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Gat Goren, PAE, LUTS, Part 5

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Posted 7/14/2014 1:12 PM (GMT 0)
Gavrikon,

Wonderful news!

I was a little worried after reading your first post last week, but this seems like undeniable evidence of improvement. May it just continue getting better and better!

Keep us posted.
Posted 7/15/2014 5:40 AM (GMT 0)
Hey Gavrikon,
Congratulations on your improvement. You mentioned not needing ED meds since your PAE and wondered if it had anything to do with it.
I believe the answer is "yes". I have read some of the studies on PAE and it seems that a high % of patients see this improvement.
The reasoning is unclear, but the thought is that as the prostate grows abnormally, it becomes spongy instead of firm. The prostate, as most know, is a major contributor to sexual function. When it is spongy it causes various types of sexual dysfunction. When the prostate shrinks, things usually begin to improve.
Posted 7/28/2014 7:47 AM (GMT 0)
Gavrikon. I'm happy for you. I hope that your 'improvements' continue.
Posted 7/28/2014 8:22 AM (GMT 0)
I did a quick internet 'look around' to compare BPH and PAE. There were quite a lot of good articles, including this one from the NHS in the UK.

http://www.uhs.nhs.uk/OurServices/Radiology-scansandimaging/PatientInformation/Prostatearteryembolisation.aspx

This also.

http://www.sciencedaily.com/releases/2014/03/140324133228.htm

Can anyone send me a link to a discussion of the differences between PAE and BPH. There certainly are lots of figures available for PAE successes. And failures. Something sadly lacking for the Gat Goren BPH method.

Gavrikon. I think that you did a very brave thing going to India for the surgery. And. Once again, thank you for your feedback.
Posted 7/28/2014 5:40 PM (GMT 0)
Clap,

The differences between the two procedures has been a perennial subject of discussion in previous months on this forum.

The GG procedure is well-described in Gat's published papers, which were available on his web site. He presents some clinical results there too.
Posted 8/2/2014 1:29 AM (GMT 0)
One of the moderator's suggested I post here, to see if anyone has had any similar experiences.

I'm in my early 40's and have had 2 MRIs of the prostate (not endo-rectal), the first of which I had approx 2 years ago, which was normal and the last of which in May 2014. To sum it up, this one stated "There are diffuse regions of reduced signal intensity throughout the peripheral zone with ADC values in the benign range measuring in the order of 1200. There is predominantly mild patchy enhancement throughout the peripheral zone." Prostate is estimated at 19cc (so small). It concludes by stating it is suggestive of prostatitis (PIRADS 2).

My PSA has been low for a number of years (0.36 a month ago) despite strange symptoms such as pain in the pelvic region after urination that lasted for hours, ED, a somewhat flat urine stream that sprays (2 cystoscopies found nothing) & a CT scan last year that found 'shotty lymph nodes.' I have been to 6 urologists over the past few years, all of which told me that my DRE and PSA are normal. The fact is that reliance on PSA and DRE means nothing. Strangely enough, my testosterone and free testosterone levels have been quite low, all along. I have read though that excess oestrogen can also drive PCa.

Lately I have been having pain in my tailbone and also pain further up in my spine. I had a bone scan 3 months ago, which focused on the pelvis but came back negative. I have been feeling weak on my legs for the past few months, along with having aching in various parts. What would you recommend for my scenario? I live in Oz, but am willing to travel to get answers asap. With prostatitis, shouldn't PSA rise and DRE be painful?? Thanks for your help.
Posted 8/2/2014 12:12 PM (GMT 0)
Peter,

I don't have any particular insights into your situation, but if you want to commiserate, please post your email address (you can remove it later) and we can talk.
===================
Edit:
Better yet...do as Peter suggests below, and just edit your profile with your email address. (You can remove it later.)

Post Edited (Chicago Dave) : 8/2/2014 3:59:15 PM (GMT-6)

Posted 8/2/2014 1:01 PM (GMT 0)
Peter and Dave,

Rather than posting email addresses, which the world can see (most problematically, spambots), it is a better idea to edit your profiles so that your email address is visible to other members, but not to the world at large. Then members can send you email by clicking the envelope icon on the left side of any of your messages.

Look at the top left of the page.

My Profile > Edit Profile > Show Your Email Address: > check.
Posted 8/4/2014 3:05 AM (GMT 0)
Hi Peter,
I read a while back that over 3,000,000 people (men and women) have LUTS (frequency, urgency, getting up at night, burning, pelvic pain, etc) for which no medical cause has been found. All the tests you have taken show up as normal, so you may be one of the 3,000,000.

Prostatitis generally creates symptoms such as burning urine, a weak stream, urgency and frequency. It does not necessarily cause pain during a DRE but it may. Prostatitis is a bit of a catchall, and in the absence of infection or detectable bacteria, may well mean "you have symptoms, but we don't know why".

If you take enough cat scans, MRI's etc. you may uncover all sorts of abnormalities, but they may not be of any consequence. Prior to my Greenlight laser 26 months ago, I had cat scans with dye, sonograms, and MRI's. They showed a very large prostate (in excess of 120g.) with a large median lobe and retention of about 400ml of urine after voiding. The course of action elected by my urologist and myself was a laser turp. The scans also showed an adrenal cyst and a complicated bladder cyst, which my urologist and I deemed not worth pursuing. My PSA tests were correspondingly high, ranging from 5.5 to 8.7 and settling at 6.5. I also had the free PSA test which said I had a 25% liklihood of PC. But My uro and I opted not to do any biopsies. Of course I was 65 at the time, so watchful waiting seemed the best course.

After the GL my PSA stayed at 6.5, the first time in about 10 years it hadn't risen. My urologist also said I had pockets of pus (abcesses) in my prostate that showed up during the greenlight, but no tests had previously confirmed bacterial prostititis. However the pus pockets indicated years of chronic prostititis.

18 months after the GL I had bladder stones removed in surgery. These had never shown up on any scans either. But I've looked at my MRI's, cat scans and sonograms and I was hard pressed to recognize anything at all. They look like a close up of the inside of raw meat. Thre's nothing recognizable or distinct anywhere like you might see on an xray. Trained readers can detect larger cysts and tumors, but the stones either formed in a year or escaped detection. The whole field of dealing with LUTS seems to me to be a lot of trial and error, and results don't always follow as hoped for.

My testosterone is also below normal, I've had protein (likely semen) in my urine since my early 30's. I also have low vitamin D. The more tests a person takes, the more irregularities he can uncover, but they may or may not have any connection to anything being experienced.

Since your only symptom is pain rather than frequency, urgency, getting up several times a night, an enlarged prostate, etc., you might consider visiting a neurologist. They are specialsts on pain, they understand all the nerve and muscle connections that can cause pain. Urologists only understand the bladder, kidney and sex organs. If the source of your pain is elsewhere, they would likely never find it.

Bob

Peter10001 said...
One of the moderator's suggested I post here, to see if anyone has had any similar experiences.

I'm in my early 40's and have had 2 MRIs of the prostate (not endo-rectal), the first of which I had approx 2 years ago, which was normal and the last of which in May 2014. To sum it up, this one stated "There are diffuse regions of reduced signal intensity throughout the peripheral zone with ADC values in the benign range measuring in the order of 1200. There is predominantly mild patchy enhancement throughout the peripheral zone." Prostate is estimated at 19cc (so small). It concludes by stating it is suggestive of prostatitis (PIRADS 2).

My PSA has been low for a number of years (0.36 a month ago) despite strange symptoms such as pain in the pelvic region after urination that lasted for hours, ED, a somewhat flat urine stream that sprays (2 cystoscopies found nothing) & a CT scan last year that found 'shotty lymph nodes.' I have been to 6 urologists over the past few years, all of which told me that my DRE and PSA are normal. The fact is that reliance on PSA and DRE means nothing. Strangely enough, my testosterone and free testosterone levels have been quite low, all along. I have read though that excess oestrogen can also drive PCa.

Lately I have been having pain in my tailbone and also pain further up in my spine. I had a bone scan 3 months ago, which focused on the pelvis but came back negative. I have been feeling weak on my legs for the past few months, along with having aching in various parts. What would you recommend for my scenario? I live in Oz, but am willing to travel to get answers asap. With prostatitis, shouldn't PSA rise and DRE be painful?? Thanks for your help.

Posted 8/25/2014 11:27 PM (GMT 0)
Guys,

It has been a long time since I posted to this forum. I have been waiting to have definite results before posting… I still do not, but I will post a few thoughts.

I have usual, uncomplicated BPH with the usual symptoms. I also have interstitial cystitis but that is well controlled with diet. Cystoscopy by my urologist did not show a significant median lobe but did show the bladder changes of IC. Actually, as I watched the probe pass through the urethra into the prostate and into the bladder, I could not really appreciate any obstruction in the prostate itself… to my eye it appeared wide-open. My sonogram showed a prostate size of 65 g.

I scheduled an appointment at South Florida Vascular (I highly recommend them). A Doppler ultrasound performed in the exam room showed a significant left varicocele and possibly a small one on the right. This was performed in the standing position and with coughing. I was having symptoms from the varicocele… I would have scrotal discomfort the day after doing yard work and would sometimes have to walk bowlegged! I had sclerotherapy the following week. He used the internal jugular approach and quickly found the internal spermatic vein on the left which he sclerosed. He was unable to locate the vein on the right, either in the renal vein or in the inferior vena cava. He said this probably indicated that the valve into the vein was still competent.

One month later I noticed that the discomfort in my scrotum had completely disappeared. I had become somewhat used to having tenderness in the scrotum but thought it was just normal. Because I had symptoms from the varicocele, Medicare did pay for the procedure.

At the follow-up appointment three months later, another Doppler ultrasound showed no reflux on either the left or the right. At the moment I am doing better symptomatically, but I am not sure if it is due to the procedure or due to medications.

In the past I have tried Hytrin (bone marrow suppression), Flomax (low back pain), and now Cialis once a day. The Cialis does not work as well as Flomax but it does work well enough and has no side effects. Recently, I also tried finasteride at a low dose but experienced “brain fog.” However, the finasteride worked very well. Even though I was only on it for one month, I became totally asymptomatic except for some urgency. I am now off the finasteride but still taking Cialis. I am tempted to try the finasteride again, at an even lower dose, because it might prevent future enlargement of my prostate.

Presently, my main symptom is urgency… when I have to go I have to go. I usually have good flow and feel like I totally empty my bladder. I still wake up to pee once or twice a night, but I do not think it is the urge to void that wakes me up; I wake up because of my sleep problems (I am on CPAP for sleep apnea) and then feel the need to pee. At some point I may be tempted to discontinue the Cialis to see how symptomatic I become.

I have a question for the group. I have reviewed the articles by G and G and I have reviewed the venous anatomy. From what I have read, there are no valves in the inferior vena cava nor in the common iliac veins. Only 10% of the population have a valve in the internal iliac. There are no valves in the smaller veins going to the prostate and bladder. Therefore, the full hydrostatic pressure from the inferior vena cava should already be transferred to the venous plexus serving the prostate. Therefore, there should be little pressure differential between the veins of a varicocele and the veins of the prostate.

In a normal male, the venous pressure in the testicles should be low due to the pumping action of the valves in the spermatic veins. There might actually be a flow of venous blood from the prostate towards the testicles. When the valves in the internal spermatic veins fail, the pressures should actually equalize. In this case there may be some blood flow from the testicles toward the prostate and this might still explain the increase in testosterone that is found in the prostate in BPH.

Does anyone know if doctors G and G selerose the deferential veins? It would seem that would be a sure way to prevent testosterone from the testicles to directly flow to the prostate.
Posted 8/27/2014 1:54 PM (GMT 0)
Hi Frank in Florida!

Thanks for posting an update. I was wondering about how you were doing. It's great news that your varicocele symptoms resolved so thoroughly. Hopefully your other symptoms will improve as well, given some time. (In my own case, the first, small improvement in symptoms didn't appear until 3.5 months my G-G. So maybe you just need time....)

When I was on drugs, Hytrin wasn't strong enough and Flomax didn't work either. But I got relief from Rapaflo, and took it until last Summer. It causes reversible RE, but nothing's perfect.
Posted 9/5/2014 7:52 PM (GMT 0)
hi Frank in Florida
You are right, there are no valve in the large veins save on the top: there we have the back flow stop valve from the right ventricle of the heart. You must consider that the system you are observing is dynamic, not static. Indeed, the heart sucks in the large veins, that is why the pressure therein is around zero (minus 5 mm Hg to plus 5 mmhg) all along their lenght. Unfortunately there is few sucking effect in the small ISM vein which has a very small diameter and which at the left connect trough the renal vein where on top of that the aortic arthery very often exert a blocking pressure. In this small vein then when the valves are leaking or do not exist in the first place, even when the heart sucks, the vertical hydrostatic pressure is not compensated at the bottom where the teste and the prostate are (38 to 40 mmHg) Consequently there is a severe permanent backflow which drive first very inflamatory métabolites from the kidney and the surrenal gland and also drive the free testosterone plus the métabolites all trough the prostate veinous system
Posted 9/6/2014 7:26 PM (GMT 0)
FRANK IN FLORIDA
Apparently reading the GG patent, they mention they block the deferent veins only in case of prostate cancer. In this latter case I understand also that they do not necessarily block the ISM veins.

In case of BHP, it is clear that they describe the typical ISM veins embolisation used for varicocele treatment as practised by the belgian Interventionnist radiologists (whereoff their experience come from) at least as observed trough the experience i had recently with one at a local belgian hospital.
Posted 9/13/2014 4:10 AM (GMT 0)

Peter10001 said...
One of the moderator's suggested I post here, to see if anyone has had any similar experiences.

I'm in my early 40's and have had 2 MRIs of the prostate (not endo-rectal), the first of which I had approx 2 years ago, which was normal and the last of which in May 2014. To sum it up, this one stated "There are diffuse regions of reduced signal intensity throughout the peripheral zone with ADC values in the benign range measuring in the order of 1200. There is predominantly mild patchy enhancement throughout the peripheral zone." Prostate is estimated at 19cc (so small). It concludes by stating it is suggestive of prostatitis (PIRADS 2).

My PSA has been low for a number of years (0.36 a month ago) despite strange symptoms such as pain in the pelvic region after urination that lasted for hours, ED, a somewhat flat urine stream that sprays (2 cystoscopies found nothing) & a CT scan last year that found 'shotty lymph nodes.' I have been to 6 urologists over the past few years, all of which told me that my DRE and PSA are normal. The fact is that reliance on PSA and DRE means nothing. Strangely enough, my testosterone and free testosterone levels have been quite low, all along. I have read though that excess oestrogen can also drive PCa.

Lately I have been having pain in my tailbone and also pain further up in my spine. I had a bone scan 3 months ago, which focused on the pelvis but came back negative. I have been feeling weak on my legs for the past few months, along with having aching in various parts. What would you recommend for my scenario? I live in Oz, but am willing to travel to get answers asap. With prostatitis, shouldn't PSA rise and DRE be painful?? Thanks for your help.

Hi Peter, I am not a regular poster but follow posts periodically.

Your posts have been somewhat relevant to my own situation in that I suffer the double afliction of both prostatitis ( from my 20's) and BPH ( in my mid 60's ) Prostatitis has not elevated my PSA to any great degree, even when suffering episodes. I maintain a above average physical condition to get through such episodes. The tailbone and spine discomfort may well be from prostatitis in my experience, although as lower back only. Some may be from BPH ? With regard to prostatitis I took a leap into Changsha, China for some medical therapy. Treatment was rather severe and not cheap but after several visits it alleviated the condition. Had all the usual tests, ultra's both sides, blood, sperm etc. In summation the prostate calcification/stones will likely harbour infections and the trick is to get the required antibiotic in sufficient dosage  to the 'area'. As mentioned this did not erradicate my prostatitis, with the march of BPH this I believe has added pressure to calcifications and caused returning bouts of ill health. I have consulted with urologists for scoping etc in Australia but apart from suggesting a TURP nothing further is on offer. I might add that given the muliple areas within the prostate (stones= infection ?) that exist in my case there is no garantee the TURP would do anything to help my periodic ill health. The BPH I can endure with 1 to 4 night strolls. Hope my experience may throw some light on this double issue.

 

 

Posted 9/14/2014 6:32 AM (GMT 0)
Just visited my GP. Left a page with him with the Internet Address of this forum to give to another patient who had the GG procedure and if failed completely. My GP, when I mentioned that I had learned from this site that GG had moved his operations to Cyprus, he responded that as far as he knows, the Israel 'Medical Council' has prohibited GG from performing the procedure in Israel.

Now. I know that at least one person posting here had had considerable success from the GG procedure. However, there are troubling reports of many others who went through the procedure, costing at least 16,000 dollars a 'pop', but was not effective. However, I am not qualified to make any serious determination.

Having written that, one would have thought that such a long running thread would have attracted a written response from the GG pair themselves.

Post Edited (ClapTheHammer) : 9/14/2014 12:39:17 AM (GMT-6)

Posted 9/14/2014 6:41 AM (GMT 0)
Chicago Dave. It's a good year at least since you had your GG procedure. How are you feeling now in relation to prostate problems???
Posted 9/14/2014 9:38 PM (GMT 0)

ClapTheHammer said...
Chicago Dave. It's a good year at least since you had your GG procedure. How are you feeling now in relation to prostate problems???

Thanks for thinking about me, Clap! I was thinking about posting an update soon, and now you've forced my hand....

======================== UPDATE 3.25 YEARS ========================

Another cycle of improvement, which comes as both a surprise and a welcome development!

I had posted previously that I was having trouble tolerating water-soluble vitamins. Well, that seems to be greatly improved. I can now take my Vitamin C and B with only occasional frequency. Also, I've been under the distinct impression that most days I'm visiting the loo less often, maybe two times less frequently. A nice touch of blessed grace.

I noticed these improvements right around 1 June 2014, my 3-year mark. I didn't want to post anything until I had a chance to see if the improvements were stable. After three-and-a-half months, I can say that they seem permanent--if not quite so glorious as in June. I still have good days and bad days, but the bad days are less bad than bad days were year ago, and the good days are even better than good days a year ago. I think this is a bona fide improvement. I told a local osteopathic physician, who is open-minded on such things, and he was as surprised as I was.

How much is the improvement? Well, if 100% represents the perfect function like I was at 25 years old, and 20% represents all my terrible cramping and frequency problems in 2010, then maybe 80% can represent where I was last year, after June 2013. Now I'm about 84%. It's just a minor improvement, but still noticeable. And I'll take a minor improvement over a major reversal any day.

My history to date in a nutshell: I had my GG procedure on 30 May 2011; call it 1 June 2011 to make it easy to remember. I began noticing the first slight improvement about 3.5 months and then 6.5 months afterwards. In Summer 2012, my urologist measured my prostate with TRUS and it appeared to have shrunk significantly from the Spring 2011 trans-abdominal measurement by another doctor (22.3 versus 51 grams). As I've stated before, some of the shrinkage might have been a measurement artifact. Incidentally, I have both ultrasonographs. The prostate size is indicated inconspicuously on my urologist's U/S photo, but the first doctor wrote me a nice report along with giving me U/S photos suitable for framing....If you're into framing ultrasonographs of your nether regions. Some posters on this board have stated that there is "no evidence" to support GG. Maybe so, but this sort of evidence convinces me well enough.

I continued to see improvement in Year 2, but at a slower rate. After June 2013--the two-year mark, coincidentally--I was doing pretty well. No improvements at all during Year 3 until 1 June 2014--at the three-year mark. Honestly, I'm not trying to sync improvements to the calendar; the last two major improvements just happened to occur around my anniversary dates. Interestingly, my improvements have always come in cycles: Plateau/aggravation/sudden improvement that lasts. The improvements have invariably caught me by surprise; I've never anticipated them. Rather, my mindset has always been, "Well, I guess that's as good as that will ever get."

I don't think my vitamin supplements could have accounted for my improvement. I wasn't on them but a month. Then I got bored and switched to other supplements, but I had been off those for a couple months before the June 1 burst of improvement. Neither can my improvements be explained by any weight loss--I haven't lost any weight, unfortunately.

The only sour note is that my Testosterone levels have *not* made further improvement. They are much better (more stable) than *before* GG, but 15% lower than 4-months post GG.

It seems that Andy Action and I are the two main beneficiaries of the GG procedure on this board. Andy has apparently gotten bored and gone on to other things. I blame him not one whit! Other folks have not been so lucky unfortunately. That makes me think that I'm one of the luckier ones here.

I still recommend this procedure to folks (with appropriate diagnostic test results), with the proviso that my kind of good results are apparently not a slam dunk.

I'll continue to update periodically or when lasting changes--positive or negative--occur.
Posted 9/15/2014 3:55 PM (GMT 0)
2 Years after the GG procedure, I don't see any difference in urine flow. My BPH has not gotten worse nor better. Initially diagnosed with Median lobe enlargement and 45-50 gram prostate, I have not gone back to my urologist who recommended a TURP and gave me some Flomax..... which I dumped in the garbage after trying 3 pills that gave me retrograde ejaculation. Mostly normal altho slightly hardened bladder wall. I do not take drugs for BPH nor for anything else as I have been in perfect health. I have good T levels for my age, and have never had prostatitis. At 72 years of age I still play singles tennis in the Florida heat with my pro who taught the Williams sisters. about 6 weeks ago, I started taking 1500 mg of Inositol, a B vitamin for sleep. This has helped me immensely. I get up just once a night with incredible REM (dream) sleep. I generally wake up after 4 hours with Moderate urgency, and very very slow flow, which might be expected after deep sleep.. The Inositol helps me to fall back to sleep and wonderful dreams.. I know of one other person (not on this board) who had great results with GG and more than a 50% reduction in the size of the prostate.
Posted 9/15/2014 4:15 PM (GMT 0)
Proscar (finasteride) prevents the conversion of testosterone to dihydrotestosterone (DHT) in the body. DHT is believed to be involved in the development of benign prostatic hyperplasia. Others say that high levels of estradiol is the culprit. In any case, balancing one's hormones (DHT, estradiol, testosterone, SBGH, etc) is certainly beneficial.

Problem with Proscar though is the many unwanted side effects.

So far I have tried supplementing my diet with alpha reductase inhibitors like zinc, saw palmetto, beta sitosterol, progesterone, and gamma linolenic acid (GLA). Still cannot bring my DHT levels down from 50 to around a low of 30 which would in theory shrink the prostate just like Proscar.

It is high levels of DHT that bathe the prostate based upon Dr. Gat's research that cause the inflammation and enlargement. And his theory is that failure of the internal spermatic valves and resultant changes in pressure gradients cause this to happen.

The GG didn't work for me. Glad it worked for Dave others and I hope Dr. Gat has continued success in Cyprus. I do find it strange that the results of his research were never revealed. Many months ago, his office asked me to fill out the typical BPH questionnaire and email it to them.
Posted 9/15/2014 5:23 PM (GMT 0)
Hi Martin

I am considering the GG procedure and trying to ascertain how many bonafide successful stories there are. I talked with Chicago Dave and also emailed the person GG website http://www.pirion.co.il/ under patients share and confirmed it was success for him. However it is a little disheartening that they only have one person listed and you can contact him only by email. The person you mentioned who had great success. Do you know him personally or is it a web contact? Your input would be appreciated!

Thanks!
Jeff
Posted 9/15/2014 5:37 PM (GMT 0)
Jeff... I know him personally. When I was in Israel, I had hoped to get together with him for lunch. He couldn't make it, but we communicated several times by phone. In my last internet communication, he indicated his prostate was still shrinking in size. His procedure was 2 months ahead of mine. I cannot relate to you his satisfaction level as we haven't spoken for a long period of time.

Why some do well with GG and others don't is a question. My PSA is only 0.6, so that certainly wasn't a factor. I question why the procedure is now done in Cypress (as I understand from this board) and not in Israel.

I think the GG team is very competent and professional. But, I am disappointed that they have not followed up with me for almost a year. I did ask, why my results were not as I anticipated and have not received an answer with the exception that mid lobe protrusion may take longer to heal...but it is now 25 months!
Posted 9/15/2014 6:05 PM (GMT 0)
http://www.rxlist.com/proscar-drug/clinical-pharmacology.htm

"PROSCAR decreased prostate volume by 17.9% (from 55.9 cc at baseline to 45.8 cc at 4 years) compared with an increase of 14.1% (from 51.3 cc to 58.5 cc) in the placebo group (p < 0.001). (See Figure 4.)"

So, according to one website..." the basic assumption is that BPH is caused by low bioavailable levels of testosterone, high levels of DHT and Estrogen binding with the hormone receptor sites on the prostate gland. This stimulates cell growth."

So trying to balance hormone levels makes good sense. Sounds easy but it aint. There are so many variables. Body builders try to do it all the time by increasing testosterone levels but mostly fail.
Posted 9/15/2014 8:23 PM (GMT 0)
it was mentioned here that in this forum only two guys benefitted from the GG procedure. I believe there are more but forgot their names.
at any rate I myself am in the process of improvement.
at 8 months after the GG procedure my prostate size is down to 102 (from 123 before). I get up at night mostly once compared to 2-4 before the procedure.

I feel I have to repeat my observation: GG is beneficial, the least "invasive", has the lowest side effects, and is based on sound principles. HOWEVER: those who have midlobe enlargement will see less improvement or none at all.
Posted 9/15/2014 9:13 PM (GMT 0)
Nosheds....Theoretically if the ISM's have been sclerosed, the progression of mid lobe enlargement should cease, if one considers the cause of BPH to be a failure of the valves resulting in an excess of DHT bathing the prostate. So, it would still benefit patients with this condition to see Gat Goren.
Posted 9/15/2014 11:08 PM (GMT 0)
Martin,

I already asked you about your Vitamin D levels, didn't I?

There is a common blood test to measure serum Vitamin D levels. I ask because my levels are kept high by supplementation under a physician's orders. (It's possible to overdose on oral Vitamin D, so periodic blood tests are needed to guide the dose.)

http://www.ncbi.nlm.nih.gov/pubmed/23930605

I started Vitamin D supplementation three years *before* the GG procedure. It did *not* do anything to help my BPH symptoms, which grew much worse in those three years. However, I've always wondered if it helped me *after* the procedure.

-dave
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