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Gat Goren, PAE, LUTS, Part 5

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Posted 12/6/2014 5:30 PM (GMT 0)
Dave,
I'm not sure follow up tests are even needed. I think patient satisfaction surveys would tell most of the story. Either they feel their issues were addressed to some extent or they are unhappy. When I buy a piece of electronics or a camera and read Amazon reviews, I read the negative ones first. If enough people bring up valid negative points I don't buy the item. I also ignore the negative reviews by people who have trivial complaints. As a result, I'm happy with virtually all of my Amazon purchases. The same thing on ebay. If I read a half dozen people say the vendor shipped them broken or shoddy items, I look for another vendor who has a 100% positive approval rating or a vendor whose negative reviews are just trivial complaints. It's not foolproof, but again, I am happy with nearly all my ebay purchases. It's just another layer of endorsement above the official pronouncements and advertisements. I can quickly and easily seek out the most likely positive outcomes. It's like LiamIreland just posted. He could care less what his prostate measures, he' just happy not to have uncontrolled urgency and raging infections. A hundred similar opinions is probably worth it's weight in gold for someone with the same problem.
Compare that with the present state of consumer knowledge of medical procedures. You go to a doctor who sounds nice, and hope to God he actually knows what he is doing. You go into a hospital with no knowledge of their record, or take a drug with no knowledge of it's effectiveness. If you are lucky, rxlist or drugs dot com or medical grades dot com may have a half dozen reviews by other people. There's a big cloud of secrecy and lack of information. Your friends and family all have stories of good doctors and bad doctors, medical successes and medical nightmares, and nobody knows which is which until they use them. In the rare instance I buy a bad product on Amazon, I return it and write a negative review. And probably save lots of other people from having to do the same.

Amazon reviews and clothing reviews on online clothing stores are not even mandatory. But enough people benefit from them that they contribute freely and willingly. Once you reach a statistically valid sample, the reviews are quite predictive and people shop accordingly. The same would be the case for medecine if the structure were known and advertised. At some point people would freely contribute and all would benefit.

Chicago Dave said...
Bob and Skateman: I think you both dramatically understate the difficulty of obtaining follow-up test results for patients. Liam has generously offered to undertake his own prostate measurement at six months, so that will be another data point in our efforts here.

I was going to post a long reply, but then got fascinated by Graham's post. In deference to his new initiative, I'm going to be quiet and give this time to play out. I hope certain people take Graham up on his offer, and that Liam and others continue to fill in the details of their experiences, which I find most interesting.

Post Edited (Bob_NJ) : 12/6/2014 10:41:07 AM (GMT-7)

Posted 12/6/2014 5:47 PM (GMT 0)
Dave,
On another point. Where is noshed's spreadsheet located? I have forgotten.
Thanks,
Bob
Posted 12/6/2014 7:40 PM (GMT 0)
Bob:

Shhh. I'm just a fly on the wall waiting to see if Clap decides whether or not to take Graham up on his offer to learn more about GG. If Clap declines, it would give weight to the theory that he's just a basher trying to pass himself off as a sincere questioner.

The current medical system evolved out of the medieval guild system and the German "professor" system. If you were an illiterate peasant 200 years ago, you could make a trek to the Big City and seek out the services of a "Doctor" of medicine, who knew the answers to all your questions. It was one-stop-shopping at the local sage-on-a-soapbox. Folks on this board are on different points along the spectrum that runs from "Total Belief in Anyone in a White Coat" to "Agnostic skepticism and self-reliance on research of various forms", with most guys toward the skeptical/self-reliant end of the spectrum. But there is at least one guy who is conventionally minded. I suppose you yourself used to be fairly conventional, Bob, but experience and time have conspired to temper the old white-coat deference.

Researching medical alternatives is very time consuming and difficult. It's a real pain in the butt. In the future it may become easier, but that's how it works now.

I can’t find the spreadsheet, so I emailed Nosheds.

Post Edited (Chicago Dave) : 12/6/2014 1:02:02 PM (GMT-7)

Posted 12/7/2014 4:13 AM (GMT 0)
Bob: If you email me, we can discuss the issues in your last posts.
Posted 12/7/2014 4:52 AM (GMT 0)
Liamireland - ' I intend to do anything I can do to broadcast the success of this procedure and try to get this accepted as a mainstream treatment so that it can be accessed by people who cannot pay the €17,000 that I luckily was available to afford. In hindsight if I did not have the money, I would forego a lot of things in my life to achieve this result.'

That's very admirable.

But Gat/Goren could do that quite easily. Gat/Goren could do that so much more easily than you with your limited resources. They could just publish clearly their success and failure rates with qualifiers and allow their peers access to the data with all personal details removed. However, there would need to be some way of knowing if the material made available reflects the true situation as to success or failure ratios.

That would surely be the instigation for a true medical trial. I was not aware that medical trials would cost Gat/Goren a penny apart from their time training other interventional radiologists the small delicacies of the procedure. I thought that academic medical institutions did medical trials for procedures at their own costs. Part of what these institutions 'do'.

Then. Imagine that a true medical trial confirmed the viability of the revolutionary procedure and provided a virtually pain free, almost hospital free procedure for a good percentage of males past the age of 60. Gat/Goren would be 'the toast of the world'.

But it is not happening.
Posted 12/7/2014 4:36 PM (GMT 0)
Clap:

Are you going to take Graham up on his offer to help you learn more about this procedure which you post so much about? That's what I'm interested in knowing. Well? Are you?

Most of your suppositions seem off-target to me. To take one example:

ClapTheHammer said...
I thought that academic medical institutions did medical trials for procedures at their own costs. Part of what these institutions 'do'.

In a perfect universe this might be true. But that's emphatically *not* how the game is played in our universe. Academic medical institutions *themselves* lack the funds to pursue clinical trials and also most types of bench research. They depend on the federal government for some funds, especially for basic research, and for well-heeled private corporations to "sponsor" (pay for) clinical trials of their new devices or drugs. They get a lot of money from these sources, and it is only this external money that makes the academic medical centers seem so rich. But unless you happen to have a few million dollars laying around, I doubt they would be interested in your ideas.

I won't address your other musings, except to say that they also seem to miss the mark.

So. What's it gonna be, Clap? Dig deep into GG or just continue to post uninformed and misleading speculation?
Posted 12/7/2014 6:35 PM (GMT 0)
Dave,
I'm just blue sky speculating here. Just a wild crazy idea that may someday have some economic motivation behind it. Nothing gets done without money being made so the human race has been rife with "good ideas" like peace, love and understanding that turn out to be pipe dreams...
Regards,
Bob

Chicago Dave said...
Bob: If you email me, we can discuss the issues in your last posts.

Posted 12/7/2014 7:02 PM (GMT 0)

ClapTheHammer said...
Liamireland - ' I intend to do anything I can do to broadcast the success of this procedure and try to get this accepted as a mainstream treatment so that it can be accessed by people who cannot pay the €17,000 that I luckily was available to afford. In hindsight if I did not have the money, I would forego a lot of things in my life to achieve this result.'

That's very admirable.

But Gat/Goren could do that quite easily. Gat/Goren could do that so much more easily than you with your limited resources. They could just publish clearly their success and failure rates with qualifiers and allow their peers access to the data with all personal details removed. However, there would need to be some way of knowing if the material made available reflects the true situation as to success or failure ratios.

That would surely be the instigation for a true medical trial. I was not aware that medical trials would cost Gat/Goren a penny apart from their time training other interventional radiologists the small delicacies of the procedure. I thought that academic medical institutions did medical trials for procedures at their own costs. Part of what these institutions 'do'.

Then. Imagine that a true medical trial confirmed the viability of the revolutionary procedure and provided a virtually pain free, almost hospital free procedure for a good percentage of males past the age of 60. Gat/Goren would be 'the toast of the world'.

But it is not happening.

Clap,
You are right of course. But in a small way we have already done this on this forum. The procedure has worked for some, not for others. That's likely the case for every single medical procedure and medication. They work for some and not for others.

I saw a post on the IC-forum by a man who claimed desmopressin cured his nocturnal polyuria, which he has had for years, and has been working like a charm for 10 months. He hasn't responded to my questions. Two other people on the forum tried desmopressin for nocturnal polyuria and discontinued it, so it wasn't a silver bullet for them. They also haven't responded to questions, so I don't know why.

Desmopressin is generally prescribed for bed-wetting and has been used for 30 years. Using it for nocturnal polyuria is a sort of off target (I don't recall the medical term) use for it.

Nocturnal polyuria can be caused by three things. The first is failure to release ADH (antiduretic hormone) at night. Desmopressin taken before bed stimulates the hormone. But Nocturnal Polyuria can also be caused by nephrotic syndrome (failure of the kidneys) and I have signs of that with high albumeria and have had proteinuria my whole life. And nocturnal polyuria can be caused by congestive heart failure in early stages, and I have had high BP for decades and an irregular heartbeat and electrical irregularities across the heart detected by EKG's. So desmopressin may or may not work for me, and it has the potential for nasty side effects like edema, which I don't have. So like every other procedure or medication, it would be a crap shoot. Do I or don't I, I don't know. There's not enough data.

So like the decision to do GG it may or may not work. For those for whom "it" (desmopressin, GG, a holep procedure, a greenlight, a turp, and every other medication and procedure on the market) does work it's a miracle. For those for whom it doesn't work it's a disappointment. All the trials in the world won't change that for the individual who makes a choice. After all, the greenlight laser is supposed to be 98% effective as determined by extensive double blind studies and more than a half million procedures. But most people on these forums avoid it like the plague. And more than a thousand posters on the Topix Greenlight Complications forum wish they had tried something else.

Regards,
Bob
Posted 12/8/2014 4:50 AM (GMT 0)
Well, hello everyone. I've been away for a while but I see nothing's changed.
But I do have something sad to report. A good friend of mine who lives in London has, as so many of us do, left things until his symptoms have become extreme, and has had to seek treatment hurriedly.
Of course I told him of my good experience, and of course his urologist said words to the effect that GG are unknown, and so I referred him to this forum.
Where he ran into the relentless stream of suspicion, negativity and doubt sown by one of our number.
He's opted for green light lazer. Good one, ----, there's one for your report.
But on the more positive side, I'm struck by the outstanding consistency of the experiences, the outcomes, and the views of those on this forum who have had the GG procedure. This level of consistency is not to be found elsewhere, and given that we represent only a small proportion of the total number who have received the treatment, the results speak for themselves.
Posted 12/8/2014 7:13 AM (GMT 0)
Bob NJ. 'So like the decision to do GG it may or may not work'.

Well. Yes. But then I will just write over the old contention that no peer reviewed figures are actually available. The 85% figure bandied about here is unsubstantiated as far as I am concerned. A potential patient needs those kind of substantiated statistics before deciding.

Now. One of my GP's patients has had the procedure. It failed miserably according to my doctor who has no ax to grind, no dog in the ring and is a forward looking person. I have left with the doctor a request that that person contact me and I supplied a link to this forum several times. I have not had any contact from the person. My doctor is quite reliable and I believe him when he says that he handed over the request 3 times with no forthcoming result. One failure doesn't mean that the procedure doesn't work for others though.

I will be going to see an Israeli urologist that I haven't been to for a few years, quite youngish but mature and I will ask him about Gat/Goren procedure. (I will print out what you have written above Bob and ask him about it.)

Thanks for the information.

Will keep you all informed. You never know, he might be gushing over the GG procedure.

Reading back through the comments here, I can't get out of my mind that the fertility procedure that GG have been doing for a number of years may have caused a 'side effect' statistical reduction in prostate size and GG noticed this. Then was born the idea that perhaps a similar procedure specifically orientated to causing reduction in prostate size may provide a solution for so many of the enlarged prostate problems that occur in 'the older male generation'. Then a complex theory of defective one way valves involved in 'vertification' of human kind, was 'evolved' to explain the problem. I'm not an engineer. But I ain't stupid either.

I would defer to a hydrological engineer on this subject though. Anyone??
Posted 12/8/2014 7:35 AM (GMT 0)
guys,

it has been very long time since I last touched the spreadsheets and to be honest I did not see real enthusiasm in accepting it or contributing status and results to it. so I simply lost track - now I can't find it.

however, I am trying to have the simple basic form be used as a general short status. it was started by
Jeff57 on page 7, and I continued it with a change: "some improvement" rather than "success".

there are empty lines there waiting for members to contribute their name at what they consider appropriate line. the last one is in page 8 - please enter your name and c/p to the last post! also, it would be nice if someone will create a frame around it (is it a form of quotation?) - I don't know how to do that.
Posted 12/8/2014 5:19 PM (GMT 0)
Clap: Please get your doctor's patient to post his experiences hear. We need to hear both the successes AND the failures.

As for seeking a second opinion from your urologist, don't hold your breath. I know the type, and they will reflexively bad mouth GG. I've posted my amusing experiences with two urologists in earlier threads of this board.

There are some new TURP-like procedures available now. The British-based http://www.patient.co.uk board makes for interesting reading.

[Edit] Here's a good discussion there: http://www.patient.co.uk/forums/discuss/turp-operation-or-laser-or-leave-alone--61900?order=oldest+&page=0#topic-replies
There's apparently a new TURP-like procedure called TURis. It uses a new device, and there's some technical information on Google.

###

Golfosca: You did your best with your friend, but the decision was always his. And perhaps he made the best decision for his case, after all. We just don't know. But what we do know is that the vast majority of patients will do what their doc tells them.

If this board deterred him, that is *not* a problem with this board or even with any particular posters. That's his problem, IMO. Yes, Clap posts the Conventional Wisdom, but it is the job of a patient's pre-treatment research to sort the wheat from the chaff. Few folks have the perseverance to cope with contradictory case reports and studies. But that's what science looks like at the "bleeding edge."

A friend of a friend in California had a high PSA reading five years ago, and went immediately for a TURP, based on the advice of his physician. He had no other major symptoms. Would I have gone along so compliantly if it had been me? Hell, no. But the decision wasn't mine to make. I hope it all works out.

Clap is going to go to his urologist, who will tell him that Dr. Gat's theories are totally silly and can't possibly work. (Been there, done that.) Hearing that, Clap will opt for something else, something mainstream. And, who knows?, as far as we can know that could be the exact right decision for him. I will hope it is. But I also hope he comes back to this board every year or so and updates us on his progress, whatever direction he goes.

And by the way, Golfosca, we have had our share of failures and disappointments already (Thunder, Martin). I don't know what the percentage of satisfied patients on GG is, but it's probably less than 85% from what I've seen on this board. On the plus side, no one has reported any significant adverse events following GG.

To compare apples with apples, of course, you'd have to read similar first-person reports from folks receiving PAE,laser,TURP, or devices or whatever. I believe that the published statistics on these exaggerate the percentage of satisfied patients, so I take these statistics with a very large grain of salt.

###

Bob: I've been following the green-light laser treatment board at Topix for a few years. I saw your posts there way before you started posting here. There are a lot of GL-laser problems posted there, as you mentioned. I have the official Greenlight promotional DVD, which even now I occasionally watch. Funny thing: NO ONE on that DVD ever had any type of complication. Those guys are the happiest men in the world. And yet some guys are posting about adverse effects, repeated GL operations, and poor symptom resolution. And on that same forum, yet other guys have posted that it worked great. Who to believe? I'd like to know what the percentage of satisfied GL patients is, but I don't have a clue. It would be interesting to track some patients before and after treatment for several years to see how things progress.

###

Nosheds: At least you tried. I never thought it would work. Patients generally lose interest about talking about their treatments after a few months and move on to other matters. Sorry.

Doctors face the same problems tracking outcomes with their patients.

Post Edited (Chicago Dave) : 12/8/2014 2:33:21 PM (GMT-7)

Posted 12/8/2014 11:15 PM (GMT 0)
4 days ago I wrote this thing for ClapTheHammer:

"I wish to believe that you are genuinely want to know more, but to be honest, since I read all your comments it seems to me that you are not seeking for a cure (like we all do here) but just have a passion to comment badly on one specific treatment that you never have gone through. Please don’t get me wrong. Everybody has his own opinion and you are not forced to believe in anything. But if you don’t believe this thing works, why don’t you just continue to find a different treatment instead of repeatedly bad mouthing this specific one? You should understand that it looks a bit odd and make someone think of your motivation and your interests. And frankly, the fact that you search things in Hebrew via google make this suspicious even stronger - why on earth would an Israeli guy like you search for comments about Israeli treatment in English forum (!?) and why would you spread this negative questions when you can easily go to their clinic in Tel Aviv and just ask them yourself? or if you are not Israeli (but still know Hebrew) call them over the phone? If you are really seeking for help, write me your phone number and I will connect you to my GP that read all the data and statistics and told me to do this. I will be also ready to make a phone conference with you and Dr Gat (I suppose he will agree, he is very nice man, apart from his skills) and you can find out all the information you want. Then we can both write here our impressions from the conversation. Are you in the game? My email is published in my profile and I will share my phone number as well if you wish too. I have nothing against you personally and If my things hurts you or my suspicious is in vain – I do apologize. But I think that if a one demand things to be clear and open, he should be clear and open as well. And at list should show that he doesn’t have hidden interests"

He didn't replay me, until now. Not here, and not in my personal email
Other members encouraged him to contact me, to identify and to make this phone call together with me
He didn't replay them ether
Instead, he keeps writing here the same bad comments, as usual.

ClapTheHammer, to be honest - you can't expect me to take your words here seriously any longer...
Posted 12/8/2014 11:41 PM (GMT 0)
Hi haven't been on here for quite a while, since I mentioned I was seeking through my Urologist to try and get the Urolift treatment on the NHS, as its since been approved by them.

I must say that the Urologist I see, which was previously via private insurance, but now via the NHS as had to change insurers as previous medical conditions are not covered, has been first class. I did originally mention the GG method, amongst other alternatives, but he had not heard of GG. Though he did know about Urolift and how it works, didn't do it himself, but offered to try and get another Urologist who had brought this over to the UK and who he knows quite well to see if he would come to his hospital and perform the operation, if thats what I wanted.

To cut a long story short, the Urologist was willing to come to the hospital, but the hospital wasn't willing to fund the costs, so he then wrote to my local area of the NHS, who said its not something they would do unless there was good reason for it and that my Urologist would have fill in various forms etc.
When I saw him about a month ago to discuss this he said, there were about 50 pages of forms to fill out and he thought it would be a complete waste of time, as at the end they would say no!

He asked me again if this is what I really wanted, I told him yes as there are no side effects, as per Turps etc, so he told me there was now another Urologist who was performing this operation on the NHS in the my so called NHS area, albeit quite far away to me, but would write to him to see if he would see me.

Within three weeks of my seeing my Urologist, I had a phone call, which I actually thought was a joke at first, to book me in for 14 January for an appointment at this hospital, I presume to see if I am a suitable candidate, for the op! So all in all whether I get the actual Op, my Urologist has been a star as trying to get any new procedures done on the NHS is a miracle in itself let alone being seen so quickly, plus he has never once rubbished any other methods and has always been willing to listen! Better than the first private Urologist I originally saw many years ago, who just wanted to get me on the table for a turps, even though I had told her, I wanted to try tablets first!

I will keep you posted incase any one else may be looking at this alternative treatment but would also really like to know, rather than try and trawl through reams of pages, has anyone else had Urolift and if so, how did it go and any complications!
Posted 12/9/2014 12:08 AM (GMT 0)
1.
Best of luck, Chumley.

2.
In today's world, "varicocele repair" does not really mean "repair." It means removal of veins leading to a malfunctioning valve, specifically, varicocelectomy. This is analogous to vein stripping or vein sclerotizing to "repair" varicose veins in legs.

In any event, men with varicocele are known to suffer from zero to varying degrees of diminished testicular health. Varicocele is likely to have similar effect on prostate health (or "hyperhealth").


There is an interesting article here:
https://www.cornellurology.com/clinical-conditions/male-infertility/general-information/varicocele/

by surgeons pushing their microsurgical varicocelectomy procedure.

Note that these surgeons report their experiences with 1500 patients.


Here are some interesting parts (footnotes omitted):


"A study by the World Health Organization (WHO) on over 9,000 men showed that varicoceles are commonly accompanied by decreased testicular volume, impaired sperm quality, and a decline in Leydig cell function. Another report by Johnson and colleagues showed that 70% of healthy, asymptomatic military recruits with palpable varicoceles had an abnormality on semen analysis. Furthermore, studies in animals and humans suggest that varicoceles cause progressive testicular damage over time. It appears that surgical repair of varicoceles not only halts this declines in testicular function but often reverses it. Whether the improvements in semen parameters, seen in 80% of men after varicocele ligation, translate into improved pregnancy and delivery rates has been a matter of ongoing controversy. Recent studies employing non-operated control groups clearly indicate that varicocelectomy does improve pregnancy rates.


* * *

"Although the relationship between varicocele size and seminal improvement following varicocele repair was controversial for many years, the overall rates of seminal improvement following varicocele repair have been approximately 65%. Moreover, some recent studies indicated that the degree of improvement of semen parameters following varicocele repair is directly proportional to the size of the varicocele repaired surgically.

* * *

"This meticulous approach to varicocelectomy requires extensive training and the use of a high-quality operating microscope. Even loupe magnification is inadequate for the reliable identification of the tiny vascular channels and lymphatics of the spermatic cord. An experienced surgeon can perform this procedure in less than 30 minutes per side, and the procedure is always performed on an ambulatory basis.
"Using the microsurgical technique at Cornell, we have reviewed our results of over 1,500 men who underwent microsurgical varicocelectomy, the couples' pregnancy rate was 43 % after one year and 69% after 2 years compared to 16% in couples with men who declined surgery and had hormone treatment or used insemination. There have been only 14 recurrences (1%), no hydrocele, no testicular atrophy, and a 1% incidence of inadvertent unilateral (one side only) testicular artery ligation."

3.
I say "shame" on you folks that bash ClapTheHammer.

What ClapTheHammer is clearly, AND CORRECTLY, pointing out is that Gat and Goren's data is deficient.

What we have here is a good theory. But do we have adequate evidence that the theory (i.e., that varicocelectomy by the GG method or otherwise will lead to reduction of BPH symptoms) works sufficiently frequently to justify the expense?

Obviously, some people say that for them the theory itself is convincing, and they are willing to give the theory a shot. I say, thank G-d for those people, for how else would any theory be proved or disproved.

However, in view of the number of procedures apparently actually performed by Drs. Gat and Goren, and in view of the representations of actual success that GG have put on their website, people like ClapTheHammer, Golfosca's good friend, and me think that more detailed data should be forthcoming. Since the data is actually known by GG, I put it on them.

Skateman

Edited by Skateman to fix spelling errors.

Post Edited (Skateman) : 12/8/2014 10:27:41 PM (GMT-7)

Posted 12/9/2014 7:31 AM (GMT 0)
Skateman - However, in view of the number of procedures apparently actually performed by Drs. Gat and Goren, and in view of the representations of actual success that GG have put on their website, people like ClapTheHammer, Golfosca's good friend, and me think that more detailed data should be forthcoming. Since the data is actually known by GG, I put it on them.

Yes indeed.

While scouring the internet about Gat Goren with 'Israeli Health Ministry', nothing comes up except this thread.

Some other thread dealing with the Gat Goren procedure featured some of the commenters here giving glowing accounts of the results. My suspicions are aroused even more.

My bottom line is that I hope that the good doctors are right and that their procedure does benefit 80% of their patients. I would see it as a true benefit to mankind as a whole. (Well, the male part of mankind at least).

However, strange that we have no commenters here who wanted to have the GG procedure but were rejected for whatever reason.

After buying a washing machine over the internet and saving a good few Shekels, I was pestered by someone from the internet seller phoning me to go onto a price comparison site to give them a good review. I had no problems with the purchase but couldn't be bothered to do as he asked. Have any commenters here, having had verifiable success with the GG procedure, been asked by the good doctors to comment positively on this site??? And other sites?
Posted 12/9/2014 3:38 PM (GMT 0)
Hi Chumley,
From what I have read on other sites about the urolift (very little info out there, unfotunately) a very large prostate (either over 80g. or over 100g. I'm not sure) will disqualify you from the procedure. Also a prominent median lobe (especially one that protrudes into the bladder) will also disqualify you. There was a fellow, Ron Texan, on the Patient.uk.forum thread Dave referenced above, who was going to get the urolift, but opted instead for a holep procedure (removes most of the prostate inside the capsule) in preference to a simple protatectomy that his surgeon recommended due to his very large prostate and prominent median lobe. He had all three lobes removed and is pretty happy so far in spite of some minor leaking issues that seem to have quickly resolved.
.....
Just to weigh in on the Greenlight I had, half a million people have had it, it gets excellent peer review stats, but there's more than a thousand posts on the Topix Greenlight Complications forum from people (including myself) who got less than the glowing predictions on the DVD, which I saw once and wouldn't watch again. The bottom line is no procedure works for everyone. If you are one of the ones it doesn't work for, all the stats in the world won't help you. If it works you are a supporter.
.....
I've also said Clap is correct in his assertions. But once again, if it works for someone, whether a greenlight, a GG, a turp, a holep, a button turp, etc., they will be a booster and supporter. It is an experimental procedure, but one which apparently helps a percentage of the people who submit to it. I had a great doctor who died a couple of decades ago who was very unorthodox, didn't follow standard protocols, but cured me of whatever I went to see him for. They don't make them like him today, I sure wish they did. Most doctors today just follow the cookbook and could care less about outcomes.

Procedures that don't work for anyone (like the TUMT I got a year before the greenlight) get found out and dropped from the repetoire. Even the tech who administered the TUMT told me in the middle of the procedure that it probably wasn't going to work and I'd be back in a year for the Greenlight. She was 100% correct. But that procedure was published and peer reviewed and reported a great success rate, so all it took was money to hire the right peer reviewers to get it accepted and embraced by the medical establishment for a number of years. Several years later it is pretty much discredited.
Knowing what I do now, I probably would seek out a holep or button turp surgeon if I needed another procedure.
Bob

Post Edited (Bob_NJ) : 12/9/2014 8:45:51 AM (GMT-7)

Posted 12/9/2014 6:00 PM (GMT 0)
I did a little investigating to see what 'Medical trials' are. As far as I can gather, serious hospitals have a Helsinki Committee that oversees 'medical trials'. Their main concern is the well being of the ... persons treated. In this specific case, it would probably be that closing off some blood vessels doesn't cause gangrene to develop in out private parts since interventional radiology is an already established part of treatments available for blood vessels around the heart. From what I gather, the hospital itself funds the trial.

Of course, the patients are treated free of charge.

When the viability of the procedure is established, then the doctors performing the procedure are free to charge whatever they want for performing the procedure. But then, I imagine that the details would be in the public domain for other interventional radiologists to use. Although I would imagine also that whoever established the bonafides of the procedure would have other interventional radiologists queuing up to learn the procedure first hand from the experts.

After at least 3 years of performing the GG procedure in Israel, this has not happened.

Post Edited (ClapTheHammer) : 12/9/2014 9:44:47 PM (GMT-7)

Posted 12/9/2014 6:03 PM (GMT 0)
And if I am not mistaken, the http://www.tasmc.org.il/sites/en/Research/Clinical-Trials/Pages/RD-Clinical-Trials.aspx, is well within walking distance from the GG clinic in Ramat Gan.
Posted 12/9/2014 9:06 PM (GMT 0)
Clap,
Well, to look at the other side... Clinical trials usually take a decade or more. If Gat Goren had started in 2006 when they first published, they would still be waiting. At their ages can you blame them for not going that route? Also, ask yourself, how many peer reviewed and tested procedures have killed patients?, how many are worthless? If you are honest you will have to admit that medecine is not a precise science by any means, and approval of the medical establishment is no guarantee of effectiveness or safety. If people want an experimental treatment that is minimally invasive and appears to do no harm, and they have the means to try it, what harm is done?

Another point is that in a clinical trial, generally 50% of the participants get a sham procedure. Maybe Gat Goren didn't want to deprive 50% of the participants from getting a possibly beneficial effect.

Finally, around 2007 another minimally invasive BPH procedure went into trials. It was a protein injection into the prostate that ate prostate cells. It is called NX-1207 by the Nymox corporation. Here's an interesting Pub Med article about it:
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3513892/

It is now completing phase three trials and the trials have been expanded for it to be tested as a treatment for prostate cancer as well. Just as it eats prostate cells, it is believed it will eat cancer cells as well.

A few years ago I was hoping this would be the silver bullet. All trials reported positive results in reducing prostate size and easing bph symptoms with a single treatment. The effects were shown to last several years. People who participated in the trial reported good and lasting results. However, due to rules of the trial, no one who had received any other treatments were eligible, so although I tried to get in, I was ineligible because I had had the worthless TUMT. I couldn't wait for NX-1207 to be approved for general use. No one can even predict if it ever will be approved after jumping through hoops for 7 years now. Whether it worked or not, I would have given it a shot.

Bob

ClapTheHammer said...
And if I am not mistaken, the http://www.tasmc.org.il/sites/en/Research/Clinical-Trials/Pages/RD-Clinical-Trials.aspx, is well within walking distance from the GG clinic in Ramat Gan.

Post Edited (Bob_NJ) : 12/9/2014 2:53:41 PM (GMT-7)

Posted 12/10/2014 12:50 AM (GMT 0)
Alas, Nymox's NX-1207 has not done as well as hoped for in phase 3 trials.

http://www.nymox.com/resources/content/d226.pdf said...

"HASBROUCK HEIGHTS, NJ (November 2, 2014) Nymox Pharmaceutical Corporation (NASDAQ: NYMX) announced today that the Company’s two Phase 3 U.S. studies of NX-1207 for the treatment of BPH, NX02- 0017 and NX02-0018, failed to meet their primary efficacy endpoints. Full results will be reported at a later date. The Company will hold a teleconference for shareholders on Monday, November 3, 2014 at 4:30 pm Eastern Time. The phone number to call for the teleconference is 1-866-436-9172 for U.S and 1-630-691-2760 for Canada and International. The confirmation number: 38420531.

"Nymox CEO, Paul Averback, said, 'The two studies failed to meet the pre-specified efficacy endpoints. Drug safety was acceptable. Drug efficacy reached levels similar to earlier studies but was not statistically significant in comparison to the placebo control due to a higher placebo response than in earlier NX-1207 studies and in other placebo-controlled BPH studies. The compound remains promising for low grade localized prostate cancer where the Phase 2 results showed evidence that NX-1207 treatment had a positive effect on biopsy results and clinical and biochemical progression.'"

FYI, Nymox's stock price plummeted on that news, and has not recovered at all in the 37 days since then.

ClapTheHammer is correct: Gat and Goren's website just might be overselling the efficacy of their procedure, and their presentation of data is deficient. Any negative inference that could be drawn from Gat and Goren's presentation (or lack thereof) is probably deserved. That is, even if it turns out that the Gat Goren procedure provides great results, I think ClapTheHammer correctly points out that GG's poor presentation of data has been to their disadvantage.

Bob_NJ is also correct. I will repeat Bob_NJ's pithy summary:

Bob_NJ said...
"I've also said Clap is correct in his assertions. But once again, if it works for someone, whether a greenlight, a GG, a turp, a holep, a button turp, etc., they will be a booster and supporter. It is an experimental procedure, but one which apparently helps a percentage of the people who submit to it."

So, ClapTheHammer, I think you've correctly made your point. I also think there are some who just will not get it. (Perhaps sort of like a GG procedure: successfully done, but not necessarily effective for some of the procedure recipients.)

On a slightly different note: Many men suffer from varicocele. Even without an improvement in BPH symptoms, varicocelectomies, whether achieved by a GG or other procedure, appear to improve testicular health of men suffering from varicocele. If varicocelectomy procedures become more available (i.e., affordable), and prove to be safe to perform and without negative side effects, varicocelectomies may become the next BIG thing.

Post Edited (Skateman) : 12/9/2014 6:02:52 PM (GMT-7)

Posted 12/10/2014 2:50 AM (GMT 0)
In response to some prior comments
I just recently had the procedure nobody asked me to post on a website. But I intend to whatever the results are good or bad.

In discussion with Dr Gat I told him the hospital was very impressive he told me that is one of the reasons they picked this hospital because of its modern facilities.

Dr Yigal Gat and Dr Alain Perlow were very personable and professional. From my perspective they were "good doctors"

Thats my 2 cents :)

Post Edited (Jeff@57) : 12/9/2014 8:04:27 PM (GMT-7)

Posted 12/10/2014 3:02 AM (GMT 0)
I might add I appreciate all the comments on what people have done to find relief. I think we all agree everyone who has BPH we just want relief. Its great when people post what they have done and it worked.
Granted it may not work for everyone but if through the web we can share good results possibly it may work for others. Its potentially a great asset to pool our findings. Whether it be a vitamin, herb, or medical procedure.
Posted 12/10/2014 2:34 PM (GMT 0)
Well, guys: We are well down into page 9 of this thread; we all know what that means.

This is the time to make last-minute edits to existing posts. Was there anything you would have phrased differently? If so, this is the time to re-phrase it.

Soon the mighty hand of the Moderator will descend godlike from cyberspace to snatch the breath of life from this thread and breathe it into a new thread. Then our Moderator will "lock" this thread to further editing and link it to the new thread.

See you guys on the flip side.

Peter: I like the thread's current title. It's very appropriate.
Posted 12/10/2014 5:00 PM (GMT 0)
To NO SHEDS

I thought your accumulation of results re Gat Goren were well laid out and useful, I have no idea how to have a format that people can add to, I will post any changes to my position and I hope that you will keep a record of your original post and then add in any updates, some work, sorry about that.

JEFF 57

Delighted that you have had your Gat Goren procedure and I will follow your progress with interest. Again my apologies that every time I tried to you e mail you, I made a mess of it.

Liam Ireland
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