Gat Goren Method part 2

martin victor said...
Bob: Given my recent dental implant and dose of antibiotics, I believe I received a slight case of candida...a yeast infection. I now plan to take probiotics daily as a prevention for bacterial and yeast infection. I also drink 40 oz of water when I awake in the morning to flush out the bladder along with a special preparation of raw protein powder made of organic sprouts, also an enzyme based multi vitamin, mineral and herbal supplement powder and an organic greens powder. There are no side effects from being on probiotics.

Martin,

Thank you for the info.

Bob

There was a 1962 article by a Dr. Antonio N. Feliciano who I believe gives the most accurate description for the reason for BPH. Gat might disagree given BPH is a mechanical problem. But perhaps, there is a tie-in. According to Feliciano... "Congestion" in the prostate can give rise to BPH. According to the Biotherapy Clinic, studies have shown that prostatitis has been found in 98% of patients with BPH. Digital prostate massage according to the clinic improves the urinary stream, reduces other symptoms associate with prostate infection, brings about a return to a more normal prostate size and shape, and causes the softening & shrinking of the enlarged prostate. A release of prostatic fluid (including toxic bacteria, yeast etc) occurs during massage.

http://www.biotherapy-clinic.com/bph.html

According to Dr. Feliciano: "The term "Prostate trouble" refers to the prostate gland including enlargement and infection. Englargement can be due to a chronic prostatitis, benign growth (BPH) or cancer.

Briefly, Dr. Feliciano states: "The prostate gland is compared to a bunch of grapes (glands) and the stems (ducts) all joining to form one main stem (duct). Whenever infection or bacterial invasion involves the prostate gland, inflammation results. The duct linings swell, occluding or partially occluding the ducts. Infected fluid is retained in millions of tiny infected microscopic sacs or glands. Whenever drainage of a closed or partially closed space is restricted, infection gets a deeper foothold. In this case it extends through the walls of the glands and finally enters the spaces and tissues between these glands. When this happens the process is irreversible in spite of the use of large amounts of medication and treatment.

Whether the initial bacterial invasion is abrupt or overwhelming as in an acute prostatitis, or whether it is gradual, the end result is chronic prostatitis and most likely will end up as a permanent condition. In short the cause of chronic prostatitis is bacterial invasion or infection and it becomes chronic because the infection has obtained a foothold in closed or partially closed spaces and crevices of glandular tissue.

With the advent of Sulfa drugs, then penicillin, then other antibiotics, it was thought or hoped that a permanent cure had been found. Each time a new medicine was tried improvement was followed by recurrence and we now know that bacteria killing drugs help at first and can help again and again until the organisms infect the prostate learn to live with the drug. THEN THE DRUG HAS LOST ITS USEFULNESS.

Up to the present time nothing has been completely satisfactory. Most of us who treat this condition, however, feel that the regime of treatment which is most satisfactory includes massage of the prostate at regular intervals. By and large, however, massaging the prostate does the most good. Each tiny gland and duct needs draining in this condition, and millions of tiny microscopic areas can't be drained separately. The next best approach is by getting behind them all and pushing or "milking" these areas all at once. This is exactly what is accomplished by prostatic massage.

Chronic prostatitis is usually due to non specific (non-venereal) infection. It can reach the prostate either through the urethra or by way of the blood stream (rare). In passing we mentioned that the seminal vesicles are frequently involved and it might be mentioned here that prostatic massage usually includes massage of the seminal vesicles."

Dave: Well...which came first, the chicken or the egg? Did infection and inflammation from high levels of toxic bacteria in the prostate cause changes in the pressure gradients of the veins servicing the prostate resulting in failed inter spermatics. Something to ponder. Can we accept Gat's hypothesis that evolution of humans to a vertical standing position caused failure of the ISV's...or is the human anatomy more perfect than Gat gives it credit for.

martin victor said...
Dave: Well...which came first, the chicken or the egg? Did infection and inflammation from high levels of toxic bacteria in the prostate cause changes in the pressure gradients of the veins servicing the prostate resulting in failed inter spermatics. ...

Martin,

1. I suppose it's possible that inflammation in the prostate could affect the gland's internal circulation. But I don't see how infection and inflammation from bacteria could affect the circulation through the testes-bladder-prostate system as a whole.

It's pretty well attested--by radiography, etc.--that the circulation changes we're looking at are caused by outright failure of the ISV valves. When I was undergoing the procedure, I could actually follow the catheter as it threaded through the ISVs. The upper-most valves were working in my ISVs, and Dr. Goren had to struggle to thread the catheter through them. All the other, lower valves had failed, and the catheter navigated those valves easily.

Now, I suppose that it is possible that there is ANOTHER, undetected mode of failure of this lower abdominal circulation--one due to infection and inflammation--but I've not read anything about this.

2. I think that it's an observable fact that the ISV valves fail a lot. An important unanswered question is how frequently they fail. Until someone does an observational study on men of different ages, we really won't know often they fail. (I'd guess that the failure rate is extremely high in older guys.)

3. about PAE. I've been waiting for our PAErs to post a more definitive explanation for the prostate shrinkage observed after this procedure. Until they do so, I'm forced to speculate. Martin, why go so far as to attribute the shrinkage on the pressure reduction in the artery? Wouldn't it be more intuitive to propose that the prostate shrinks when it loses its oxygen and nutrient supply? And I'm still not sure whether this shrinkage process could be considered "necrotic" or not. Nor am I sure how this shrinkage would actually biologically occur. Is it mass cell die-off? Do immune system cells scavenge the dying/dead prostate cells?

I always thought that PAE totally occludes the prostate artery, but perhaps it just MOSTLY closes the artery, allowing some blood flow to the prostate. I'd still like to know how the prostate shrinks following PAE.

-dave

Martin:

Of course, I remember your concerns.

You should have seen prostate shrinkage after even just a year. Possible reasons why you didn't:
(1) It's tricky to measure, despite what they say. Perhaps the enlarged lobe was throwing off the calculation. Don't laugh: I had a urinary flowmetry done in 2011, and the machine said that the MAXIMUM flow rate was less than the AVERAGE flow rate. Obviously, a software bug. I think similar glitches could affect the calculation of prostate size.
(2) You're responding much more slowly than most guys. Perhaps. That's why we've suggested you wait a while more. When I had the procedure in 2011, I was told/expected that six months should be enough to see a lot of improvement. But I've seen major improvement even as late as 20 or 21 months post-GG. Maybe your case will take even longer than mine.
(3) The GG procedure didn't close the ISVs and any collaterals. You could be like Thunder, who had a big collateral that they needed to close. Dr. Goren closed Thunder's, but perhaps you have an existing or a new collateral that wasn't closed. I think either of these is unlikely, but sooner or later, it's gonna happen to someone. But you report that you HAVE been experiencing improvement in other areas, just not prostate size. So this doesn't sound likely to me. If you still show a lack of both symptomatic improvement and prostate-size reduction at your 1.5-year post-GG time point, then I think you'd be justified in bringing it up to Dr. Gat, and possibly asking him to put you back on the machine. I'm sure he doesn't want to do this for cost reasons. However, he is fair-minded and very concerned about treatment failures, so I imagine he would go along if your case objectively needed it.

If you suspect a hidden infection, you can ask for a good urinary antibiotic. Septra worked for me back in 1992, but they have newer ones now. You need an antibiotic that can penetrate the prostate capsule; not all antibiotics can. When I had BPH symptoms in 2010, this is the first thing I tried. It didn't help me.

-dave

Martin - I think there is a way to check if your varicocele has been sealed - get a scrotal color doppler ultrasound exam and see if there is still backflow of blood (backflow will show up even if the varicocele is small).
If you have backflow, that means the veins did not all close.
Also you mentioned you are a vegetarian - this means that you have anti-inflammatory diet, and when you have anti-inflammatory diet - it can interfere with sclerotharapy. I think I maybe in the same boat as you in that our veins may not all close after the procedure because our diet is so "healthy" (anti inflammatory). Basically if you eat garbage food and get in a pro-inflammatory condition it can help the vein close faster...of course your cancer risk goes up too so....

Regarding PAE can shrink the prostate faster - I think the sentence in this paper actually is very concerning:
http://www.ncbi.nlm.nih.gov/pubmed/11992054
This is a paper talking about Androgen Deprivation Therapy for prostate cancer - this means that getting rid of the guy's testosterone-making ability - it is essentially chemical castration.
"Mean percent volume reduction of the prostate was 33% after a 3.7-month average duration of androgen deprivation"

So after 3.7 months of NO TESTOSTERONE, the prostate shrunk 33% on average. PAE is shrinking it faster than that in some cases - and because it cuts artery supply of blood with nutrient/oxygen, it smells like tissue necrosis (tissue dies from lack of nutrients) is a possibility.

I am not sure about wanting to have "tissue necrosis" as the basis for fixing something, considering that some surrounding tissues could also face necrosis (such as uretha or bladder, or some nerves). When cutting arteries, necrosis will happen, and there are some sensitive stuff down there.

Martin,

Please check with Dr. Gat before going to the trouble of getting a color Doppler ultrasound. (I got mine at the Clinica Biblica in San Jose, Costa Rica while I was vacationing. A local urologist wrote the prescription for it. He also told me I didn't have it and even if I did, it doesn't affect prostate/bladder function. Two strikes!)

This is THE test to diagnosis Type 1 or 2 varicocele, but I have a distinct recollection that Dr. Gat once told me that this test is NOT useful after the GG procedure. I could be wrong, but I remember this distinctly. You can ask him how he diagnoses treatment failures. (And I think it's still premature to tell if your case is a treatment failure, Martin. But you can direct that question to Dr. Gat too.)

Also, I have to part ways with Thunder here on the "inflammatory diet" thing. The sclerotizing agent they use is plenty strong to overcome even the healthiest diets. And they do a clotting test beforehand to make sure that your veins will clot. (That said, my diet is so bad in an inflammatory sense, that maybe Thunder is onto something here!)

Good luck!

-dave

Martin and Dave
Dr. Gat said color doppler ultrasound would not be a good way to detect "new collataral bypass" that are formed in some people after the procedure - I think that's what you are referring to Dave. But if you are paranoid about your veins still are not closed - the color doppler is the way to detect there is still backflow in the scrotum. Martin - I think you could follow Dave's advice and just wait longer if nothing is getting worse.

I don't doubt GG did the procedure correctly and I saw them close all my veins too. It's more can we as patients do something to mess that up - although GG did tell me not to worry about it since if the veins are shown to be closed before leaving the operating room - then they would stay closed - which was comforting.

Post Edited (thunder2004) : 8/13/2013 8:36:11 PM (GMT-6)

Hello Guys,

about infections. I thought I would write about my experience. First of all, I have a very large prostate. 120. It has doubled in size since 2006. For years I had problems with voiding and a frequent burning sensation. The situation was worse at night. I found an paper by Prof Federico Guercini, in Rome, Italy, "Prostatitis: why not cure it" His belief was there is no such thing as non specific prostate infection. The premise was it was just never identified. I contacted him and arrange to have a DNA test of my sperm sample to determine what was causing the inflammation. It came back chlamydia std. This can only be detected via a DNA analysis. So many people have it, and don't know it. I scheduled a visit to see him. about a 1 hour flight from Munich. At that time my prostate was about 60. I did not opt of surgery for the enlargment because I did no want to kill my sex life. ( my wife is 20 years younger) but went on a program to get rid of the chlamydia. It took a long time and consisted of 3 antibiotics. Doxicilian 1 x 2 for days 1 - 10. Aritheomyacine 2 x1 days 11 - 13. Rifampicinihefa days 14 - 24 450 mg 1 x 2. then Rifampicinhefa 250 mg Daily for 4 weeks and then for another 4 weeks. After this course of treatment it was gone verified by DNA test. Most Urologist don't do his. My flow improved, but my prostate also got larger. I tried a few of the pharma drugs to improve flow, but they also caused me to feel ill and caused leakage. I found this worked for me. IP-6 (look it up on google) for first month 2 x 2, then 1 x 2. I really cut down the inflamation, and Vita-prosta-hpx from a company in Holland. It worked fantastic! It really helped the flow without the leakage. Now, after many years, I am down to 1 ip-6 daily and 1 x 2 Vita-prosta-hpx. Now, my only hope is the GG or PAE since it is so big. The alternatives are horrible. I should also mention that Dr. Guercini in Rome also does echo guided drug infusion direct to the prostate for really bad infections.

On The days that my flow is slow, I take 200 mg of Ibuprofen it keeps me sleeping at night and I have a reasonable flow in the morning. . I only take it as I need it. Maybe 2 -3 times a month. I have been accepted for the PAE in Lisbon, but am also getting more information. The GG seems a better option, but I don't know. Waiting! I should mention that my sperm count is 60 million/1 ml which is very high for a 72 year old.

Marshall:

From your experience with Dr. Guercini, you're already an accomplished medical tourist. I had no idea! I'm definitely going to bookmark your post in case I need to look into causes for so-called chronic prostatitis. That information is very specific, relevant and based on personal experience. Exactly what I'm looking for on these boards.

Do you know if Dr. Guercini's DNA-diagnosis is available in the US? I like no-risk diagnostic tests. You never know what you'll find....

I agree that GG might be useful to you now. Based on Dr. Gat's published statistics, a 120-gram prostate would (on average) be expected to shrink to 60 grams (120 minus 60% of (120-20)) after the GG procedure. That would still be a large prostate, but if you were okay with it in 2006, then it might work out fine.

Ross:

How are you doing? We haven't heard from you in quite a while.

-dave

My email address is in an earlier post on this thread should anyone out there wish to contact me.

martin victor said...
Can it be possible the ISV's failed due to a connection with toxic bacteria/fungus in the prostate resulting in inflammation, subsequent enlargement and varicocele.

This hypothesis: Bacteria, fungus or virus in the prostate ===> ("causes") failed ISVs and varicocele.

Martin, I find this unlikely. The infection would have to travel from the prostate to either the ISV valves or the ISVs themselves and cause them to fail. I have not read about infections in the ISVs.

martin victor said...
Can a varicocele along with failed ISV's and subsequent hydrostatic pressure increases be expressed as a symptom of BPH rather than the cause????

This hypothesis: BPH ===> failed ISVs and varicocele.

Again, no, I don't see this at all. If this were true, Dr. Gat would see a lot of cases of BPH without varicocele.

martin victor said...
Can we say with certainty, that because the Gat procedure shrinks the size of the prostate, that the original cause of the problem is resolved? Dave...whaddya think?

Dr. Gat's hypothesis: "In MOST men: Failed ISV valves ====> varicocele and (eventually) prostate problems"

There is excellent proof that this is true for a lot of men. (Not necessarily ALL men.) See: Dr. Gat's published papers and our own reports that symptoms of "BPH" and also prostate size partially resolve following GG. That's pretty strong proof!

Another possibility which I find plausible, based on what little I know, is:

Chicago Dave said...
Infection more easily attacks--and is harder to eradicate from--a prostate weakened by poor circulation, high T and hypertrophy.

Without sufficient blood flow, I think the body would find it difficult to fight any infection.

Do I think this is a possibility in your case? Yes, I think it is certainly CONCEIVABLE that you have a hidden infection in the prostate. You might want to look into the DNA Sperm Test that Marshall mentioned. That would seem a no-risk way to explore this. Standard antibiotics would be another.

By the way, I checked the web site you mentioned, which was several years old. I had heard previously of this Dr. Feliciano. My off-the-top-of-my-head thought is that some/many of his patients have varicocele and need GG. He seems to have a very aggressive approach to treating prostate infection and it's great that it works in many patients even without GG. And he probably has non-varicocele patients with resistant prostatitis that he cures too. I don't doubt his treatment works, but I don't see a direct connection to GG. I suppose that for some guys, GG and aggressive antibiotic treatment might be complementary. But I have no idea whether you are one of these guys.

The question is, would the GG by itself improve the body's capacity to fight any prostate infection? I assume it would, but it's possible that long-standing infections would need an additional turbo-boost in the form of very aggressive anti-biotic treatment. No one can know.

This is all so theoretical, Martin! We could discuss this all day and come out none-the-wiser for it. However: If you test positive for an infectious agent, then that could be a breakthrough clue to your problems.

-dave

Martin: Ah, no. I don't see how a diseased prostate can affect the ISVs, and certainly not through the mediation of pressure changes.

Yes, I think it quite likely that infertility in older men and autism are connected. The most likely connection is through the varicocele-related changes in blood flow to the testes, which decreases both sperm count and sperm viability. The sperm cells go through generation after generation in a man, with accumulated genetic abnormalities being passed down the germ line. (I think the sperm reproduction cycle is about one cycle a month.) After a few hundred of these cycles, many of the sperm contain genetic mutations. At least this is what I gathered from my recent reading.

I hope you took out a patent on this discovery!

I think you would be on more fruitful ground if you continued exploring a latent-infection possibility.

-dave

Martin,

I actually asked Dr.Gat this question between Asians and Western countries - and his answer was that height plays a role here, considering the age at which Chinese are getting BPH - these people mostly went through hunger during the cultural revolution and Great Leap Forward during their youth.
Actually, height has been found to be positively correlated to prostate cancer risk:
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2566735/

Also, if ISV did not cause BPH and it's the other way around, then it would seem weird that Chicago Dave's and many other's prostates shrunk after the GG procedure.