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Posted 8/31/2013 4:37 PM (GMT 0)
Gat Goren Method, Part 3

The new thread is here:

https://www.healingwell.com/community/default.aspx?f=35&m=2917982

-- PeterDisAbelard.

I am starting a new thread for the Gat Goren discussion since there is a limit of 9 continuation pages on the forum before a thread becomes corrupted and lost. Please continue that discussion here.

If you want to read the previous (Part 2) thread it is here:

https://www.healingwell.com/community/default.aspx?f=35&m=2649671
Posted 8/31/2013 6:00 PM (GMT 0)
Thanks Peter for setting up the new thread. I think it's the best BPH thread on the internet.

PeterDisAbelard. said...
I am starting a new thread for the Gat Goren discussion since there is a limit of 9 continuation pages on the forum before a thread becomes corrupted and lost. Please continue that discussion here.

If you want to read the previous (Part 2) thread it is here:

www.healingwell.com/community/default.aspx?f=35&m=2649671

Posted 8/31/2013 6:49 PM (GMT 0)
Martin, Dave and all,

To continue the discussion in Martin's last posts in part 2 of the thread ...... I can't quite get my head around how reduction of prostate size and/or relaxation of the prostate through drugs like flomax, is the one size fits all answer that dominates this field. Maybe it's that way because one size actually does fit most.

But there are so many other factors touched on, bacteria, bladder condition, sphincters, amount and type of food and liquid consumed, even pelvic nerve bundles, that leave a sizable minority without adequate relief after they have gone ahead and had their prostates reduced in size by a number of different methods.

Like Martin, my daytime voids are better than my nighttime ones. More significantly, I sometimes (maybe 5% to 10% of the time) have a relatively satisfactory void during either the day or night. When that happens it's like the floodgates open, no straining or burning or pressure, the urine just pours out for 10-15 seconds, without even the sensation that I am participating in the process. I always ask myself "How did that happen"?

All of the other factors commonly addressed haven't changed in the hour since my last void, and won't change in the hour until my next restricted, dribbly void. My bacteria count, the condition of my bladder, my diet, the size of my prostate are all exactly the same. This leads to the conclusion that maybe none of those things are involved. They may have caused the problem, but they no longer are the cause of it occurring.

The only thing I can come up with is maybe it is nerve related. Pelvic nerves control urination, bladder emptying, the opening and closing of sphincters, etc. Although I have had frequency my whole adult life, I never had a problem urinating until about 3 years ago. I urinated every 45 minutes to 1-1/2 hours for most of the day, and 4 or more times at night for decades (and still do), but each void was a painless, easy process. I had also been told for about 15 years, during my annual physicals, that my prostate was enlarged.

My first experience of full retention, about three years ago, which brought me to the ER to be cathed, and eventually to a urologist, was a few days after a hard fall on my butt, while removing ice from my driveway. So maybe pelvic nerve damage suffered in that fall was the cause of my retention. Maybe that's why removing almost 60% of my prostate only gave me partial relief. I should also mention that about 20 years ago I was diagnosed with meralgia peristatica, in which a nerve that travels through the pelvis is damaged and causes a burning sensation on the outside of my right thigh after walking for an hour or more. This is mostly managed by never putting anything in my right coat or pants pockets, which puts pressure on the thigh and fires up the nerve, causing numbing and burning of the thigh. There's no literature linking meralgia peristatica to pelvic floor disfunction or other manifestations of LUTS, but it all is centered in the pelvic nerve bundles.

The final point I'd like to make is that compared to sports medicine, it seems prostate medicine has very few diagnostic procedures that go beyond measuring the size and shape of the prostate gland itself. In sports medicine, muscles and ligaments are imaged in the process of their activity, like during a golf swing. The one thing that it seems could really get to the root of the LUTS and BPH problem would be real time sonogram videos of a person having a good void versus having a restricted one. I think most people with treated or untreated BPH have both. It seems that type of sonogram video could pinpoint what is causing a restricted flow, when, where and why.

about 6 months ago I told my urologist I had a very vivid dream that my urethra inside the prostate was filling up with urine like a test tube and was blocked at one end with only a tiny hole for urine to pass through. My urologist probably thought I was nuts and made a joke out of it. Maybe this dream was caused by my research and having to wake up and void, but if it were actually true that my external sphincter was closing off my stream, there would be no way to verify it. I actually considered buying my own laptop sonogram head and software on ebay from Hong Kong for about $1200 and try taking those sonogram videos of myself voiding, but my wife might divorce me. I had a hell of a time getting her to agree to let me post my own videos on youtube. Doing my own sonogram imaging might just put her over the edge.

Bob

Post Edited (Bob_NJ) : 8/31/2013 1:00:50 PM (GMT-6)

Posted 8/31/2013 9:31 PM (GMT 0)
Has anyone heard about this book:

A Headache in the Pelvis: A New Understanding and Treatment for Prostatitis and Chronic Pelvic Pain Syndromes, 4th Edition Paperback
by David Wise (Author) , Rodney Anderson (Author)

I came across this book a couple years ago, but put it down once I concluded my symptoms were different. But Bob's talk about “pelvic nerves” made me think of this book. I have not delved into this. I mention it merely as a Book of Possible Interest to members of the forum. But one of the authors is an MD at Stanford University, a fairly respectable college. Here's a quote from one of the positive reviewers at Amazon:

A reviewer at Amazon said...
"To all those suffering with CPPS/Prostatitis: You must give yourself the gift of reading this book. It is the scripture of the new paradigm for treating chronic pelvic pain. Most importantly, it was written by someone who had actually suffered for years with pelvic pain and, by using the techniques introduced in the book, freed himself from chronic pain. For an author to be able to say to a reader, "I have been where you are", creates overwhelming trust and compassion that is felt throughout this book.

"I write this review with the utmost confidence because I, too, suffered with pelvic pain for several years, and was misdiagnosed with "prostatitis" over and over again, as many men have been for years. When I read this book, I just knew it was the truth, because it spoke so fully to every aspect of my condition, both physically, mentally, and emotionally. I committed myself to doing the protocol described in the book, and attended one of the monthly clinics that the authors run. In short, all of my pelvic pain symptoms have complete[ly] abated after following the protocol, and in many ways I feel that my overall health is even better than before my pain started, as so much of the protocol taught in the book possesses benefits far beyond healing pelvic pain."


So I'll just throw this out there for what it's worth. Someone reading this board might even have this condition! I'd love it for someone here to investigate it and even take it and report back. Be aware that the authors run some expensive clinic in California, so this book functions partly as advertising. (Martin: I sort of doubt this applies to you, but I haven’t looked deeply into it.)

Peter:

Thanks for setting up the new thread. I had been expecting it.

-dave

Post Edited (Chicago Dave) : 10/27/2013 3:15:48 PM (GMT-6)

Posted 8/31/2013 9:44 PM (GMT 0)
Hello,

I am new to this forum, but have been lurking for many months.  Let me start off by saying that I have been conditioned to assume (maybe unfairly) that everything posted on any internet forum is written by a paid spokesman for a particular product or procedure.

It seems to me, that the people on this forum might be interested in my story.

- 50 year old male, healthy and in good shape.  Since the age of 15, I have lived my life with the almost constant sensation that I am in the midst of a digital prostate exam.

- I sit on two books, in my car and at my office.  One for each cheek.  If I don't, the pain in my "taint" area is intense by the end of the day.  Only lying on my back gives me temporary relief.

- In my late teens to early 20's, I started to notice a lump on my left scrotal area, that, after on-an-off arousal, would be painful.  Like "Blue-b***s" times 50.

- I went to at least 5 urologists and two family doctors throughout the past 25-30 years.  Since freshman year in college, all I was told was that my prostate was "a little enlarged, but nothing to worry about."  My PSA as of last month was only 0.4.  My prostate is "the size of a 50-year old prostate."  My bladder is "a little thickened, but that's to be expected."

- I live near Philadelphia and there are some top teaching hospitals here.  I became determined 6 months ago to do something about this, once and for all.  One time when the lump appeared, I took a picture with my phone.  It was a serious "bag of worms."

- THREE urologists refused to look at my picture and instead tried to feel it, but could not.  One suggested acupuncture, and the other sent me for perineal (sp?) massage, and I went to a few sessions but felt that I was wasting my time.  Whenever I do get an actual digital exam, It is extremely painful when they touch my prostate, to the point of almost passing out.

- My family doctor looked at the picture and sent me for an ultrasound, which confirmed a left-side varicocele.  Urologist, however, was not happy that I went behind his back and ordered a CT scan to make sure there was "nothing awful" that was actually causing my distress.  CT came back with nothing.

- I went to an IR guy for embolization (NOT Dr. Gat) but I showed him a few sentences from Dr. Gat's papers, and he shook his head as if it was baloney.  I told him I wanted the procedure bilaterally, but he said he would do the left side, and only give the right side a college try.

- I had the procedure on Wednesday August 28.  Unbelievably, he could not find the correct path on the left side.  He moved over to the right, and popped a whole bunch of coils in there, claiming that he blocked all the "collaterals."  He went back to try the left, but had to give up after another hour!  He said he would have to try it again a different way, on another day.  He said it was the first time in his long career that he couldn't do the left side, but easily did the right side!

- Guess what?  It's only been four days, and NO pain from sitting!  NO sensation of having a digital exam.  Nothing.  Will it last?  I don't know.  But I can't wait to go back in a few weeks for the left side.

Folks, I believe there is something to this whole "hydrostatic pressure from the ISV" thing.  I'm not advocating any procedure or method, but I would definitely say DO NOT STOP PUSHING AND LOOKING FOR A DOCTOR WHO WILL LISTEN TO YOU!"

At this point, I am calling this a life-changer for me.  I will keep everyone posted.

 

Posted 9/1/2013 12:52 AM (GMT 0)
Hey guys!

We started a little iodine thread on the Curezone Iodine Supplementation forum. Ever-ready Grizz has already contributed a couple of links and opinions to it.

Grizz dug up the following new testimonial for iodine as a treatment for prostate problems. He has links to other prostate-related information too. Clicking on the link should take you to the discussion.

http://curezone.com/forums/fm.asp?i=2100048#i

Poster over at Curezone said...

If interrupted sleep by frequent pissing is due to prostate problem, then Iodine protocol with raw zero carb diet has cured me of it.
Took about a year and a half, but note that things happen more slowly at my age of >70.

-dave
Posted 9/1/2013 2:08 AM (GMT 0)
ROBC:

I've been thinking about your post. Urologists have standard procedures for treating varicocele. But you were treated by an interventional radiologist.

Are you saying that you convinced a local interventional radiologist to attempt to perform the Gat-Goren procedure on you? Yes, that's exactly what you're saying. And he performed it--or rather he performed it on one side. That's like half a GG procedure: a "half-Goren" procedure.

That's amazing. I mean, it's amazing he would even attempt it after just reading about it--hubris breeds overconfidence--and amazing you could work out the financial arrangements with him. It's not cheap to have it done even in Israel.

Dr. Goren--who performs the procedure for Dr. Gat--uses a sclerotizing fluid to close the ISVs and any collaterals. Your guy used "coils". These must be a standard tool, but I'm not familiar with them.

Dr. Goren inserts the catheter in an incision in a vein on inside of one of the thighs. He can reach both ISVs from one entrance point. You had a similar experience, correct?

It doesn't surprise me that he had so much difficulty with the ISVs. Those very small veins that are so delicate they tend to decompose quickly upon death and are hard to locate on autopsy.

You should continue to push him to fulfill his promise to do the left side. Dr. Gat says that both sides need to be done. So it's interesting you got such good results from just one side.

We have so many resourceful and creative guys posting on this board! My hat's off to you, my friend.

-dave

Post Edited (Chicago Dave) : 8/31/2013 9:12:42 PM (GMT-6)

Posted 9/1/2013 7:12 AM (GMT 0)
Chicago Dave:

Actually, I saw both a surgeon (a micro-surgery specialist) who has repaired many varicoceles as well as the Interventional Radiologist.  I made the decision to go with IR just based on less recovery time, and the use of local instead of general anesthesia.  These two doctors are not affiliated, however it is interesting to note that they both received special training in Italy, and both claimed (separately) that in Italy, varicocele ligation had been quite advanced as compared to the rest of the world until the past few years.

I did not "convince" him of anything.  I showed him two sentences that talked about hydrostatic pressure created from a standing column of blood in the ISV, and he basically blew it off as either nonsense or just another theory.

I wouldn't call the procedure a "mini-gat" or anything else.  The procedure he did was the exact same procedure he and many other IR MD's have been doing for over a decade.  The only thing that has changed is that they have learned how to enter the catheter through the underside of your bicep, and they have changed the materials used for the coils.  (platinum now, vs other metals like tungsten in the past.)

The coils are a widely used method for many types of vein embolization.  It's pretty cool ... You watch on the screen how they come out of the catheter and "fill up" the vein, blocking it completely the whole way up.  He said they only use the sclerotizing agent, or "glue," in certain circumstances, because they have found the recovery time is longer in that this "glue" can cause some abdominal pain.  I received only the coils, and went on a pretty hard bike ride the next day without so much as ibuprophen.

As to doing the left side, I don't think these high-end doctors really "promise" anything other than to do their best.  He is going to look at my CT scan and try to figure out why the catheter wouldn't pass through the way he wanted.  He may come back to say he's not confident, just because of the way I am built ... If that's the case, I will go back to the micro-surgeon to have the left side done.

The upshot is that I think Dr. Gat may be on to something, and maybe he is "fine tuning" the method, but regardless, the first, and most difficult, part of the process is to get a doctor to listen to you and agree that you even have bilateral varicocele.  Once you get a consensus on that, either micro-surgery or IR by a competent MD should be therapeutic.

 

Posted 9/1/2013 3:35 PM (GMT 0)
Dave, just like to correct an impression that the China prostatitis treatment was not effective.
Although it has taken seven trips to do it I believe I am around 80+ percent better 80 % of the time. Not a cheap exercise but they have patients from around the world including Israel.
I believe that although prostatitis may proceed the onset of BPH (and vice-versa?) it may well require both treatments to achieve a normal life.
The patients I have met in China have some cynical views of urologists - still it comes down to urologists conservative nature and not wishing to deviate from the trodden path.
RobC
Seems that you have had better luck with your IR. Certainly good news for you there. The GG explanation just seems to make practical sense for anyone who wants to spend a little time to read it.
The input into this forum by current and past contributors is both cogent and altruistic. It is certainly most helpful in understanding the conditions affecting the prostate and treatment options.

Not sure if anyone saw my remark about a procedure called " urethal lift" seems to indicate a stendt within the uretha which is a seemingly to clear a pathway for urine flow. A procedure on offer in the US, a little far from Australia for news to have filtered through. It would have to be capable of allowing prostate product to penetrate, or is my understanding of the process incorrect?
Posted 9/1/2013 4:08 PM (GMT 0)
ROBC:

Thanks for your explanation. It seems I was mistaken in exactly the procedure you had. The next time you talk with your IR doctor, could you try to get some more details on the procedure? Does it have a technical name (perhaps, "The Italian Varicocele-Repair Procedure")? The main technical question is exactly which veins are being treated. Gat-Goren treats both Intraspermatic Veins and any collaterals. {...}

I don't know how coils stack up against sclerotizing fluid. It wouldn't surprise me if coils were preferred in larger veins.

It will be interesting to do repeat measurements on your prostate size in a year to see if that has been helped. And to see if your bladder shows improvement either symptomatically or diagnostically. (Less thickness, perhaps? But I don't know whether this can be expected or not, or even how to diagnose it.)

Thanks for the lesson in Italian approaches to varicocele repair! Do keep us informed. And the main thing is that your life has turned around!

=============

Seasign:

Well, you've certainly paid your dues in treating your prostatitis! I think you are probably right that some people will require both GG and intensive prostatitis intervention procedures. But it would seem plausible to me that if a guy needs both treatments they might start with the GG first and follow-up with standard antibiotic therapy. {Edit: But see Seasign's response in the next post.} This assumes that the GG would normalize their prostate and immune response to fight the infection better. That's just armchair speculation on my part; I have no links to any successful patient testimonials.

Before my own GG procedure I had a 51-gram "boggy" prostate. It was never biopsied so there's no telling what was in it, but being "boggy" for almost 20 years doesn't sound healthy. A year after the GG procedure it was 22.3 grams and hard. If I had a prostate infection, I would rather fight it with a small, firm prostate than a large, boggy prostate.

As for the urethral stent you mentioned, I myself don't have a reason to research it. You know how jaded I am regarding medical-device and drug companies in the prostate-disease space. I think they are mostly or all treating symptoms rather than root causes. I think the temptation will be to blindly apply the stent to push back the prostate and allow urine to flow freely, but without treating the underlying causes that are making the prostate enlarge. I think the long-term effects of this strategy would not be pleasing. The stent might postpone some of the symptoms of "BPH" for a few years, but patients will probably get other, dire symptoms somewhere down the line.

That said, I can see how it might be useful for some folks that have already had the GG procedure and aren't getting a satisfactory response. We await to hear from someone who has the reason and time to research it in depth.

-dave

Post Edited (Chicago Dave) : 10/21/2013 5:33:40 PM (GMT-6)

Posted 9/2/2013 3:10 AM (GMT 0)
Dave,

Mid 2012 I had talked to GG about my condition and they recommended their procedure post prostatitis therapy.
I accepted this as I have not read about BPH patients feeling sick/feverish/unwell but perhaps I am incorrect here ?
My BPH symptoms are generally the classic of voiding slowly but frequently, resulting in sleep deprivation, urgency etc.
I endorse your assessment of urethal stendt possibly promoting additional problems, clearly the prostate will continue its growth and impinge on bladder and surrounds.
I previously mentioned that GG had treated one patient in July or August. He was a young bloke I met in China and exchanged email addresses with.
Cheers 'n regards
Posted 9/2/2013 1:25 PM (GMT 0)

Seasign said...
Mid 2012 I had talked to GG about my condition and they recommended their procedure post prostatitis therapy.


Seasign:

I stand corrected--again! Since you've already checked with Dr. Gat, you have to follow his advice. I can certainly see why he doesn't want to do the GG procedure if the prostate is inflamed with an infection. It makes sense to treat the prostatitis before fixing the circulation problems.

{...}

Seasign said...
I accepted this as I have not read about BPH patients feeling sick/feverish/unwell but perhaps I am incorrect here ?


Are you asking whether these are typical symptoms of BPH? Or, instead, whether they are typical symptoms of prostatitis? I would say prostatitis. I haven't heard of cases where BPH causes fever (though it often makes guys feel unwell, especially if they can't sleep at night).

Seasign said...
My BPH symptoms are generally the classic of voiding slowly but frequently, resulting in sleep deprivation, urgency etc.


Many of us on this board have acquired intimate familiarity with these common "BPH" symptoms through years of painful experience!

Seasign said...
I previously mentioned that GG had treated one patient in July or August. He was a young bloke I met in China and exchanged email addresses with.


Yes, you can follow his progress here. He posts as "Thunder". I am hoping he will give us a three- or four-week update soon.

-dave

Post Edited (Chicago Dave) : 10/21/2013 5:34:23 PM (GMT-6)

Posted 9/2/2013 7:37 PM (GMT 0)
Dave: Well, you started me on a new project: iodine supplementation.

I have tried to find other people who have had success aside from Grizz with iodine supplementation and BPH. Here is one guy called Pain In the .....

http://www.dailystrength.org/c/Enlarged_Prostate/forum/16184794-bph-relief

Yesterday, I took 18.5 mg of ioderol (potassium iodide and iodine) . Needless to say, I felt like a Zombie. I could have been a star performer in World War Z with Brad Pitt. No energy, felt totally fatigued all day. No doubt, I was in detoxification mode, probably passing out a lot of halides like bromine. I must say though, I had a fabulous sleep. I did buy Vit c, selenium, celtic salt, magnesium to assist in the detox. If breast fibroids and uterine cystic tumors are so common with women who lack iodine & show improvement with supplementation, one has to wonder what is going on with men in their corresponding organs like the prostate. So, what's to lose! ...I will maintain a daily program of 150 billion probiotic bacteria and eventually 50 mg of iodine based on the premiss that BPH patients have a latent or aggressive form of prostatitis. Whether infection has anything to do with the mechanical failure of the ISV's and the formation of a varicocele is a question. But worth pursuing based upon the fact that both iodine and probiotics reduce harmful bacteria. If prostatitis (latent or not) is a forerunner of BPH...what does one have to lose.

Note: 10 years ago I did an iodine loading test and scored in the mid-40's. A highly suitable score is 90. Basically the test shows how much iodine is excreted in your urine after taking a 50 mg dose of iodoral. Since my body absorbed so much iodine, the test showed I was severely lacking this mineral which it surely craved.. Being primarily a vegetarian, I never eat fish and seaweed. The Japanese eat 15 mg of iodine every day in the form of seaweed and fish and have very low rates of prostate cancer and BPH. I believe much is diet and infection related (iodine is an anti-septic).
Posted 9/2/2013 8:10 PM (GMT 0)
Dave,

As far as I know, there isn't any special technical name for the procedure I had.  I may have overemphasized the Italian connection ... I'm pretty sure what was learned there were finer points.

Also what leads me to believe it's a standard procedure is that it is fully covered by my medical insurance policy.

I did ask about the collaterals, venous bypasses, etc. during my initial consultation.  He told me that the first coils are placed so low into the ISV that they block all the intersections with the smaller veins, thereby blocking the small veins themselves.  Then additional coils are "stacked up" so the entire vein is useless for its entire length.  I don't know ... It sounded plausible to me.  And it looked pretty good on screen during the procedure!

Seeing the post by Seasign also reminded me:  I had sent an email to Dr Gat's clinic back in November, I think.  I asked two questions:  If I got the "standard" procedure here, would it preclude ever going to Isreal to get the GG procedure later?  He said it would not, but it would be technically more challenging.  And I asked if the procedure here would afford the same results re: my prostate?  He said it would if the doctor "understands hydrostatic pressure in the venous drainage system."  Of course, there's no way I could verify that, and in fact, I have my doubts.

The thing is, even Dr Gat himself would never tell anyone they would feel improvement within days after his procedure.  I'm pretty sure he says it takes months, correct?  That's why I'm still skeptical about my own improvement and won't believe it until I'm convinced it's permanent. 

Maybe it's just due to the "shock" of the foreign objects in my body, or the poking and prodding of the catheter that somehow changed something down there, only temporarily?

Here I am, though, almost a week later (and only the right side done) and I truly feel like a new man.  As I type this, I'm sitting on a chair, with no books under my cheeks.  I hope it lasts.

 

Posted 9/2/2013 9:11 PM (GMT 0)

Martin said...
Dave: Well, you started me on a new project: iodine supplementation.


We "zombies" like company!

I'm taking 18.75mg/day and am having symptoms similar to yours. Fatigue during the day but a good, sound sleep. I'm having trouble maintaining this dose, and have been skipping days. "Zombie" seems like the right way to describe it. My target dose is 50mg/day, but that seems far away.

By the way, I took an iodine loading test myself a couple months back--the 50mg iodine table and 24-hour urine collection routine--and discovered that my iodine was low, but my fluoride and bromide were high. None of which surprised me. (This test is criticized for accuracy, as is the iodine painting test.)

I think that maybe we should start posting on Curezone, where seasoned iodine users can chime in. You found an interesting post, which echoes Grizz's experience. Grizz obviously doesn't know about it. But it was based on experience only a few days after starting supplementation. I'm always dubious about claims for improvement unless the improvement sticks around for several months.

I have *not* experienced any improvements in my remaining symptoms recently while on iodine. On the contrary, I've been experiencing some LUTS symptoms while sitting yesterday and today. I have no idea whether that's the iodine or something else. But if it continues, I will probably go back to a small dose of an alpha-blocker.

Keep us informed!

====================


ROBC said...
He told me that the first coils are placed so low into the ISV that they block all the intersections with the smaller veins, thereby blocking the small veins themselves. Then additional coils are "stacked up" so the entire vein is useless for its entire length.


robc: The main issue is how closely your procedure resembles the standard GG procedure. I can't tell for sure, but it would seem to be a kissing cousin of GG based on your interventional radiologist's (IR's) description. Your procedure closes off the Intraspermatic Veins (ISVs); so does the GG procedure. Some differences: GG uses a sclerotizing agent rather than coils, and is *always* performed on the ISVs on both sides ("bilaterally"). There might be other differences, but it's hard to tell from the brief description your IR gave you.

If this procedure really is a close variant of GG, then it might be an attractive alternative to GG for guys who have obvious varicocele or another condition...and good insurance. You were really on the ball to diagnose your condition as you did and to find a specialist to correct that. If you had chosen the urologist, I don't know whether you would have had the same pleasing result. It's ironic that your IR doubted this would work. He will be surprised at what a great job he did!

Regarding your communication with Dr. Gat: I'm not going to butt in here, but I have to wonder if there was a misunderstanding. I thought that the "standard" approach to treating varicocele was some procedure done by urologists since time immemorial. I think it is quite different from the IR procedure you had. Urologists are not taught how to lay coils down in veins like IRs can. I wonder if Dr. Gat understood this when you asked him? I don't see how Dr. Goren would be able to perform a GG procedure on you when your ISV's have already been packed with coils. But this is way over my head, so I shouldn't even speculate.

It's true that Dr. Gat says that it takes months to get improvement in symptoms. But this is because of the types of conditions his patients typically have. The GG procedure allows the body to start healing itself. Enlarged prostates take a lot of time to normalize, but the testes should start producing more hormones and/or healthier sperm in less time. Your condition is unusual, so it wouldn't surprise me that your symptoms resolved so quickly.

Robc, this sounds to me like a ***genuine*** cure to your problems, not a mirage! You'll know for sure in a few weeks.

-dave
Posted 9/3/2013 1:39 AM (GMT 0)
Slide 61 of 95:

"Question: Could the prostate be enlarging to absorb more iodine just as breasts enlarge when there is an iodine deficiency."

http://www.scribd.com/doc/1959949/IODINE-Solution-to-Healthproblems
Posted 9/3/2013 2:48 AM (GMT 0)
well, I am at the 3 month date of my PAE procedure.
Certainly, it shrank the size of my prostate, but with no therapeutic benefit at all so far.
I believe I was told that most of the result would be seen at 3 months with minor improvements until about 5 to 6 months.
I am still catheterizing myself morning and night after urinating. I am usually cathing about 360-480 ml of urine.
I have a diverticulum about as large as my bladder, so I imagine I can hold 800+ mls of urine.

My uro told me I have a narrow bladder neck and sphincter. Told me he'd likely send me to Birmingham to a doc there that's done thousands of incisions to allow the neck/sphincter to expand.

I am also going to a neurologist end of September to check for nerve damage. I've supposedly (according to xrays from a chiropractor) got a couple of vertebrae with compression fractures. I do have issues feeling my big toes for quite some time and tingling in legs, numbness in my butt, etc. So, possibly a nerve controlling bladder may also be aggravated. who knows?

In the meantime, I talked with him about switching up meds. His advice was either Rapaflo or Cialis. I don't have ED, but being a pharmacist I know it's being used for BPH also. He suggested instead of trying one, I use them both and really give a good aggressive attempt before a next step.

Well, 2 weeks on Rapaflo/Cialis. I went from experiencing Retrograde about 10% of the time, to practically every time I have sex. I quit the Rapaflo today and back on Flomax to see if the Rapaflo was the cause or not.

I'm really just tired of the whole situation.
PAE was clinically successful. My prostate shrank. But, thus far, a complete therapeutical failure.
Posted 9/3/2013 3:36 AM (GMT 0)
Rphguy,

It looks like we are in a similar situation, though your symptoms are worse than mine.
I had 60% of my prostate removed with the GL and got very little improvement in
my symptoms.

Do you know the cause of your diverticulum? Could that be involved in your retention?

I have had a PVR after urinating of about 140ml the last few times I cathed. Last month it was as high as 250ml. I find that if hold onto the bottom of the bowl with the calf/shin area of my legs and slowly lean from my waist about 30 degrees to the right or left or sometimes forward on my toes, the stream will usually start again after 10 or 15 seconds. Many times I'll spend a minute just dribbling heavy drops, then I'll pass a stream of 50ml or so at the end. To me it feels like something is tight and holding the flow back, but over a few minutes, lets go. Or like my bladder needs to be tilted to let some more out. Since I'm voiding on average 20 times a day, it's a tedious way to pee, but I don't want to give up until I feel that sense of relief when the tightness and pain relax. That feels like a long 2 to 3 minutes, but if I don't do it I'm liable to get that last stream in my shorts.

My cousin's husband had a full turp and was good for a couple of years but now caths 4x daily because he has no sensation of needing to urinate, and his bladder got so extended it lost it's elasticity.

I think the neurologist is a good call, in case the retention is nerve related. I voiced some
suspicions in my long previous post, above, that nerve damage may be causing my sphincters to
spasm and restrict my flow.

I still have a large median lobe that takes up about 1/4 of my bladder on the ultrasound, which
might be the cause of my frequency and urgency, but my restricted flow is a mystery.
I haven't got a good answer on it from my uro.

I only cath every other week (cathing once a month didn't work out, it took me 2 caths and about
5 minutes of twirling the cath to get it in last week.)

Is your urologist confident the incision of the bladder neck will cure your problem?

What's the odds of incontinence?

Good luck in coming up with an answer.




rphguy said...
well, I am at the 3 month date of my PAE procedure.
Certainly, it shrank the size of my prostate, but with no therapeutic benefit at all so far.
I believe I was told that most of the result would be seen at 3 months with minor improvements until about 5 to 6 months.
I am still catheterizing myself morning and night after urinating. I am usually cathing about 360-480 ml of urine.
I have a diverticulum about as large as my bladder, so I imagine I can hold 800+ mls of urine.

My uro told me I have a narrow bladder neck and sphincter. Told me he'd likely send me to Birmingham to a doc there that's done thousands of incisions to allow the neck/sphincter to expand.

I am also going to a neurologist end of September to check for nerve damage. I've supposedly (according to xrays from a chiropractor) got a couple of vertebrae with compression fractures. I do have issues feeling my big toes for quite some time and tingling in legs, numbness in my butt, etc. So, possibly a nerve controlling bladder may also be aggravated. who knows?

In the meantime, I talked with him about switching up meds. His advice was either Rapaflo or Cialis. I don't have ED, but being a pharmacist I know it's being used for BPH also. He suggested instead of trying one, I use them both and really give a good aggressive attempt before a next step.

Well, 2 weeks on Rapaflo/Cialis. I went from experiencing Retrograde about 10% of the time, to practically every time I have sex. I quit the Rapaflo today and back on Flomax to see if the Rapaflo was the cause or not.

I'm really just tired of the whole situation.
PAE was clinically successful. My prostate shrank. But, thus far, a complete therapeutical failure.

Post Edited (Bob_NJ) : 9/2/2013 10:21:35 PM (GMT-6)

Posted 9/3/2013 3:44 AM (GMT 0)
RPHGUY:

Thanks so much for the update. It seems that yours is another case of a procedure that was a technical success but that didn't actually improve the patient's symptoms. (At least it reduced the size of your prostate, so that should be something.) I think this disconnect is common, but patients generally don't go around saying that their treatment was a disappointment. But we appreciate hearing the truth.

I'd say this: If you're not worse off than before, then you're still ahead of the game. The Birmingham surgeon and the neurologist would have been on your calendar sooner or later anyway.

I've had no experience with cathing, so I'm not in a position to offer you cogent advice as to what to do next. Gosh, I feel your pain! Your plan seems reasonable to me as you stated it. (I'm sure you've ruled out B12 deficiency already as a cause of the nerve tingling. But cases do occasionally crop up. http://www.amazon.com/Could-It-Be-B12-Misdiagnoses/product-reviews/1884995691)

I was on Rapaflo for for a year and a half. It gave me Retrograde 100 percent of the time. It is one tenacious little alpha-blocker: It would take me 2 or 3 days to get back to normal whenever I stopped taking it.

##########################################

Martin: Iodine supplementation is a fascinating and profound topic, isn't it!

I'm just now ordering some fluoride-free toothpaste from Amazon. It doesn't make sense to brush with fluoride toothpaste if I'm trying to detox fluoride. I've found one with xylitol, so hopefully that will take the place of my old staple.

################

Bob: I'm sorry about your cousin's husband. I'm sure the surgeon considered his procedure a technical success, too.
Posted 9/3/2013 3:45 AM (GMT 0)
Dave,

Great observation on my email with Dr. Gat!  I thought exactly the same thing ... I read and re-read my email to him, thinking "Did he misunderstand my question?"

Just a thought:  I know that sometimes these varicoceles recur.  And I also know that you can go back and get them embolized again if they do.  I don't understand how that could be possible either, but maybe the answer is the same for both questions?  At my one-month followup, I'm going to ask.

In my case, I really had no choice but to make a move immediately.  My varicocele was so painful, and I have been dealing with it for so long, that there was no way I could wait to try to make arrangements to go to Isreal, especially since I think maybe they're not even doing the procedure right at this moment. 

I'm considering the therapeutic effect on my prostate to be just a lucky side benefit of a one-sided varicocele repair.

I'll be sure to keep you posted ... I will say again that I refuse to be convinced so early on.

 

Posted 9/3/2013 1:35 PM (GMT 0)
ROBC:

Dr. Gat has said that in about 5 percent of his cases treated by GG, the treatment fails because the body develops "collateral" veins running in parallel to the now-shut-down Intraspermatic Veins. These cases require re-treatment to shut down the collaterals.

-dave
Posted 9/3/2013 1:54 PM (GMT 0)
RPH Guy: Thank you for keeping us informed. Hopefully you will see improvements in the next 3 months. Have you tried a smaller dosage of Rapaflo which comes in a .4mg size same as Flomax. "For Flomax, the sexual side effect of abnormal ejaculation occurred in up to 19.1 percent of men who took the higher dose of Flomax (0.8mg daily). For men who took the lower dose (Flomax 0.4 mg daily), 8.4 percent of men experienced abnormal ejaculation. Up to 1.6 percent of men stopped taking Flomax due to this side effect. This problem can include decreased amounts of ejaculate, inability to ejaculate or retrograde ejaculation." I question whether a larger dose of Flomax gives increased benefits.

Excess vitamin B-6 can cause nerve tingling.
Posted 9/3/2013 5:18 PM (GMT 0)
Iodine supplementation=zombification?

Is the "cure" worse than the problem?
Posted 9/3/2013 5:50 PM (GMT 0)

martin victor said...
Dave: Well, you started me on a new project: iodine supplementation.

I have tried to find other people who have had success aside from Grizz with iodine supplementation and BPH. Here is one guy called Pain In the .....

http://www.dailystrength.org/c/Enlarged_Prostate/forum/16184794-bph-relief

Yesterday, I took 18.5 mg of ioderol (potassium iodide and iodine) . Needless to say, I felt like a Zombie. I could have been a star performer in World War Z with Brad Pitt. No energy, felt totally fatigued all day. No doubt, I was in detoxification mode, probably passing out a lot of halides like bromine. I must say though, I had a fabulous sleep. I did buy Vit c, selenium, celtic salt, magnesium to assist in the detox. If breast fibroids and uterine cystic tumors are so common with women who lack iodine & show improvement with supplementation, one has to wonder what is going on with men in their corresponding organs like the prostate. So, what's to lose! ...I will maintain a daily program of 150 billion probiotic bacteria and eventually 50 mg of iodine based on the premiss that BPH patients have a latent or aggressive form of prostatitis. Whether infection has anything to do with the mechanical failure of the ISV's and the formation of a varicocele is a question. But worth pursuing based upon the fact that both iodine and probiotics reduce harmful bacteria. If prostatitis (latent or not) is a forerunner of BPH...what does one have to lose.

Note: 10 years ago I did an iodine loading test and scored in the mid-40's. A highly suitable score is 90. Basically the test shows how much iodine is excreted in your urine after taking a 50 mg dose of iodoral. Since my body absorbed so much iodine, the test showed I was severely lacking this mineral which it surely craved.. Being primarily a vegetarian, I never eat fish and seaweed. The Japanese eat 15 mg of iodine every day in the form of seaweed and fish and have very low rates of prostate cancer and BPH. I believe much is diet and infection related (iodine is an anti-septic).

Any suggestions on scaling up the probiotics from 3 billion rather than jumping straight to 150 billion?
Posted 9/3/2013 6:22 PM (GMT 0)

Skateman said...
Iodine supplementation=zombification?

Is the "cure" worse than the problem?


Hey Ira!

I'm totally zombified as I write this. It's bad, gotta say. Headachy, fatiguey and sweaty.

It's four hours after my iodine dose (18.75 mg), but that doesn't mean that iodine is the culprit.

With a detox regimen, the bet is that there will be a period of detoxification marked by unpleasant symptoms as the "toxins" (presumably fluoride and bromide) are mobilized from their stores and washed into the bloodstream on their way out of the body. The period of unpleasant symptoms is supposed to be limited in duration, weeks, ? whatever. But afterwards, there's supposed to be a post-detox period of indefinite duration of bliss.

That's the theory anyway. Ask me in a year how it all worked out.

-dave
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