Talk Health Partnership

[andyaction]

I was diagnosed with BPH, I did not want to go through the surgical procedures that would "deal" with the enlargement (but not the cause). Surgical procedures would leave residual problems which in effects would in my mind, be the beginning of the end. So checking the Internet I came accross the GAT GOREN procedure.

This was developed in Israel: Drs GAT and Goren. Yigal Gat, MSc, MD, PhD, is Head of Andrology & Interventional Radiology at the Maayanei Hayeshua Medical Center in Bnei Brak, Israel, and a research consultant in Condensed Matter Physics, Sub-Micron Research, Weizmann Institute of Science in Rehovot, Israel. Goren is a B.A. cum laude in Biology at Harvard University and with medical degree from Temple University in Philadelphia, Dr. Goren did specialty training in Diagnostic Radiology and neuroradiology at Washington University. At the Rabin Medical Center in Petach Tikva, Israel, he served as a senior interventional radiologists until 2006. During that period, he spent time at the University Hospital of Ghent, Belgium, where he was introduced to the transvenous approach to varicocele treatment initially developed by Prof. M. Kunnen. In 1999, with Dr. Gat, he co-developed a non-surgical method to treat failure of the venous drainage of the reproductive system. Dr. Goren is presently an interventional radiologist subspecializing in the male pelvis in Maayanei Hayeshua Medical center in Bnei Brak, Israel.

Their research group has been working together for several years and via physical understanding have come to the conclusion that prostatic enlargement is actually a secondary symptom of a hitherto disregarded clinical problem—varicocele – namely, malfunction of varicocele, which in turn is the result of a malfunction of one-way valves in the testicular venous drainage system, a phenomenon that exists only in humans. It results in abnormally high levels of free testosterone in the prostate and is simply treated by super-selective venography and sclerotherapy of the network of impaired testicular venous system, thereby eliminating the flow of free testosterone from the testes to the prostate. The procedure is painless and quick (takes an hour or two ) and you can walk out of the treatment room afterwards.

I went to Israel last week to undergo the procedure and in just the week following I have noticed significant improvement in my flow and the need to frequently urinate. Obvioulsy this is early days but the signs are encouraging. Time will tell!!!

The procdeure has however helped over 2000 men with fertility problems and as far as I know some 200 men with BPH. The UK NHS don't appear interested and neither do prostate organisations supporting sufferers as it hasn't undergone clinical trials. Wait for them and those reading this will probably be dead by the time it becomes accepted (Incidentally, although only on a small number (6) - some men suffering from PCa were treated and six months later a biopsy confirmed the cancer had gone)!

So, this treatment looks like it has great potential.. why is it not being investigated by complacent experts in the UK - could it be they are happy to support drug and equipment makers who are major sponsors in the health sector ?

I believe an 85% success rate overall is worth investigative calls to these Doctors who are not cowboys - they are educated specialists who are convinced they have found the real cause of prostate enlargement. They have a website, but it tends to major on fertility - so go through that and you can get the science on the procedure.

[andyaction]

Right, it's six months since I underwent the Gat goren prodecure. My life has positively changed and blood tests recently undertaken confirm a substantial improvement and shrinkage of the prostate. I am now no longer taking Finaseride / diffundox and my stream is much improved and continuous - although I do still need to double void. Night time visits are reduced or not at all - depending on how much I drank before going to bed or how tired I was. Frequency during the day are similar to when I was a much younger and I'm no longer desperate to get to the loo every half hour. however, when I want to go I must go. I'm happy to live the rest of my life as I am. i'm still expecting some further improvement though.

Was it worth having the Gat / goren over green light/ turp.. the answer is YES.... if you have the money, have prostate enlargement, then get in touch with Gat/ goren.

[andyaction]

10 months down the line, everything great, frequency normal, night time visits just about done away with,
flow mediocre .. still of the opinion that it was worth every penny. Other who are in contact with me also state improvements...

[admin]

I believe an 85% success rate overall is worth investigative calls to these Doctors who are not cowboys - they are educated specialists who are convinced they have found the real cause of prostate enlargement.

[thebowman]

I was very interested in the posts by andyaction on this subject, particularly as surgery may well be necessary for me - something I wish to avoid.

Nearly 18 months down the line how are things with you andyaction? Also, can you give me an idea of the cost of the treatment?

Many thanks.

[sculptor]

Thanks to andyaction for all the messages about the Gat Goren procedure. It is certainly reassuring to hear of your ongoing improvement , as I am considering this myself - I really don't like the sound of any of the conventional options for BPH! I have been in touch with the clinic in Israel, and have received some straightforward and completely plausible answers to my questions concerning success rate (85%) and any possible negative consequences of the procedure. It seems that success is determined by age, how longstanding the BPH is, size of the prostate, elasticity of the tissue etc.. As for possible negative consequences, the varicocele condition that is the root cause of the problem can occur again in other veins - thus leading to more BPH - but this takes some time to develop.

The current cost of the procedure is €17,000, and the clinic requires 4-5 weeks notice. One should also plan for a week's stay in Tel Aviv.

If this really does work - which it seems it does - it seems almost criminal that it is not available in the UK on the NHS. I suppose it will be down to 'pioneers' like andyaction and others spending a lot of money to perhaps pave the way for this.

[sculptor]

The Gat Goren clinic has recently shifted its base of operations to the American Medical Centre in Nicosia, Cyprus - hence (so I have been informed) the current high price for the procedure.

[andyaction]

Nearly three years down the line since i had the Gat Goren procedure. I am off all medication, I no longer get up a night, visits during the day are just about normal, flow very slow first thing if I've slept on my back, but once I get moving flow when I go is steady and a decent stream - but not like when I was 17 - i'm 63 now. I still try to double void to ensure I'm emptied. Am I satisfied with the results - YOU BET! Would I go through the procedure again.. Definitely if I needed to. Sorry to see the cost has gone up, it was 9000 euro when I had it done. Still at 17000 euros, it's still a bargain. Anyone considering the procedure. GO FOR IT if you can afford it because Uk urologists or the NHS seem to have other agendas.

[MGL551959]

Just wanted to stick my 2 cents in re GG:

I am 55, have 118 gram prostate and have been on 4-6 mg of Cardura, and Uroxotral before that, for several years. My BPH is manageable, but not great. I have to go every hour or two although I can hold it in if I have to, like on the golf course or at a movie.

If I don't void for a while, it is sometimes difficult to go at all until I walk around for 15 or 20 minutes.

I can sometimes sleep through the night, but usually go 1-3 times per night.

I had the GG procedure 3 months ago in Cyprus. A radiologist from Israel (originally from South Africa) did the procedure and Dr. Gat supervised (I guess) in the operating room. It took about 2 hours if I recall correctly and was not uncomfortable at all.

I was supposed to take it easy for a few days after that, which I did, but there was no discomfort other than a little dull ache in the region where they inserted the catheters into the veins.

For a few weeks to a month after the procedure I had occasional mild pain in the testicles, which Dr. Gat said was normal in some patients.

Dr. Gat and the radiologist were very nice and the hospital in Cyprus was clean and modern. The city (the capital Nicosia) where the procedure took place was typically eastern Mediterranean/Middle Eastern - not a high standard of living, not very pretty, but it seemed safe. If you want to combine the procedure with a vacation, I suggest going during their high season, and going to the north or south coast. There are some very nice hotels and casinos on the north coast (there is Vegas style casino gambling in Northern Cyprus, but not Southern).

That is the good news. Now the bad news. The procedure did not help me at all. So far at least, although they claim that there should be lots of improvement after 3 months. I am not holding my breath. To be honest, although Dr. Gat was very nice, he seemed to be a little bit of a quack when talking to him about this procedure and some other things. I am not a doctor, so take that impression with a grain of salt.

Now, just because it has not worked for me, so far at least, does not mean that it is not a valid procedure. However, my impression is that it is not. I was also surprised that Dr. Gat is not a urologist. I just assumed that he was. He apparently "discovered" this procedure while working with men who were having fertility problems. There was another, older man, from Israel who was there having the GG procedure, but for prostate cancer. I am VERY skeptical of using GG to treat PC, but I know nothing of that.

[MisterJa]

Thanks for the info, Andy. I've been reading your posts here and on other forums.

I'm in my mid 20s and have had a varicocele for as long as I can remember (at least ten years and probably more). Last time it was examined it was grade 2 on my left testicle. I also have spermatocele on both my left and right testicle that seem to grow and shrink for reasons my urologist hasn't really explained to me.

To add to this, I've had worsening urinary problems over the years; I sometimes must use the bathroom every half hour and at least once or twice at night, my stream is slow to start and thin, the total volume my bladder appears capable of holding is about 1 cup (about half or less than half a normal bladder). I'm also certain I have lower than normal testosterone levels since I have very little body hair, no facial hair, etc.

I saw one of Dr. Gat's papers a while ago and couldn't believe how well it all fit together and how it seemed to relate all my symptoms to the single cause. I read some more stories online and heard of other folks in my situation (younger men in their 20s and 30s with BPH-like symptoms and varicoceles who got relief after undergoing the GG procedure).

On account of the pain from the varicocele and hoping to relieve my other problems, I had a varicocelectomy microsurgery about five months ago by a local urologist. A few days in the swelling was making things miserable, but after about a week it started to get better; even my urinary symptoms showed a little improvement. Then less than a month after the surgery everything started going back to the way it was and as the swelling disappeared it became apparent that the bulkiest portion of the varicocele was still present, though the urologist claimed he clipped a good half dozen veins or so.

More reading has made me realize that my hopes for fixing the urinary problems with a simple microsurgery were naïve, since it appears that GG involves additional modifications relating to the backflow of blood into the prostate.

Anyway, I sent the Gat Goren Clinic an email yesterday and I hope to hear back from them. I am a little bummed to see how much the surgery cost. I figured it wouldn't be cheap, but now I am worried that even if this is my problem and I can get it fixed that I will never be able to afford it.

We'll have to see how things go.

Thanks for reading, folks. And good health to all!