. I’ve been experimenting with K2 and iodine for the past couple months for general well-being.) Nor have I begun to exercise more. Nothing has changed since May 20, 2011, that would explain the shrinkage of the prostate or the improvement in my symptoms.

I’m not where I’d like to be as far as urinary symptoms are concerned, but I am much improved. And my testosterone is still low. All in all, I’m fairly impressed with the past improvement. Will the improvement continue over the next year? I sort of doubt it since I haven’t noticed any improvement in the past four months. However, I guess it is possible that it continues to improve at some lower rate.

I will post a progress report next June, or sooner if something changes.

-dave

martin victor said...
Thunder:"I actually asked Dr.Gat this question between Asians and Western countries - and his answer was that height plays a role here."

Good point Thunder: So, you are saying that shorter men have less hydrostatic venous pressure and are less apt to get BPH.

According to Gats chart, the left ISV averages 40 cm while the right ISV averages 35cm in length. Can one assume that the valves on the left spermatic vein will fail faster than those of the right due to its longer height since they cannot maintain the upstream venous flow of elevated hydrostatic pressure? Can we say that if they both fail at the same time, that height doesn't make much of a difference? Given Gat's 2,000 procedures, he must have an answer.

Martin - it is exactly as you described, most varicoceles that are severe enough to be manifested in the scrotum are on the left side, like 90%+ of men with varicoceles find it in the left side of their scrotum.

If they both fail at the same time, you will still get more pressure from the left side as that side is longer, but that means you have to fix both sides to fix the problem.

Most varicocele procedures besides GG only closes the left side.

howard: I can't find the original article on the web but patients of Dr. Feliciano who experienced prostate size reduction discusses his program on the following website:

http://www.watercure2.org/prostate.htm

This is a study of the success of the Feliciano program with numerous patients.

http://ispub.com/IJU/4/1/12836

He claims 98% of prostatitis results in BPH. Most BPH patients have a subliminal form that might not be detected even under microbial examination. For example:

In 1998, an article was published about a 69-year-old man who presented to the Makati Genitourinary Clinic (Philippines) with acute urinary obstruction wearing an indwelling urinary catheter. He had been diagnosed with BPH by a urologist and had been told he needed to undergo transurethral resection of the prostate. He also complained of impotence, having had no erection for many years. The catheter was removed, the man was treated with 8 prostatic massages, microbial tests were done, and antibiotics were given. The man reported that his urinary symptoms completely resolved and his sexual function returned by 60% - 70%. At last follow-up, the man had avoided surgery for over 5 years, and at 5 years reported normal urination with only occasional nocturia.[6]"

Dr. Gat makes an excellent case for the mechanics of BPH. But their can be factors intergrated into the etiology of BPH such as prostatitis which causes inflammation and swelling of the prostate. Massage therapy (prostate milking) seems to work along with a diet of sprouted green juices (ex cucumber, celery, sprouted sunflower, sprouted pea greens) and wheatgrass juice which introduce oxygen into the system to kill e-coli bacteria as done at Hippocrates Health Institute. But these could all be temporary measures.

http://www.hippocratesinst.org/

howard: The Prostatis Center, in Tucson, Arizona headed by a Dr. Polacheck, a Harvard, Columbia Univ M.D.. Resume: http://www.prostate-usa.com/polresume.html (I have not researched them...so I cannot make any recommendations, nor do I know their current availability). Supposedly Feliciano has an affiliation.

Their Story: http://www.prostate-usa.com/ourstory.html

Dr. Feliciano's work is known as the Manila Protocol. It is controversial!! Many urologists criticize it. Am I surprised? No! I would imagine there are many doctor's out there who criticize his procedures without having the knowledge and training to do it themselves. Prescribing drugs and antibiotics is their preference. I hope you have scrolled down to the patients stories on http://www.watercure2.org/prostate.htm. Presuming most people with BPH also have a "silent" form of prostatitis, I question whether the Gat procedure would see even faster positive results after ridding oneself of prostatitis. I cannot help but believe that prostatitis, BPH and prostate cancer are all related. Gat himself, recognized a correlation between BPH and PCA.

martin victor said...
howard: The Prostatis Center, in Tucson, Arizona headed by a Dr. Polacheck, a Harvard, Columbia Univ M.D.. Resume: http://www.prostate-usa.com/polresume.html (I have not researched them...so I cannot make any recommendations, nor do I know their current availability). Supposedly Feliciano has an affiliation.

Their Story: http://www.prostate-usa.com/ourstory.html

Dr. Feliciano's work is known as the Manila Protocol. It is controversial!! Many urologists criticize it. Am I surprised? No! I would imagine there are many doctor's out there who criticize his procedures without having the knowledge and training to do it themselves. Prescribing drugs and antibiotics is their preference. I hope you have scrolled down to the patients stories on http://www.watercure2.org/prostate.htm. Presuming most people with BPH also have a "silent" form of prostatitis, I question whether the Gat procedure would see even faster positive results after ridding oneself of prostatitis. I cannot help but believe that prostatitis, BPH and prostate cancer are all related. Gat himself, recognized a correlation between BPH and PCA.

Martin--I just found the correct web address for Dr. Feliciano's Clinic in Manila, which is called the "Manila Genitourinary Clinic." http://www.prostate.com.ph/index.htm

martin victor said...
howard: Thanx for the website for Dr. Feliciano. He reports on a number of studies indicating prostate size reduction. Here is one case study:

A 78-year-old man with an enlarged prostate complaining of urinary symptoms was treated with 10 prostatic massages combined with antibiotics. The patient was asked to assign a global symptom score to his symptoms throughout the 16- day treatment period. A 10-point scoring system was used, with 10 representing the most severe symptoms. The patient's global symptom score fell from 5 before treatment to less than 1 after treatment. His prostate was markedly reduced in size per palpation, and his prostate volume decreased by 52%, from 63 g to 30 g, as measured by transrectal ultrasound. This case report demonstrates that repetitive prostatic massage plus antibiotic therapy was effective in alleviating one man's chronic pelvic symptoms, while decreasing the size of his prostate as measured by transrectal ultrasound.

http://www.prostate.com.ph/casereports/Case1.pdf

I emailed Dr. Feliciano yesterday about whether anyone in the U.S. was practicing his protocol. Here's his response:

Hi Howard,

The manila protocol is not available in the US. Although we have several physicians educated with the protocol. They have deviated form the original protocol and have not updated with us.

I am told that although they have reported success in treatment, in comparison with what we have today the other physicians who deviated from our improved protocol take a longer time and less durable than what we have today.

Good Luck
Regards,
AEF

NB : I understand the GG procedure alone is now at a cost of 17,000 USD

I still do not understand the mechanics of PAE. Marshall: can you asked the Portugal doctor if prostate cells die (necrosis) from lack of nourishment and oxygen and as a result the prostate is smaller? How does this affect the bladder and other components of the uro-genital system. Is their less blood pressure into the organ, in effect gradually shrinking it and reducing inflammation? Does starving the prostate of blood just shrink the organ but preserve the cellular structure. The Gat procedure was $16,000 at this time last year.

http://www.brazjurol.com.br/march_april_2013/Lopes_222_227.pdf

The histology of prostate tissue following prostatic artery
embolization for the treatment of benign prostatic
hyperplasia.... Looks to me as partial necrosis of the prostate. Successful on pigs. Now humans are the new guinea pig. It seems to work, but long term ramifications are not known.

Hello guys,

I found a clinical study for the PAE which may be interesting. I am not a doctor, so not able to evaluate. I am still doing research. The Doc in Portugal is swamp so his replies to detailed questions are very short. Interested in anyones opinion.

Marshall:

If Dr. Gat's presentation to a roomful of urologists went over like a lead balloon, it doesn't surprise me. What you said was spot on: Urologists can't learn to do Gat's procedure; only interventional radiologists can do it. So urologists don't care.

The first time I've heard of Nymox. This site is very negative on the drug and the company:

http://bir-llc.com/nymox-pharmaceutical-nx-1207/

QUOTE:
"Key Points: Nymox’s valuation is almost if not entirely driven, in our view, by NX-1207. Based on results from the single potentially supportive phase 2 study (NX-0014) we believe there is >95% chance of failure in the pivotal program assuming it is ever fully enrolled. The uninterrupted flow of press releases citing uncontrolled and highly dubious long-term follow-up data from phase 1 and 2 studies is evidence, in our view, of an attempt to maintain the illusion of progress where there is none."
UNQUOTE

I remember that some clinical trials had been going on with Botox injected into the prostate, but I don't know the status of these. I don't think that either Nymox or Botox affect the true cause of BPH. I suspect that the off-the-wall iodine therapy I posted in the previous link would be a better bet than these new drugs.

As for the Urologix's Cooled ThermoTherapy(TM), this is yet another one of the old (read: ancient) variants of TUMT therapy. I asked a couple of urologists about TUMT, and they were much cooler on it than the companies that market the therapies. They said that the TUMT therapy doesn't last long, and one urologist discontinued offering it to his patients for that reason (in favor of laser ablation and TURP, which last longer).

Marshall, regarding the manufacturers of TUMT, lasers and other devices for BPH, my impression is that their "research" leaves a lot to be desired. I don't think that they systematically or scientifically monitor sexual side effects. Neither do I think that they run the trials out long enough to determine the long-term effect of the treatment. You'd think they'd have to do both of these things, but these aren't new drugs. They are slightly improved types of existing medical devices, and the licensing requirements are easier than for new drugs.

I actually collect marketing DVDs from laser manufacturers and TUMT purveyors! I like sometimes to look at them and see the smiling, happy men, and wonder what how they feel now. But they all look great at the time of filming.

I think the most promising conventional therapy might be something called "plasma button surgery". I have not investigated it. There's a thread on Topix about it:
http://www.topix.com/forum/health/prostate-cancer/TE0UINE2B17700911

There's also a Topix thread on the side-effects of conventional laser (mostly Greenlight) surgery:
http://www.topix.com/forum/health/prostate-cancer/TC8IDERKRD1HJTAB3/p58
Supposedly, it works for a lot of guys, but evidently not for everyone.

-dave

Post Edited (Chicago Dave) : 8/28/2013 8:38:16 AM (GMT-6)