Gat Goren, PAE, LUTS, Part 7

MGL59
I'm sorry to hear your story

I know it's too late to say that but I think you should have listened to the friends here who advised to wait, even a year after the treatment before going to TURP since the effect suppose to take a while like we all know.
Did you try to call the doctors before going to TURP?
I know that they are very helpful and they call their patients all the time
One of the patients I know (perhaps he writes hear as well) didn't feel any improvement in the first 6 months and one of the doctors kept giving him instructions over the phone and it did help him a lot until the big improvement came in. He is very satisfied now after a year.
I don't say that just to make you feel bad but to help others - I think it worth to be patient. I know I gained my relief thanks to that

Anyway - please let us know about the effect of the TURP.
I learn new things all the time about that

Get well soon!

MGL59
Thank you for you updates

I tend to agree with Carl. I think you should had given this more time. I think that all of us - the patients that feel good with the treatment, waited for a while and the game was - patience

I know as a fact that Dr Gat himself calls his patients on the first 6 months and gives very useful instructions about medications and way of life that support them on the first months before the big relief. I know I had a few which helped a lot.

But what really matters right now is that you feel much better. Lets hope that we will hear more good news from you about the last treatment you had

BTW - don't see any connection between bladder stone and prostate size. Seems like two different subjects that should be treated in different operations

Post Edited (Graham_A) : 7/17/2015 5:05:58 PM (GMT-6)

Hello Peter

wondering if you had updates on your implant results?

Thanks Big Al

Hullo Eddy,

I think you're on the right track. You probably saw the "Running List" of patients and outcomes a couple pages back. GG has its share of both outright failures and great successes, but there's uncertainty of the proportions of same. In my mind, it works best when done *early*.

Patients who are put off by GG (because of $$$$cost, travel, uncertainty+fear, etc.) often opt for Prostatic Arterial Embolization (PAE). It's getting great reviews on the patient.info web site. So, I think those are two excellent choices for BPH.

Of course, I'm not a doctor, so you still have to rule out other conditions (e.g., infections) with your own physicians.

Urologists can't perform either of these procedures; they would have to refer their patients to interventional radiologists. Hence, no interest.

-dave

This website might be of interest:

http://www.sirweb.org/patients/varicoceles/

I've not seen a list of USA doctors who perform this procedure.

Eddy. The thing is that as far as I remember, nobody on this thread who went through the GG procedure, experienced any damage or serious discomfort. Even short term. So if 20,000 is not too much of a problem, why not try it?

True. There were failures but, nobody has talked of any worsening of their prostate problems.

Having said that, I am still very sceptical of the procedure because of the failure of the good doctors to supply any material relating to their success/failure rate.

But. We will see how Bibi gets on. He will have to publicize any further treatment for his prostate if he has any.

Here is the url to Eddy's referenced document

http://www.ncbi.nlm.nih.gov/pubmed/25389666

Post Edited (Jeff@57) : 7/28/2015 10:36:49 PM (GMT-6)

Gentlemen! Great news! Thanks to Eddy we finally got what we all waited for - an external American research about the Gat Goren treatment that shows good results:
http://www.ncbi.nlm.nih.gov/pubmed/25389666

It says: "CONCLUSION: Interventional occlusion of the spermatic veins in patients with BPH is a feasible outpatient procedure with a low complication rate. Intermediate results are satisfactory"

No more doubts for me

Thank you Eddy for the finding!

Hi,
Eddie G here.
I posted in February and promised to post an update when i had something concrete to report.

I had the GG procedure in Cyprus in July 2014. As I had posted, I was lucky to have a supportive and open-minded US urologist.

As part of the required battery of tests for the GG procedure, I was dismayed to find out my prostate size was 109CC.

I had reported before that in the months following the GG procedure my symptoms did improve. I became a solid "once a night" urinator and daytime urinating became something I was not even thinking about (just regular, almost like in my youth).

I ignored all this, thinking that the Placebo Effect may be at play.

In February I posted after visiting my urologist. He measured my prostate by ultrasound. However his new machine did a trans-rectal measurement, while the previous measurements were trans-abdominal. I was elated that the measurement came up at 70CC. However upon calling Dr. Gat in Israel, he said there is a sizeable discrepancy between trans-abdominal and trans-rectal measurements.

I was in Europe this month, and decided it was important enough for me to get a measurement after one year with the same exact equipment as the year before so i flew to Israel and scheduled an appointment with Dr. Gat.

My measurement on the same trans-abdominal ultrasound equipment as last year was 85CC ( I do have to say Dr Gat was very conservative. He measured a few times and one measurement came up at 81CC but he chose to go with the highest result as the official measurement).

In a way I was "disappointed" as I had expected a lower result after the February trans-rectal measurement in the US. However it is hard to be disappointed with such a massive reduction in prostate size one year after the GG procedure, on the same equipment.

Dr. Gat explained the way he looks at the reduction is: he considers the reduction in the EXTRA TISSUE. For example, if I had a 109CC prostate size and a normal prostate is 29CC (just for illustration purposes), then the EXTRA is 80CC. At 85CC prostate size, the extra is now 56CC. Thus he views it as a reduction from 80CC to 56CC, which is a reduction of 29CC out of 80CC - or about 36%.

In our discussion the point was raised that it may be possible that if I had not done the procedure and my prostate continued to increase in size, there was a possibility that my July 2015 measurement would have been higher than the July 2014 measurement (pre GG) of 109CC. This is speculative but an interesting point to ponder. Would it have stayed 109CC? Would it have grown to 120CC? Any other number (likely higher than 109CC)? We will never know and I am glad we won't.

Graham_A - 'Gentlemen! Great news! Thanks to Eddy we finally got what we all waited for - an external American research about the Gat Goren treatment that shows good results:'

Sadly, that is not a 'Medical Trial'. You have little information of the methodology used and, as far as I can see, the number of patients involved, and how they were selected, is not clear.

chelseadons, if you go back through the forum thread your question is more or less answered. there are a lot of smart people who have contributed their thoughts and between them have consulted a vast array of urological specialists. Unfortunately, urology is too narrow a field to treat our constellation of problems. much of what is happening to us simply has to do with aging. we have to pee alot. part of that has to do with the enlarged prostate making it hard to go and the bladder changes that occur that leave us feeling that we need to go constantly even when there is only a tiny amount of urine. but that is an oversimplification. women get very similar problems but don't have
much in the way of a prostate. my wife suggests that constipation may have an obstructive effect. the amount of pee produced by the kidneys can vary wildly while seemingly unrelated to our fluid intake. there is a neurological component of all these things-the bladder responses,the vasopressin production, the lower urinary tract sensations, the sleep changes.
we wake more easily now partly because our brains produce less melatonin and maybe because of a disturbance in orexin regulation.
some one should write a book.

Skateman,
For more than a year it was written here by one or two members that "more data is needed" and that there is a need of external study. Well, here it is.

All medical studies are looking for more follow ups. it's natural. But the bottom line is the important thing here: "CONCLUSION: Interventional occlusion of the spermatic veins in patients with BPH is a feasible outpatient procedure with a low complication rate. Intermediate results are satisfactory".

I would expect the members to be happy about that but I suppose there are people who can never be satisfied:)

Post Edited (Carl1950) : 8/6/2015 2:27:59 PM (GMT-6)