NEW! Gat Goren, Part 4. Now with PAE and LUTS!

Hey Bob, glad to hear things are improved.
question, though. I don't remember if you stated you had retrograde as a result of your previous GL laser.
If not, have you noticed since you had your bladder mouth widened?

I am urinating better than many years. I certainly couldn't not bark off trees and my flow is not a wide stream, but it does get my bladder fairly empty. I have residuals of anywhere from 60-90ml. I check it occasionally.

My next 2 options, if necessary, would be bladder neck widening or whittling away at the median lobe that presses up into my bladder. May not be necessary for the near future, though.

RPHguy,

Your residual is really good! 50ml is supposed to be normal, but my uro told me previously that 200ml or less would not hurt me. And being able to muster a good stream and empty out is a major improvement. That's great!

I did not get retro with the greenlight and I do not have it now. My uro said I could get it if he does another GL to remove more of the protruding median lobe.

I don't know if the widening of the bladder mouth did the trick for me but it seems like it may have. I think the bladder stones he removed must have been small because they weren't shown on the catscan report. On the other hand with a 24 fr foley in me, they should have come out on their own if they were small. Sometimes I feel like the three blind monkeys in the folk tale describing an elephant, it's guess work in the dark.

I'm going back in 7 weeks for an office visit. I know my uro would like a second shot at the median lobe. He told me he only got some of it the first time because he spent most of the 70 minutes on the other lobes. Also he brought two GL tips to the surgery and had used them both up, so that was all he could do. On the other hand, I'm thinking the prostate supposedly grows 5% a year, so it would take several years for my median lobe to grow another cm. Unless I experience difficulties I may not want to go forward at this time with another surgery. The possibility with a median lobe that protrudes into the bladder is to act as a ball valve and shut off the opening to the bladder mouth. But with the way I am peeing I don't believe that is happening. I think that would be like going into retention. More questions to put to the doc on my next visit.

I also have the median lobe which extends about 4cm into my bladder as measured inside the bladder with the cat scan.
I figure that is about 20% of my bladder.

rphguy said...
Hey Bob, glad to hear things are improved.
question, though. I don't remember if you stated you had retrograde as a result of your previous GL laser.
If not, have you noticed since you had your bladder mouth widened?

I am urinating better than many years. I certainly couldn't not bark off trees and my flow is not a wide stream, but it does get my bladder fairly empty. I have residuals of anywhere from 60-90ml. I check it occasionally.

My next 2 options, if necessary, would be bladder neck widening or whittling away at the median lobe that presses up into my bladder. May not be necessary for the near future, though.

Post Edited (Bob_NJ) : 12/26/2013 1:22:12 PM (GMT-7)

Hello Ganzman,

Glad you made it though the colectomy and hernia repair. Hope you are on the mend.

I thought I replied to your post, but I must have not finished the post and/or posted it.

I did not have the GG procedure. I had the 180 Watt XPS Greenlight laser procedure 18 months ago but did not get good or lasting results. After a 2 month difficult recuperation and 4 months of good results, most of my symptoms returned at about 50% of the pre Greenlight level about a year ago. I had some scar tissue removed in January and started self cathing every 2 to 4 weeks to keep scar tissue from restricting the channel. I never got the hoped for results until a few days ago after my emergency surgery two weeks ago. During the surgery my bladder mouth was widened and some bladder stones were removed, and three bleeders were cauterized. I am now back on flomax and at present have a great stream, voiding about 7 to 8 ounces at a time in just a few seconds. I also have a large median lobe protruding 4 cm into my bladder, but am undecided on whether to address it at present. I guess it depends on how my voiding continues once I heal from the surgery. At present I still get about 30 seconds of bladder pain after each void. If that goes away I would be reluctant to do anything more for now. If it continues and is related to the protruding median lobe, then I may have no choice but to have the median lobe trimmed down with another Greenlight procedure. It's a shame none of the hoped for procedures with injectibles to kill prostate tissue have panned out.

TheGanzman said...
Good news, Robert! I just went on Alfuzosin myself; no surgery/procedures yet, but I'm leaning heavily towards Gat-Goren. I am 8 days post-op from a da Vinci Robotic-assisted sigmoid colectomy; had ~7" of my diseased sigmoid colon removed due to severe diverticulosis - had a hernia repaired too.

Jog my memory - you HAVE had Gat-Goren, yes?

Post Edited (Bob_NJ) : 12/26/2013 1:18:05 PM (GMT-7)

nosheds,

Glad you were able to get the procedure done!
I could help you with the data collection or excel if you like, am very into data-oriented stuff. You could email me at yudeng2004(at)hotmail(dot)com if you need some help.

nosheds,

Thanks for the info. I don't think testosterone level is any more personal than any of the other information. And we are somewhat anonymous.

Regards,

Bob

nosheds said...
Bob,

on your first question: I live in Israel and have been in contact with GG for about 7-8 months. I simply asked to be on the list and be notified when treatments are renewed. when they called me they mentioned the new place. note this is a locally owned private hospital called "American medical center" which GG use under some type of agreement.

second question: DR Gat diagnoses median lobes during ultrasound but I don't know what are the qonsequences as luckily I myself don't have one. however I have heard him mentioning that with median lobes the problems can begin with much smaller prostate volumes. at any rate, I suggest you ask him yourself. I have reasons to believe English language communication will be improved (he knows there is a problem).

Thunder,

thanks for the encouragement.
I will be happy to share the job with you any way you prefer. by the way, have you gone through one of those procedures? which one? (this, by the way, is the problem for new members who have to go thru pages and pages of posts to find anything).
here is what I suggest. the Excel table will have the following details: name (user or any), age, Prostate volume, median lobe/not, PSA, times at night, symptoms and problems (this needs a wider column).
all these before the procedure.
then: type of procedure, date, perhaps by whom, how easy or difficult, recovery duration
now the results: same parameters as before the procedure at different times after it (this way different stages of improvements can be shown) .

please review - this to Thunder and to all members - this plan and suggest stuff to add or delete. for example, I thought Testosterone level is also important but was told it is too personal. is it?

Thunder,

thanks. actually every field can be optional. people will enter whatever they are comfortable with.

it looks you are volunteering for the job, which I happily accept. why don't you start with building the table and entering your own experience? then make the table accessable to changes only to you and publish the link so all can see it but not change it. individual data will be mailed to you for entering. I will mail you mine, which is only pre - treatment (of course I have to wait few months for results). ask all to mail you theirs.

nosheds

A happy and as healthy as possible new year to everyone.

Well, this forum has come a long way…… It's now almost two years (Mar 29 2012) since I had my G/G procedure. Time to update you all on how things are going. SO: currently…..

NO DRUGS ANYMORE
NO GETTING UP AT NIGHT ANYMORE!
A GOOD FLOW 95% OF THE TIME: Strongish to start but as the bladder empties,flow slows - but still steady.
STILL double voiding.
FREQUENCY NORMAL.
URGENCY -when I need to go I need to go! This is the only issue. Perhaps it's because I'm becoming an old codger.

Overall satisfaction with the results of the G/G procedure = 10/10.

Now, lazy so and so that I am, I've not bothered going to see my urologist since the procedure as he poo hood the procedure and I have no respect for him. Can't even be bothered to have blood tests undertaken. I suppose, while things are ok, I'll not bother. Perhaps, The Doc's will insist sometime, on me having a blood test, so whenever I do decide to have blood tests or a further visit to the Urologist, I 'll keep you posted on what's said or found.

Yes - I myself am especially interested in the before-after PSA #'s for those that have gone through the G-G procedure. My own PSA score has been edging up for the last few years; I KNOW that my prostate is enlarged, thanks to a whole body scan back in '08. At 57, my most recent PSA was in the 4.5-5.3 range; I'd like to nip this in the bud by getting the G-G procedure done sometime in G-1 of 2014. I WILL not submit to a needle biopsy, for the record...

martin,
from what I understand there is a reduction in PSA values (with GG) but it is more pronounced at higher levels, above 3-4 or so.

NoSheds..Ganzman...Here are the facts from Andrologia...Reversal of benign prostate hyperplasis by selective occlusion of impaired venous drainage in the male reproductive system: novel mechanism, new treatment by Dr. Gat and Dr. Gornish (Goren)...2008 page 273

http://onlinelibrary.wiley.com/store/10.1111/j.1439-0272.2008.00883.x/asset/j.1439-0272.2008.00883.x.pdf;jsessionid=63AC127BF9498D3A953D3A7D08D19192.f04t01?v=1&t=hpzjej6d&s=4ae4c04d1e2bf58f9b97f0083067e985ea9635df

28 patients:

Before Treatment:

PSA: 3.56 plus or minus 0.63

After Treatment:

PSA: 3.27 plus or minus 0.45

If you wish to really lower your PSA try this program of supplements:

New Study from U.K. National Cancer Research Institute of 4 supplements that drastically lower PSA:

https://www.lef.org/magazine/mag2013/dec2013_New-Study-Reveals-Four-Nutrients-that-Lower-PSA-and-Slow-Cancer-Progression_01.htm

TheGanzman said...
Honestly, I would think that there would HAVE to be a reduction in PSA values after the G-G procedure. It's pretty simple arithmetic - a larger prostate (read: BPH) will produce higher PSA values; G-G procedure makes for a smaller prostate - that fact ALONE should produce lower PSA scores...

Good thinking, Ganzman, but my own experience is different. My prostate shrunk by half, but my PSA remained at 1.8 (or something). My PSA level did not influence my decision to have the GG procedure.

My local urologist continues to do PSA tests, but my personal physician stopped offering them to me at my annual physical a couple years ago. The PSA is not exactly an ideal diagnostic test.

Post Edited (Chicago Dave) : 1/3/2014 8:10:06 PM (GMT-7)

Re: Pre/Post PSA scores before/after G-G, I would call your attention to this article:
http://prostatecancerinfolink.net/2009/12/25/gats-hypothesis-for-the-cause-of-most-prostate-cancers/

To wit: "Before the procedure, the patients’ average prostate volume was 65.3 ml (range 41.7–114 ml), and their average PSA level was 8.89 ng/ml (range 3.69–14.5 ng/ml). At 6 months after the procedure,the patients’ average prostate volume had decreased to 36 ml (range 26.2–71.4 ml), and their average PSA level had decreased to 5.95 ng/ml (range 2.24–9.5 ng/ml)..."