Urolift is failing

I would respectfully disagree. My brother and I both had the FLA over a year ago, mine will be 2 years in October. And both are complete failures. Both of us have Retro ejaculation, and other sexual side effects. AND no improvement in symptoms. And we are out $20,000 or so each.

So wait for some of these procedures to be perfected. FLA is not the answer yet.

Good luck

I to have had fla twice. Although I have no obstruction I have retro, take flomax every other day and have some bladder issues.

Jim

I am so sorry to hear that. All the procedures for BPH have a hit and miss percentage. FLA for bph has now had a little more than two and a half years of results to calculate and it is now settled into about a 15% unsuccessful rate in FLA for BPH. This appears to be consistent with the numbers of most of the procedures offered. So we have no absolute and I don't see anyone working on the cure. Some Doctors have learned a lot more about recognizing which situations would benefit more for specific treatments.

This is a horrible condition. IT never stops, not even when you have it treated successfully. The gland continues to grow. The growth may not impinge the urethra again but it also can do just that and you would be right back to where you started. Our biggest problem is they do not know WHY we continue to grow even after a successful treatment of the condition.

I wish I had a recommendation that was a successful solution every time. We don't and I feel lost for men that cannot get treated successfully. Rezum seems to be the same but it is a little early to tell what the numbers really are.

As one top UK Uro said, We don't have a cure only treatments.

I had GL for my 75 grm prostate in 2004 and by 2013 it had regrown to 135 grms. It was then reduced by 80 grms by Thulium/Holmium laser. I suppose it is slowly growing like the weed it is but I've had no need to have it treated again.

yes Derek, what you are saying is a reality that most of the men on this thread do not realize. they are still wanting to treat and deal with the condition they currently have. but the reality is after they do so the growing of the prostate never stops. the continued growth does not mean that they will have a urination issue again but they could have one. I think that the treatment you choose and the method of treatment used could have a lot to do with the results you get when the growth returns. but as I said earlier most people are not even thinking that way yet because they are trying to deal with the current situation and not aware that the growth continues regardless of the fact they had a treatment. as I said earlier this is a horrible and strange condition. I just feel that we have no Advocate really is trying to develop a cure. there's too much money into the treatment and,. The Cure could interfere greatly with that money being spent. I'm glad your new growth is not affecting you urination I'm in the same boat so I'm pleased about that

One thing my PSA has not gone up in the six years since my last procedure. After my GL it dropped from 9.8 to 5.2 as I recall. After the second procedure from around 7.0 to 0.74 and was 0.70 last year

@j12080: Our biggest problem is they do not know WHY we continue to grow even after a successful treatment of the condition.

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The medical community does know why the prostate continues to grow. Our testosterone hormone causes the growth. This is not new information. Finasteride and similar drugs prevent testosterone from causing prostate growth. This is not new information either. Read the classic Combination of Avodart and Tamsulosin (CombAT) study which was a 4-year, global, multicenter study involving over 4000 men.

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There was a new study published in 2018 involving over 18,000 men, which looked at the long term effects of taking Finasteride which, so far, says that it also appears to reduce prostate cancer. One of the know side effects, is that it reduces bald spots which I experienced. I did not experience any other side effects. After my Rezum, I stayed on Finasteride and over time, I will see how successful this will be in preventing the regrowth of my prostate.

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I would recommend discussing staying on Finasteride with your urologists if you are concerned about prostate regrowth (we all are). Because this is a recently published study, unless your urologist keeps up on recent advancements (think of those urologist that still do old mono TURP), they may not be aware of this new study.

.

Steve

After my Thulium/Holmium laser procedure in 2013 my Uro suggested that I take Avodart to prevent future growth. I asked if at my age it would have time to regrow. He glanced at his screen to see my age (79) and said perhaps not 😃

I said that the procedure or GL are so simple that I would not mind having one every couple of years.

Derek76,

.

The Finasteride is only costing me about $120/year which is cheap. My Rezum was equally as simple and if my prostate does grow back, and better BPH technologies have not come along, I would do a Rezum again.

.

Steve

Thanks

Steve, this is interesting and I will research. Every doctor including the all

the urologist I have spoken with, except for Doctors Yigal Gat and Menachem

Goren, have told me that they do not really know why the prostate grows. In

conversation with Gat and Goren people in 2017 they explained it was a backwash

issue of testosterone into the prostate. Their procedure blocks this backwash.

That is it in a “Nut Shell” and I provided more information on them

below.

Finasteride has many negative side effects for most users and the worst in my opinion is the high frequency of reduced libido and loss of erection issues. This is not

worth it to me. FLA provided me relief without any sexual side effects.

Urologist in the U.S. will not even entertain a conversation or discuss the GAT/GOREN procedure. Being it is from outside the U.S. it has no creditability also it is not a procedure a urologist could preform if it did work so I bet they don’t want that knowledge out! Glad to hear you feel good and do not believe you are

having any side effects in your capabilities area of the sex life. Most

urologist feel that people of our age should not want or even miss that part of

our lives so it gets little consideration. If you don’t have that issue you are a very lucky man!

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

So, this treatment looks like it has great potential.. why is it not being investigated

by complacent experts in the USA - could it be they are happy to support drug

and equipment makers who are major sponsors in the health sector ?

j12080,

.

Thanks for the info.

.

So you flew into Israel to have the Gat/Goren procedure done? Other than my bald spot going away, I am not having any of the other side effects from Finasteride. I can understand why some men would be concerned about the side effects. It is interesting that you mention that BPH is a secondary symptom of malfunction of varicocele as bladder damage is a secondary symptom of obstruction from BPH.

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Why the Gat/Goren procedure has not been adopted in the U.S. could be a complicated question to answer. The U.S. Food and Drug Administration (FDA) has to approve it first which means it has to go through a clinical trials process which means having a enough U.S. urologists do it for a while on enough patients.

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Rezum went through this and was approved by the FDA at the end of 2015. Still it is not widely being done by urologists when it has several advantages over TURP. Both the Gat/Goren procedure and Rezum could be a case of a lot of urologist just wanting to stay with what they already know and not try something new even if the new procedure is better for the patient. I experienced this and changed urologists.

.

Steve

No.

Let me clarify, I did not go and have GAT/GOREN procedure. I did however contact them about it while doing my research to make a decision. The point I was making to you is that in visiting with the Doctors across this country I could not find one that would give me an explanation of how or why we have BPH. This was in 2015 and 2016. I went to nine of the ones determined to be the leaders in their respective procedures. We met with them and we were wanting to not just treat the symptoms but stop the condition. All said 1) could not stop it and 2) no one has an answer for why it happens. I did contact and had conversations with the GAT/GOREN clinic and they had a different story on why and how. I did not decide to travel to them to get the treatment. I instead chose to have the FLA in December of 2016 and I am still pleased with the results. I do know that the gland is still growing and I may eventually have to do something more. For now I just wait and enjoy my lack of symptoms that I had before.

Also, urologist are not capable of doing the GAT/GOREN procedure. It is done by Interventional Radiologist. So don't count on any support from them. Also, they really do want to kill the golden goose and find a cure. Treating symptoms with no cure is much more rewarding for them.

J,

I read about Gat Goren in 2013 while searching the internet for PAE . There was not much information back then.

It sounds like a varicocele is a varicose vein that is in near or in the testicle or prostate. It would make sense, if that is a cause of BPH, that the problem would get worse with age as varicose veins generally get worse with age, as the one way valves in the veins fail as they get older.

Do you know if the Gat/Goren method plugs the veins with beads like PAE or do they inject a sclerosing agent, like salt, as in the treatment of varicose veins ? Do they enter the catheters in through the femoral artery in the groin as in PAE, or an artery in the wrist also as in PAE ?

Thomas

Thomas, I am searching my records for the specific answer to you questions on plug methods. I do know the entry point is via a needle just under the scrotum of the patient. While I am looking for the plugging agent, I will provide you some of the other information I have.

After many years ofresearch, Dr. Yigal Gat and Dr. Menachem Goren have found the origin for

the evolution of prostate enlargement. In articles published around the

world, they reported on newly found route of testosterone to reach the prostate

in high concentration directly from the testes. The results of this

research led them to develop a new method of treating the problem of enlarged

prostate, without the well-known side effects. The Gat

Goren clinic in Israel accepts patients from all around the

world. The clinic team makes considerable efforts to ensure that their

timetable meets the needs of patients, and the time restrictions on those

patients who have come from overseas. Therefore, the clinic takes care to

ensure that responses are personal, discrete and convenient. This is done in a

few simple steps.

The Gat Goren method for

treating enlarged prostate is based on a smart and unique catheterization

technique performed under local anesthesia only, in a procedure that takes

around two hours. During the procedure, the entire network of malfunction

veins that divert ("illegally") the flow of testosterone into the

prostate is located and treated. Testosterone is the known factor in

medicine that control the volume of the prostate gland. High concentration

(intraprostatic) increases prostate volume low concentration decreases

prostate volume. The treatment causes an improvement in the symptoms, and

within weeks to few months later, a reduction in the size of the prostate can

already be measured. Many patients who have undergone the treatment

report a change in their quality of life after the first month.

Benign prostatic

hyperplasia (enlarged prostate – BPH) is one of the most common medical

problems suffered by men. Prostate enlargement is observed in around 40%

of men in their 50s, and in around 60% of men in their 60s. In ages of 70

and above, the phenomenon is even more common. An enlarged prostate

impedes quality of life, from disturbance to sleep due to a frequent need to

urinate during the night (nocturia) to urgent hospitalization due to urinary

retention (inability to urinate).

Despite the fact that

millions of men around the world suffer from this problem, many men do not

treat it. This is because almost all of the conventional surgical

treatments that treat directly the prostate offered at present involve side

effects with serious consequences, such as impotence or urinary incontinence.

" This is because almost all of the conventional surgicaltreatments that treat directly the prostate offered at present involve side effects with serious consequences, such as impotence or urinary incontinence "

Do you really believe that ? Where did you get the information from ? Can you give us the sources for this.

Most people have successful outcomes particularly if they don't let their prostates get to big before seeking treatment.

John Hi, Steven,

I looked into Gat/Goren my daughter lives in Israel I think she got an email, in any case from memory it was super expensive, more than FLA if I remember, and they moved their operation to Cyprus and there's not much information out there from people who have actually had it done. This sounded like a red flag to me, but could just be to make it cheaper for overseas folks to get there.

Re golden goose, I might agree on younger Urologists starting out, but well established ones with a good practice can be open minded. Just like anything else there are good and bad doctors, lawyers and so on.

Re FLA< I'm happy to hear it's still good for you, mine was a partial success, but after 3 years it feels like the prostate already grew back. Dr K told me he was cautious in my case not to take off too much, as I was concerned with RE.

Regards,

Michael

Thanks Michael.

I have found nothing on the Cyprus location. I also am trying to find current papers on this. I have understood a 901 person trial was completed but cannot find anything recent on this.

Second, I can assure you that both yours and my prostates have grown back to some degree although it is not a problem at this point. The reason I know this is they do not stop growing with the laser or Rezum treatment. This is why it is time to revisit the GG treatment as 3 years is a long time since I looked at it last time. I am going to call the Gat Goren Clinic and try to get some research on this.

Yes it is expensive but I will not worry about the cost until I know if this has improved over time. If not, then we know the answer. I wish Dr. K would look into it as I totally trust him and the IR's are the only ones that can do this. I would think that talented IR's around the country like him, Dr. Bagla and Dr. Isaacson would check this out better.

John I'll contact you offline to catch up, working right now

j12080,

Another thing about the Gat/Goren theory that makes sense is that men who have been castrated do not get BPH. That would suggest that testosterone is responsible for BPH. The Gat/Goren procedure prevents a direct path of testosterone from the testicles to the prostate, due to pooling of blood in a shared varicose/varicocele vein.

Thomas