Gat Goren, PAE, LUTS, Part 5

Dave: I take 8,000 IU Vitamin D. My blood level is over 70. I have been doing this for a long time. Vit D is excellent for prostate cancer.

Liamireland said...
I have very high hopes for good results, but now it is wait and see. I spent a long time hunting for information on GG and overcoming obstruction from urologists to get to this point.

I will submit any reported improvement or otherwise in due course.

Welcome to the board, Liam!

We'll be following your progress very carefully on this board. I certainly will.

I love it when people join the board before the procedure or right after it. That way, there is no possibility of "reporting bias". The ultimate results could go either way. (But I'll keep my fingers crossed for you.) It's about time we had some new blood on this board. And as for me, I've been waiting a long time for other satisfied patients to join me in this corner of the ring. Maybe you will be one of them. Only time will tell.

Please be patient. In my own procedure, the first symptomatic improvements appeared only after 3.5 months, with further improvements at 6.5 and 12.5 months. Immediately before each improvement, there was a momentary (like, 2 weeks) period of aggravation, which never ceased to worry me.

I envy you your long coffee break with the doctors and the other patient.

-dave

Post Edited (Chicago Dave) : 9/16/2014 7:50:37 AM (GMT-6)

Hi Liam

I would like to talk with you I am considering having it done too. If you are agreeable I can post my email in my profile for a short time.

Thanks,
Jeff

Post Edited (Jeff@57) : 9/17/2014 10:28:12 PM (GMT-6)

Thanks I unhid my email under my profile let me know when you got it and I will remove it. And if you can pop me an email that would be great.

Martin,

I was diagnosed with an enlarged prostate a number of years ago by my GP and he referred me to a urologist that he recommended.
The urologist was highly regarded in his profession (I checked).

His diagnosis was that medication would keep the matter in check and so it proved for a good few years. My symptons worsened steadily. about 4-5 years ago he started recommending a TURP and I stalled and stalled and over a number of years I am sure he was exasperated at my failure to do the TURP.

I started to find some information on the Gat Goren technique, it was difficult to find much at that time, I was interested in proceeding to get more information and I contacted Israel only to be told they were off doing some research and were not accepting patients at that time. They would contact me if they resumed.

about a year later I was contacted, by this time my symptoms really were very intrusive, I immediately asked them to assess me for consideration for the procedure.

I was sent a list of tests they required before I could be accepted. I went to my urologist and showed him the list, I told him I had not decided to have the procedure but I wanted to submit the tests and depending on what Gat Goren would say, I would then decide. My urologist informed me that he wa not going to assist me in any way to proceed with this and refused to do the tests. I pointed out I was paying for the tests, I had not made up my mind what I was doing and that he was simply accommodating me to be in a position to make a decision, all to no avail I met with a flat refusal. I said I would have to move to another urologist and I requested my records, I was asked to submit that in writing, I did.

I got no response for a month or so and tepehoned to be told they never got my request, I submitted again, there was a very long delay and it was 8 months or so before everything arrived.

I was not impressed, I considered the refusal to do the tests to be unethical behaviour to be frank.

I had my GP write a referral to another urologist who had been recommended to me by a golfing friend (a plastic surgeon at one of the better hospitals). When I attended this appointment the urologist quizzed me about my objections to doing a TURP, I explained I was here to do some tests re Gat Goren technique, he said, I read that in your referral letter, I thought it was a typographical error. I wasted no time in pursuing that and just said I want to do these test, he said this will be very expensive and my response was I want this done (it cost about €1100).

In regard to your question re why the procedures arecdine in Cyprus
I presume safety to be the issue, I never asked as that seemed obvious, it is a 45 minute trip by air from Israel.

I did not ask about what research was published, I know that both doctors mentioned that mine was the 243rd procedure carried out and that the similar procedure that they do for infertility was about on the 2,000 mark.

There was a long discussion on the basis for the procedure, the fact that free testosterone was flooding to the prostate and causing it to enlarge.

While I was in the late stages of making up my mind on this procedure, another friend of mine who is a consultant gerontologist, was at a conference in San Francisco and he knew I was agonising over this decision, he came back to inform me that having consulted with specialists at the conference, he was happy that this was the way to go, the science was right.

I hope that this is in some way helpful.

I clearly am convinced but the proof will be not just in the shrinking of the prostate but much more importantly in the relief of the symptoms.

I wait in expectation

Hi Liam

Its still there I have not removed it

Thanks

Martin,

I am not sure if you understand the situation in Israel, the security situation is what I am referring to and the fact that the safety of a patient could not be guaranteed in view of the parlours situation.

I really don't have any idea why you would presume the tax situation would be more beneficial in cyprus, is this conjecture or do you know something about this ?

I have no idea if the urologists were worried about their turf being undermined by the radiologists, I do know that from the discussions we had that radiologists are necessary to perform these procedures and obviously as urologists are not radiologists this would represent a threat to some proportion of their business.

I have no idea if urologists in Israel complained about there being no proven basis for the Gat Goren technique, do you know if this is true or are you surmising that this s so ?

It is late in the evening in Ireland and I would have to go check my epochal records to discover the size of my prostate so I will not bother tonight. Happy to do it later.

Hi Martin

Since Gat Goren did not work for you. Have you found anything that helps?

Thanks,
Jeff

Hi Liam,
I also live in Ireland and encountered the same issues as you. My eminent urologist was very dismissive of anything except TURPs.
Some history:
In May 2013 I was diagnosed with BPH after a screening initiative at my workplace. Prostate size was 85 cc after a TRUS biopsy.
The advice to my GP from the urologist was to "monitor".
During this period my GP retired and due to work pressure I forgot/ignored the issue. Had hardly any symptoms except when drinking beer so I ceased. In June 2014 I was hospatilized for 10 days with high temp/fever and eventually urinary retention, had a catheter inserted and left hospital with it still in place. Made an appointment with a local (highly recommended) urologist within 2 days. He removed the catheter, sent me for an ultrasound and told me to comeback in 3 weeks. He also started me on combodart. BPH symptoms started to kick in and I began reading including this excellent forum. By August I went into retention again while attending a weddind and required another catheter which was removed after a few days, however 2 days later I went into retention again, another catheter and extreme pain and discomfort from the catheter this time, including episodes of bypassing. Several visits to A and E and absence from work due to pain and lack of sleep.
I was attracted to urolift and made an appointment to visit a clinic in the UK to see if I was suitable as my prostate is on the large size. I asked my urologist and my new GP for a refferal but both hdn't heard of it. At least the GP googled it and thought it was interesting but not tested enough.
You can imagine the reaction when I mention Gat Goren.
At this stage the pain was so bad I agreed very reluctantly to undergo a TURP.
When he went in he discovered a huge abscess on the left lobe of the prostate which meant he couldn't proceed with a full TURP due to the risk of sepsis.
A week later the pain is gone and apart from dripping some blood and peeing the odd clot I'm much better.
Long term not sure where I'm going.
It's taken me awhile to get to the point on your medical records. After I was hospitalized in June I copied most of my hospital records (there was some surprise and reluctance) and intend doing the same for last weeks procedure and hospital stay.

Jim

Hi everyone on this wonderful board.
Does anybody know anything about PAE procedures done in Brazil ?

My question on PAE?...If the prostatic arteries are blocked, what happens to the prostate after many years of not getting blood supply and nutrition....or are the beads just temporary ...do they dissolve.

"A PAE requires an overnight or day stay in hospital. Prior to embolization, the patient will be catherized for 4-6 hrs. Most procedures take approximately 20-30 minutes. An Interventional Radiologist performs the PAE through a small catheter inserted into the femoral artery in the groin. A local anesthetic is used to numb the skin and no stitches are needed after the procedure.

An X-ray is performed to give the doctor a clear picture of the blood supply to the prostate using angiographic techniques, the catheter is guided through the artery to the prostate and tiny plastic particles are slowly injected into the arteries that supply blood to the enlarged prostate. Over several minutes, these particles block the blood supply to the prostate. With-out a blood supply, an enlarged prostate will shrink up to 40-50% in 1st 4-5 weeks. The embolization is continued until the blockage of blood flow to the prostate is complete. After complete embolization of one side is done, the other side is embolized."

http://www.indianinterventionalradiology.in/FAQ_enlarged_prostate

Sashman said...
Hi Folks,
As someone who is looking for a long term solution for my BPH, (I think I've only gained a reprieve due to the abscess) Gat Goren or PAE looks like the solution.
Gat Goren is especially attractive as it looks like it addresses the root cause (as an engineer that's important to me).
Is PAE a slightly cruder version of Gat Goren?
Jim

Jim,

Although both procedures are performed by interventional radiologists, the procedures are based on different approaches. PAE, as I understand it, attempts to block the *arterial* flow to the prostate, which causes the prostate to shrink. (Martin asked a good question, one that has come up before: Exactly what is the mechanism by which the prostate shrinks?) G-G targets improving the *venous* drainage, attempting to create better circulation in the prostate (and also the testes and bladder). The idea is that increased circulation will help normalize both the ambient pressures and Testosterone levels in the prostate, and the body will be able to (partially) repair itself on its own.

I don't know much about PAE. We had a couple members on the board, and I hope they chime in.

HTH

Shasman,
Thanks. I am trying to get in touch with Brazil. My prostate is about 100 gr. Inclugind a median lobe that intrudes into the bladder. I have no severe symptoms yet, but the size and shape of my prostate worry me. My plan is to tackle the problem with two or more techniques/medications at the same time or through a planned program. I will report any developments.