Gat Goren, PAE, LUTS, Part 5

Andy - 'But, I will tell it as it is with regards my progress.'

Thanks. I hope it fulfills every one of your expectations. As I said 'posts ago', if it can be shown statistically to be effective, they would surely be candidates for a Nobel prize for medicine.

All the rubbish about angry urologists trying to suppress the procedure for economic reasons is surely silly stuff as radiologists, on the other hand, stand to make a fortune. If it can be shown statistically to be effective

Hi Andy,
I'm happy you have found relief through this procedure. It sounds like the procedure definitely reduced the restrictive flow that you experienced prior to having the procedure. Having been in those shoes, needing to cath when I was backed up to 400ml and only able to pass a few tablespoons of urine, only a procedure to reduce the prostate volume such as GG or the GL laser I got, turp, etc., will bring relief. That you are still experiencing relief 3 years out without strictures, hematuria, scar tissue, or need for further medications is a great testimony to this procedure. I also get the weak stream in the morning, depending on which side I sleep on, also need to double void at times, but get mostly good streams and usually 3-4 hours betweens visits.

I'm 2-1/2 years out from my greenight and have had issues with scar tissue needing to be removed, bladder stones, hematuria 18 months later needing surgery, cathing, and a resection of the bladder neck during the stones and hematuria surgery about 10 months ago.

It seems the only fly in the ointment with the GG is that it supposedly doesn't help if you have a large median lobe. Although I'm not sure why not. I did have (and still do have) a large median lobe, but it didn't stop me from getting relief after the GL, and again after the resection of the bladder neck and removal of stones.
At any rate, it's good to hear success stories. Thanks for your posts.

After my surgery last December, I've been good until about 6 weeks ago when my nocturia came back with accompanying insomnia, after a hard fall on my butt. In the past 6 weeks I've averaged 1 in 4 nights of being awake until at least 8 in the morning, then finally getting 2 or 3 hours of sleep. Other nights I get a good 7-1/2 - 9 hrs., despite getting up 2 or 3 times to pee.In the middle of this 6 week period I had two weeks of good nightly sleep, but have now only slept well every other night for the past 8 days. I've kept a journal and tried to isolate what was different about the nights I slept from the ones I didn't but haven't spotted anything. I've tried every bit of advice on the internet (sleep hygiene, regular bedtimes, avoiding liquids and snacks and naps in the evening, meditation, progressive relaxation, self hypnosis, avoiding excitement before sleep, taking hot baths, getting out of bed after a couple of hours of not sleeping to read or do chores or watch tv for a few hours, melotonin, magnesium, tranquilizers, etc., etc.), but nothing works with any consistency. I guess I must just adapt to it. Well, I guess it's always something.

Bob

andyaction said...
Hi everyone who remembers me! As you may recall, I had my G/G procedure almost three years ago and have regularly updated the forum on my progress.

Prior to G/G, peeing took 10-15 minutes a go and never felt emptied so was going all the time - of you can call a slow dribble going, going three / four times every night and having to get up early.

Current situation is that since my procedure I have not visited my urologist or even felt the need to.
I am taking NO medications.
My flow varies from slow first thing in the morning (some mornings depending on my sleep position, it can be similar to pre procedure - so I try not to sleep on my back - however, second pee is more like normal)
To: A decent uninterrupted stream.
Definitely have to second void all the time.
Night time visits: from none to one or two depending on how much I drink (primarily loads of green tea daily) and how late.
Urgency - when I gotta go, I gotta go! Still!
Frequency - mostly considered normal, but there are some days when I want to pee more often. Probably normal!

Rating of the G/G procedure: still worth every penny 8/10 !!!!! Still happy to talk to anyone.

Clap, i do, from time to time look over the comments, but, not being a doctor, I am definitely out of my depth with all the technical stuff - so hence no meaningful input. But, I will tell it as it is with regards my progress.

Peter and Michael D.--Keep us posted by all means. I'm fascinated about the different approaches, and whether patients will report the great results that the manufacturers and providers claim.

Andy and Bob--It's always great to hear from you guys. Thanks for bringing us up to date on your progress.

Golfosca--Welcome aboard! Keep us informed.

Great informative posts, guys. These are the kind of reports that make me follow the forum.

Speaking of progress, I have an update....

================ Update 3.5 years ===============

I promised to post updates whenever there was a change, good or bad. This is not the kind of update I like to post, but I promised honesty.

I've had an aggravation of symptoms over the last three weeks. I still don't understand it. I'd like to think this is just another "healing crisis," but I don't think it is. about three weeks ago my lower abdominal discomfort symptoms while sitting got much worse. There was also much increased frequency during both day and night, which is unusual. It's better now, but still worse than it was a month or two ago. Sorry to have to post the bad news.

One clue is that I had given up some vitamins about three weeks ago. I suspect that vitamins had been helping my symptoms for some time. I was taking: occasional vitamin C, E and, a couple times a week, B-50 megavitamins. (Martin--By chance, have you had experience with these vitamins?) The symptoms did not come immediately after discontinuing the vitamins; it took more than a full week.

I will keep folks posted.

Good, Martin! Keep us informed about your progress or lack thereof.

Now we have *two* Martins on the board.

A lot of uncertainty and differing opinions being expressed here.
For what it's worth, the significant points that emerge regarding a Gat Goren procedure are:

The worst outcome reported is neutral; no improvement. The majority have had good results.
Most other procedures have attendant side effects, some of them nasty; GG has none.
Most other procedures involve surgery on the organ itself; GG does not.
GG works by blocking the venous flow of blood from the testes to the prostate, which is the carrier of the very high concentration of free testosterone and that causes the havoc. Thus GG addresses the cause.
Free testosterone is known to be a causal factor in the development of prostate cancer.
PAE which claims to block testosterone, acts on the arterial blood flow which carries serum testosterone, usually at quite normal concentrations. There has not been any study of the effects of depriving the prostate of oxygenated blood.

For my money, the GG procedure is the only one that goes to the cause of the problem rather than treating the symptoms. Add to that the simplicity of the procedure and the lack of side effects and it's a no-brainer. And should it all turn out to be a load of rubbish, one has not burnt anything more than a pocket full of money; all the other procedures remain as options.

We know Proscar (finasteride) shrinks the prostate by blocking the formation of DHT (with side effects). We know the Gat Goren procedure can also reduce prostate size by preventing the inundation of DHT (4x as potent as testosterone) into the prostate by sealing the ISV's. Here is an excellent video that explains how stinging nettle root has an affinity for SBGH thereby blocking DHT from attaching to receptors in the prostate. All 3 methodologies have merit. The latter (stinging nettle root) has no side effects, yet will effectively lesson BPH symptoms based upon clinical research and also shrink the size of the prostate.

http://www.youtube.com/watch?v=RdnFlW8OArM

Clap: I refer you to this double blind clinical study of 620 patients using stinging nettle root for 18 months.

What impressed me most, were those selected to take the nettle root versus the placebo group had a decrease in prostate size of 10%. Trans Rectal Ultrasonography (TRUS) was used to assess the volume of the prostate. IPSS (International Prostate Symptom Score) went from 19.8 to 11.8 in the treated group vs 19.2 to 17.7 in the placebo group...a 40% decline. Peak flow rate treated patients improved by 8.2 ml/s and only by 3.4 ml/s for placebo recipients. This is a 77% increase in flow compared with a 31% increase from the placebo group. Postvoid residual urine (PVR) was decreased in the treatment group from 73cc to 36cc vs no significant change in the placebo group. Prostate size decreased from 40.1 cc to 36.cc in the stinging nettle group with no change in the placebo group.

These are phenomenal results. What is most important in my opinion is the quality of the nettle root. In previous posts I described how the nettle root decreases the attachment of DHT to the receptors of the prostate, thus preventing hyperplasia and hypertrophy.

Study:

http://nutraxin.com.tr/pdf/UrticaDioica/Urtica_01.pdf

Yes Clap, I trust the source and was well aware of it being an Iranian study. I think you are confusing the politics of the nation with the reality that medical science in Iran using Western methodology is fairly advanced for an Arab country. I would trust an Iranian clinical study more than I would with some of the big Pharma studies in America where clinical results are motivated by money and time and time again have been proven to be faulty. A number of other studies have concluded that stinging nettle root is as effective as Proscar. But of course, you don't hear much about them, because who is gonna make money promoting a low cost herb.

I also believe your conclusion about Gat/Goren are misguided. Aside, from my experience, I have spoken to several people who have had success with this procedure. Urologists will be the first to question Dr. Gat given the bread and butter nature of doing TURPS vs an interventional radiologic approach that does not cause incontinence, infection, bleeding, and sexual impairment.

I also submit the fact that your reliance on orthodox Western medicine is not entirely to be trusted. For example it took two dentists from Australia to prove in double blind clinical studies that stomach ulcers and gastritis were not caused by stress but by a bacteria. It took many many years of effort to make the case despite the protestations of American gastroenterologists. Even Oriental medicine has many advantages using the power of natural herbs over thousands of years in combatting disease compared to Western medicine. The exception being Germany where 50% of all treatments are herbal in nature.

"H. pylori was first discovered in the stomachs of patients with gastritis and stomach ulcers in 1982 by Dr. Barry Marshall and Dr. Robin Warren of Perth, Western Australia. At the time, the conventional thinking was that no bacterium can live in the human stomach, as the stomach produced extensive amounts of acid of a strength similar to the acid found in a car battery. Marshall and Warren rewrote the textbooks with reference to what causes gastritis and gastric ulcers. In recognition of their discovery, they were awarded the 2005 Nobel Prize in Physiology or Medicine.[89]

'Yes Clap, I trust the source and was well aware of it being an Iranian study.'

Each to his own Martin.

Don't you find it at least suspicious that G&G have never responded on this thread? Don't you find it suspicious that there is no (official, peer approved) information available as to successes vs failures?

From what some comments here suggest, Gat Goren are a very personable couple.

Does anybody have a response from the good doctors as to why they moved their operations to Cyprus? Why not to the UK for instance. Or the United States of America. They could make a real splash there IF THE PROCEDURE was everything that they and some others on this thread, claim.

It's all very fishy. And I say again, I have 'no dog in the game'.

To be fair, when I read more comments down that page in Hebrew, there is one commenter who had the procedure in 2011 and says that 'the procedure saved him'.

The comment is from 11th July. 2014.

The same commenter also suggests that Gat Goren are being stifled/smothered by 'established urologists' who don't want to loose a good income. But. As I have said before, no word from intervention radiologists either who stand to profit a lot if the procedure is statistically effective.

I, too, think that the Gat Goren theory makes sense.

However, I think ClapTheHammer is correct.

The fact that US medical practitioners who could make a fortune from Gat Goren type treatments have not jumped onto their procedure is disheartening.

For your information, from what I can tell (i) Gat and Goren have been awarded this year Israel Patent No. 203271, and (ii) all their other Israel, Europe and United States patent applications pertaining to their method have been withdrawn or abandoned by now (i.e., as of November 16, 2014). (Perhaps I'm mistaken. However, I have not found any application-other than the application that led to the issuance of Israel Patent No. 203271-that has not been withdrawn or abandoned.)

I have not found an English version of the lone Israel patent, so I do not know whether any meaningful rights were granted. Of course, an Israel patent is enforceable only in the Holy Land.

The reason that all the other applications were abandoned may be because Gat and Goren's theory was not new. (An old client of mine whose patent application had been refused in view of prior work by an MIT researcher on a government grant proudly said, "I told you my theory was correct.") See this from the US Patent and Trademark Office's rejection of Gat and Goren's US Application Serial No. 11/826,283:

US Patent and Trademark Office said...
Claims 1-2,4,7-9 and 59-61 are rejected under pre-ALA 35 U.S.C. 102(b) as being
anticipated by Nania et al., Percutaneous Sclerotherapy for Varicocele: A Report of 300 Cases.
Clinical Research, Vol. 9. N.4, 2003.

Regarding claim 1, Nania discloses a method for forestalling or therapy, at least partially,
of BPH or prostate cancer comprising: (a) selecting at least one patient for prostate hypertrophy
diagnosis (inherent step in any diagnosis procedure); (b) identifying a reflux of venous blood (i.e.
a varicocele) to the prostate in the at least one patient as a result of at least a partial positive test
for prostate hypertrophy (i.e. a varicocele, Pg. 502, col. 1, ln 6-10); and (c) impeding the reflux to
the prostate by occluding one or more veins (Pg. 503, col. 1, ln 1-5) affecting or conveying the
reflux, thereby reducing BPH or cancer accelerating or causing prostate hormone levels.

Regarding claim 2, Nania discloses a method according to claim 1, wherein affecting or
conveying comprises having incompetent valves resulting in hydrostatic pressure that prevents
upstream venous drainage. Nania discloses a method for treatment of varicocele, which is caused
by the vein having a defective valve that results in hydrostatic pressure that prevents upstream
venous drainage.

Regarding claim 4, Nania discloses a method according to claim 1, wherein occlusion
comprises utilizing a sclerosant (Pg. 503, col. 1, ln 1-9).

Regarding claim 7, Nania discloses a method according to claim 1, wherein treating
comprises a combination of methods (catheterization and occlusion).

Regarding claim 8, Nania discloses a method according to claim 1, wherein a vein
comprises at least one of an internal spermatic vein or a deferential vein or a by-pass vein (Pg.
503, col. 1, ln 1-9).

Regarding claim 9, Nania discloses a method according to claim 1, wherein the venous
blood is rich in testosterone relative to a normal concentration range in the blood circulation (It is well known in the art that when males suffer from BPH high levels of testosterone are observed
(i.e. dihydrotestosterone, DRT)).

The office action goes on (pardon the expression) in a similar vein.

As ClapTheHammer has noted, it would be very helpful to see statistics relating to the results of Gat and Goren's numerous procedures. I think we do not even need a double-blind study since objective data from blood tests and prostate measurements would be available.

Perhaps the Gat Goren method works 10% of the time, or 40%, or 80%. I, for one, would like to know.

Ira

Post Edited (Skateman) : 11/16/2014 11:17:03 PM (GMT-7)

Martin. I think we can say that statistical material relating to the success or failure of the procedure is not available to the public. I don't know Dr Gat or Dr Goren. But I wonder if they describe to prospective fee paying patients, that the procedure is experimental?

Do they commit to any refund if no improvement is obtained?

When you write that a small conical pressure may prevent any benefits, OK. I can accept that. But I question 'In a small proportion of patients'. That would affect overall success rates presupposing that it is impossible to assess this 'protrusion' before the fee is handed over to the good doctors.

Unfortunately, the bottom line is that there is no statistical information supplied by the good doctors. And unless any future information is verified somehow by an independent source, I would remain suspicious.

Skateman. Thanks for the 'supported' support. I feel that I now understand better patients for all kinds of medical problems who look for solutions outside the frame.

And I state again that I would be overjoyed if this procedure was determined by proper medically backed examiners, to be effective within a statistical range, say 70 - 80%, to be effective. I would jump on it. Even at the high price which may or may not be justified.

As it is, the good doctors are simply not providing any solid numbers but, they are signing prospective patients on documents to prevent any litigation afterwards if the procedure proves to be ineffective in their case. Mind you, that might be considered standard procedure when undergoing any medical procedure. I simply don't know.