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

Colinstone,
I don't believe the bladder shrinks per se, but may regain some of it's elasticity. The way it was explained to me is that the bladder muscle gets thicker from trying to expel the urine against the resistance of whatever is stopping the stream, usually an enlarged prostate squeezing the urethra (like someone stepping on a hose) or possibly stones blocking the opening of the bladder, or a tight bladder mouth (also called the external sphincter) which doesn't open all the way to let the urine out. This thicker bladder muscle causes the bladder to have a lower capacity, which causes you to feel like urinating more often. I think my threshold was about 300ml. before I had to go. When I was retaining 200ml. or more, that was every 40 minutes around the clock as the body produces about 100ml per hour of urine. With my capacity, I needed to get down to about 50ml. post void residual to be able to last a couple of hours.
Basically you can take the tamsulosin as long as it works and you feel you can tolerate any side effects. For some that is months and for others it is years. You probably ought to get another ultrasound to see what you are retaining now as 300ml is quite a bit. Be sure you void completely (best to double void if you can) before taking the test. Your overall bladder capacity must be pretty good if you can make it through the night with voiding just once or not at all. You have a relatively small prostate, but they say that is not the deciding factor as small prostates can cause problems and big ones can have no symptoms at all. As long as your PSA tests don't have dramatic increases it sounds like except for the amount you are retaining you are doing pretty well. What does your urologist think is the cause? It seems tamsulosin is the first step most urologists take, then work from there. Has he looked inside your bladder with a cystoscope? Mine did and got a good picture of what was going on, though every time I have had a cystoscope I have gotten a urinary tract infection.
A relative of mine had a severely stretched bladder that was no longer able to contract at all, and he has no sensation of needing to urinate, so must self cath every 6 hours. But it doesn't sound like this is your case.
Bob

Post Edited (Bob_NJ) : 4/24/2014 10:52:08 PM (GMT-6)

Yes Bob... I never really had a serious BPH problem. I went to Israel to do the procedure as I saw the writing on the wall. My brother had a TURP done and was not a very happy camper. He leaks urine everytime he gets up from a sitting position. My wife has an M.S. in nutrition and biochemistry from a very recognized university in this field. I studied with her for almost a year and dropped out to pursue my business career. For years I have researched what causes BPH and was very convinced that Dr. Gat and Dr. Goren had the answer. Although their procedure does help many, it is my belief that it still treats the symptom rather than the cause. In researching the work of Dr. Lee, I became aware of the value of progesterone which is made in both the adrenals and the testis. It's more often thought of as a female hormone valuable for those who get hot flashes from menopause. Progesterone has been totally overlooked by the medical establishment for male use. It is an invaluable aid for decreasing DHT and increasing testosterone. Dr. Lee believed based upon his treatment of hundreds of patients with BPH that a key ratio of testosterone plus progesterone divided by estradiol was the way to prevent and cure BPH. As men age, their total testosterone and progesterone decrease and estradiol goes up. There are many causes of this including xenoestrogens that we intake from pesticides, plastics, estrogen dominance, lack of Vit D, trans fatty acids,etc aside from diet. When estrogens bind to prostate receptors, inflammation follows. All the evidence implicates estrogen as a major cause of both breast and prostate cancer. Estrogen dominance activates the oncogene Bcl-2, where as progesterone and testosterone activate the protector gene, p53. For the last month I have been taking a natural progesterone cream applied to the perineum area in the amount of 1/8 teaspoon. I have noticed a considerable difference in the forcefulness of my urine stream. I believe it is working and I suggest people who read this forum, investigate Dr. Lee's work. For $15, you can get the web addition of Hormone Balance for Men. Believe me please, it is a very worthwhile investment.

http://www.johnleemd.com/store/chap1hbms.html

BOB....ZRT LABS does saliva testing for hormones. Saliva testing is more accurate than serum blood testing as the hormones are not bound to proteins. Testing involves spiting saliva into a tube...Cost around $175.

http://www.zrtlab.com/patients-standard-tests/saliva?gclid=CKHVgd_1ob4CFZBxOgodpDQA9w

Good luck, Martin

Thank you Martin and Frank for the additional information.
Frank, after 5 years of experience with hormone therapy, can you tell me what the outcomes were for your improved health?
Thanks,
Bob

Hi Guys,

Peter will soon start a new thread for our discussions. Are we happy with the current title, or do we want to change it to something like, "BPH, LUTS, PAE and Gat-Goren"? Or another title?

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Interesting conversation about hormone therapy. I will check out the new book by Dr. Lee. Like Bob, I too am wondering what benefits FrankT has obtained from these over the past five years.

I myself tried hormone supplementation in the 90s, but didn't find good relief from fatigue or low T. It's not surprising: I rarely get good results from any supplements or Rx drugs. I tried T therapy in various forms, and even tried some progesterone cream about ten years ago. T is available in injectable form; in oral form in Canada by Rx--but the old methyl-T pills they used to prescribe in the US are not safe; in transdermal (cream) form; and in implantable pellets. Furthermore, some doctors use hCG--human chorionic gonadotropin, derived from urine--to stimulate the testicles to produce their own T.

Supplementing hormones gives rise to downstream effects (as the hormone is converted into other products, as T is converted into E2) and upstream effects (as the body cuts back its own production). As FrankT said, adjusting hormones is a "complex" undertaking. Normal levels of natural T naturally fluctuate in a characteristic pattern during the day, and I missed that fluctuation when I took T. I have not been on any hormones for ten years.

There's been a huge amount of literature on the subject over the past 25 years--in the form of books, papers and Internet musings--a lot of which I find lacking. Here's an interesting Internet site, which I'll pass along with the understanding that I'm not necessarily endorsing it:
http://www.allthingsmale.com/index.html
Finding a knowledgeable physician to help you is important, as FrankT so rightly says.

Back then, we didn't have salivary assays--I always had to do a blood draw. I never heard that serum estrogen (estrodiol) could be too low in men, though. This could be a new finding. (Of course, guys can take too high a dose of aromatase blockers, which would cause problems. This has been known for a long time.)

Martin, if you go this route, please report on your progress.

Anyway, if I discover that the new approaches are giving better results for general aging than the approaches I tried way-back-when, I might give it another shot. So keep on posting your results.

-dave

Bob_NJ said...
Thank you Martin and Frank for the additional information.
Frank, after 5 years of experience with hormone therapy, can you tell me what the outcomes were for your improved health?
Thanks,
Bob

Hi Bob and Dave:
I will say it has helped me achieve more vitality, although difficult to balance all the hormones for those of us with BPH.

In my view re-regulating your hormones back to optimum levels is a particular issue for those who suffer with BPH. This is because increasing some of these hormones to healthy levels may also raise downstream conversion of more DHT. If you adhere to the conventional wisdom (for those that suffer with BPH) is that we are already producing too much DHT (or our prostate is accumulating too much DHT), then it makes it more difficult to achieve that health balance. Having said that, my reading of the current evidence on exogenous administration of testosterone suggests that it does not by itself worsen BPH, and this has been my experience as well.

It would help if there was a way to selectively reduce DHT production without affecting other hormones, although I have not found any. As I mentioned previously, 5AR inhibitors affect a number of hormone pathways besides DHT, and sometimes in unhealthy ways.

To me this was the beauty of the G/G approach, as it seems that they were able to close the physical pathways which allowed continual build-up of DHT in the prostate.

I am interested in looking further into Dr. Lee's work on Progesterone levels, although I fear that any BPH improvements here were due to the fact that Progesterone is also a 5AR inhibitor. Supplementing with Progesterone is also a delicate maneuver - too much can cause undesirable side-effects in men.

IMHO, testing for these values in saliva or urine is vital to understanding a valid approach.

Regards