Introducing Dr. Philip Fish, the latest urologist joining the team at Urology Associates of Central Missouri. With a passion for urology, Dr. Fish brings a unique perspective to the practice. Let’s take a closer look at his journey, his favorite holidays, and his life in Columbia, where he attended medical school at the University of Missouri.

Q: What procedure do you perform most frequently? What’s your specialty or favorite procedure?

A: As a urologist, I frequently perform endoscopic procedures, such as the removal of kidney stones and bladder tumors, all accomplished without the need for incisions. However, my favorite procedures to perform involve robotic kidney surgery. This includes both radical nephrectomy, where the entire kidney is removed, and partial nephrectomy, which involves removing only a kidney tumor while preserving the remaining healthy kidney tissue.

Q: What can patients expect when they have a consultation/appointment with you?

A: During a consultation or appointment with me, patients can expect a high level of care and attention. I prioritize their time and ensure that their concerns are thoroughly addressed. When meeting with patients, I make it a point to actively listen to their worries and address them with genuine empathy. My goal is to maintain open and honest communication throughout the diagnosis and treatment process, ensuring that patients are well-informed and involved in their healthcare decisions.

Q: What was your first job?

A: My first job was at a butcher shop, which I started when I was just 14 years old. Working there taught me the value of hard work and responsibility at a young age, setting me apart from many of my friends. It had a profound impact on shaping the person I am today.

Q: What is your favorite holiday?

A: Choosing a favorite holiday is tough for me since I love three of them equally: Fourth of July, Halloween, and Christmas, depending on the time of year. As for vacations, my favorite one was undoubtedly my honeymoon in Puerto Vallarta, a stunning beach town on the Pacific coast of Mexico. It offered a taste of old Mexico with its charming cobblestone streets and amazing restaurants.

Q: What is currently on your bucket list?

A: One of my bucket list items is to play several renowned golf courses, including Bandon Dunes (all of them), St. Andrews, Pebble Beach, and Royal Portrush.

Q: What is your favorite book?

A: Recently, I read “Killers of the Flower Moon,” by David Grann, a gripping account of the Osage Indians in the 1920s and a series of murders orchestrated to seize their mineral rights for oil on the reservation. I highly recommend it to anyone interested in history and intrigue. I’m eagerly awaiting Martin Scorcese’s upcoming film based on this captivating story.

Q: Best thing you like about living in Columbia?

A: For my wife and me, Columbia is home. We spent 11 wonderful years here before embarking on my residency training, and our love for this city runs deep. Columbia boasts incredible local restaurants like Murry’s, D. Rowe’s, Addison’s, Flat Branch, and more. Being close enough to cheer on the Tigers adds an extra perk. In truth, I could go on and on about why we adore this place and are thrilled to be back to serve the people of Mid-Missouri.

With a warm and compassionate approach to patient care, Dr. Philip Fish is committed to making a positive impact on the lives of those he treats. If you’re seeking a skilled urologist who values patient well-being and possesses a passion for his work, Dr. Fish is the perfect choice.

Welcome to our Q&A session with Mary Roberts, a talented and dedicated new physician assistant (PA) who recently graduated from Stephens College in Columbia, Missouri. With her comprehensive education and clinical training, Mary is now actively seeing patients at Urology Associates of Central Missouri (UACM). We are excited to have Mary join our team and are eager to delve into her insights and experiences as a PA in the field of urology. Let’s get started and learn more about Mary’s journey and her commitment to providing exceptional care to our patients.

Q. What’s your specialty or favorite procedure?
A. My favorite procedures are suturing and placing central lines.

Q. What is the one problem you are best at solving for your patients?
A. I excel at explaining medical conditions to patients in plain language that they can understand.

Q. What are you most passionate about personally?
A. Personally, I am most passionate about my faith and caring for my loved ones.

Q. What advances in urological/oncology care are you seeing?
A. Recently, I learned about a groundbreaking development at the VA hospital here in Columbia, Missouri. The VA is utilizing a radiopharmaceutical that specifically targets prostate cancer, allowing for precise identification of metastasis areas when used in conjunction with PET scans. This advancement has significantly improved the accuracy of cancer staging. Additionally, there is a clinical trial called STARPORT that investigates the treatment of prostate cancer with limited metastasis through targeted surgery and radiation, combined with conventional hormone therapy.

Q. What can patients expect when they have a consultation/appointment with you?
A. During a consultation or appointment with me, patients can expect a down-to-earth and compassionate approach. As a provider, I genuinely enjoy helping people and am always willing to address any questions. If there is a query I cannot answer immediately, I am more than willing to conduct research, consult my colleagues or explore the answer together. I strive to provide thorough care and view my patients holistically, recognizing the interconnectedness of various medical aspects despite specializing in urology.

Q. Favorite words of wisdom?
A. I have two favorites. The first is, “Humility isn’t thinking less of yourself, but thinking of yourself less” — This saying beautifully captures the essence of humility, emphasizing that it is not about diminishing oneself, but rather shifting the focus away from oneself.
Another favorite saying is, “Comparison is the thief of joy.” — This reminds us that comparing ourselves to others can rob us of our happiness and contentment. It serves as a powerful reminder to embrace our own unique journey without getting caught up in comparison.

Q. Favorite song?
A. It’s incredibly difficult to choose a single favorite song, as my musical tastes are quite diverse. I find immense enjoyment in various genres such as classic rock, bluegrass, oldies and folk. When it comes to favorite artists, a few notable ones include The Beatles, Jimi Hendrix, Creedence Clearwater Revival, Alison Krauss, and Nickel Creek.”

Q. If you weren’t a PA for Urology Associates of Central Missouri, what would you be?
A. I would pursue a career as a kindergarten teacher.

Q. What was your first car?
A. My first car was a Buick Le Sabre. Needless to say, the 16-year-old me was absolutely ecstatic about it.

Q. What was your first job?
A. I worked as a grocery bagger at Patricia’s IGA.

Q. What three words would you use to describe yourself?
A. Compassionate, joyful and loyal.

Q. What is your favorite holiday and why?
A. My favorite holiday is Christmas. I adore the beautiful lights and the joy of giving gifts to others. My second favorite is probably Halloween. I love witnessing people’s creativity with their costumes.

Q. What is your favorite vacation and why?
A. My favorite vacation destination is Lauterbrunnen, Switzerland. The name itself, meaning “many fountains,” perfectly captures the essence of this place, as it is home to 72 breathtaking waterfalls within the valley.

Q. What is a bucket list item and the most adventurous thing you’ve done?
A. One of my bucket list items is to visit Greece. As for my most adventurous experience, during college we used to go caving with a friend named Holly. She would confidently lead us into caves, even if it was her first time exploring them. Somehow, it always worked out! The scariest cave adventure was when we had to wade through shoulder-height deep water.

Q. What is something that you are certain you will never do?
A. I am certain that I will never fully pay off my student loans — yikes, and more yikes!

Q. What’s your favorite movie?
A. My favorite movie, most recently, has to be the new Top Gun.

Q. What is the best thing you like about living in Columbia?
A. The MKT trail and Homecoming are two things I absolutely love about living in Columbia.

Q. What is the worst advice patients get that you’d like to correct?
A. One common piece of misguided advice is, “It looks like a UTI, so take antibiotics.” However, the presence of bacteriuria in a urine analysis doesn’t always necessitate treatment. In the case of geriatric patients, it is common for bacteria to be present in their urine without causing any symptoms. Therefore, we refrain from prescribing antibiotics unless symptoms are also present.

Take the online assessment and stay in the game.

There was a time when men didn’t speak about the problems they experienced in the bedroom. That’s changing today, as more men actively seek to improve their sexual health.

Through the Know Your Score assessments below, Urology Associates men’s specialists can help you recognize the signs of a problem. Fortunately, there are several treatment options available for men.

Beginning around age 30 to 40, testosterone levels in men may diminish, adversely affecting libido and the ability to get and maintain an erection. Although low testosterone is only one factor in erectile dysfunction, both conditions can cause stress, affect relationships, and impact your quality of life. Check out the Testosterone Assessment below to understand testosterone’s important role in male sexual health and discover if you should consult a professional.

As men age, it’s common to develop prolonged sexual health or bladder health conditions and to have questions about it. Complete our Sexual Health Inventory for Men questionnaire to assess your sexual health and our Bladder Heath Assessment questionnaire to assess your bladder health. If needed, treatments are available to you.

An excellent first step is to evaluate your current symptoms through our assessments below. If interested, we can contact you to schedule an appointment once the form is completed.

What’s Your Score?

The assessment is FREE, and the results are confidential. We do not collect or track your data. The assessments are tools to help you decide if you should seek help.

If you have questions or wish to schedule an appointment, call Urology Associates of Central Missouri at 573-499-4990 or schedule an appointment online.

Kidney Disease is More Common Than You Think 

March is National Kidney Month. As the 9th leading cause of death in the United States, kidney disease kills more people every year than breast cancer or prostate cancer.

Getting routine testing if you are at risk for kidney disease, quitting or avoiding smoking, eating a diet that is low in fat, sodium and sugar, and avoiding chronic use of medications like NSAIDs, & maintaining a healthy weight are all things you can do to help manage your risk of kidney disease. 

What can you do to prevent kidney disease? 

1. Get Tested! Ask your doctor for an ACR urine test or a GFR blood test annually if you have diabetes, high blood pressure, are over age 60, or have a family history of kidney failure. Have questions? Here’s everything you need to know about getting tested, click here.

2. Reduce NSAIDs. Over the counter pain medicines, such as NSAIDs (nonsteroidal anti-inflammatory drugs), may alleviate your aches and pains, but they can harm the kidneys, especially if you already have kidney disease. Reduce your regular use of NSAIDs and never go over the recommended dosage.

3. Cut Highly Processed Foods. Processed foods can be significant sources of sodium, nitrates and phosphates, and have been linked to cancer, heart disease and kidney disease. What are processed foods? Find out more, here.

4. Reduce Sodium. Look for food labels with words like sodium free or salt free; or low, reduced or no salt or sodium; or unsalted or lightly salted.

Look for sodium on the food label. A food label showing a Percent Daily Value of 5% or less is low sodium. Also look for the amount of saturated and trans fats listed on the label.

5. Exercise Regularly & Maintain a Healthy Body Weight. Your kidneys like it when you exercise. Regular exercise will keep your bones, muscles, blood vessels, heart and kidneys healthy. Getting active for at least 30 minutes a day can also help you control blood pressure and lower blood sugar, which is vital to kidney health.

The NIH Body Weight Planner is an online tool to help you tailor your calorie and physical activity plans to achieve and stay at a healthy weight.

6. Stay Well Hydrated. Staying well hydrated helps your kidneys clear sodium, urea and toxins from the body. Dehydration reduces blood flow to your kidneys, which can damage them.Drinking plenty of water, and avoiding sugary beverages, is also one of the best ways to avoid painful kidney stones. Those with kidney problems or kidney failure may need to restrict their fluid intake, but for most people, drinking 1.5 to 2 liters (3 to 4 pints) of water per day is a healthy target.

7. Limit Alcohol Consumption. Drink alcohol only in moderation: no more than one drink per day if you are a woman, and no more than two if you are a man. Drinking too much alcohol can damage the liver, heart, and brain and cause serious health problems.

One drink is:

• 12 ounces of beer
• 5 ounces of wine
• 1.5 ounces of liquor

8. Eat the right amount and the right types of protein. To help protect your kidneys. When your body uses protein, it produces waste. Your kidneys remove this waste. Eating more protein than you need may make your kidneys work harder.

• Eat small portions of protein foods.
• Protein is found in foods from plants and animals. Most people eat both types of protein. Talk to your dietitian about how to choose the right combination of protein foods for you.

Following these tips can help you prevent disease or slow its progression. The most important thing you can do is manage your diabetes and high blood pressure.

Living a healthy lifestyle by eating right, being active, and not smoking is another key to keeping your kidneys healthy.

When Should I see a Kidney Specialist? 

A urologist can help diagnose kidney problems such as kidney infection, kidney disease, kidney stones, and more. Additionally, urologists work with people who have high blood pressure, also known as hypertension. Because your kidneys are responsible for filtering your blood, they can be greatly impacted by high blood pressure.

Signs you have kidney disease and should see urologist include: 

• You’re more tired, have less energy or are having trouble concentrating.
• You’re having trouble sleeping
• You have dry and itchy skin.
• You feel the need to urinate more often.
• You see blood in your urine.
• Your urine is foamy.
• You’re experiencing persistent puffiness around your eyes.

If your kidneys aren’t working properly, you may notice one or more of the following signs:

• Fatigue (extreme tiredness)
• An upset stomach or vomiting.
• Confusion or trouble concentrating.
• Swelling, especially around your hands or ankles.
• More frequent bathroom trips.
• Muscle spasms (muscle cramps)
• Dry or itchy skin.

With advocacy groups such as the Movember Foundation and stories like Lance Armstrong, who famously battled the disease, there are still many men who don’t understand the facts when it comes to testicular cancer. Medical oncologist Dr. Andrew Iliff and urologist Dr. Clay Mechlin break down some of the myths about testicular cancer.

Myth #1: Older men are at the highest risk for testicular cancer.

FACT: Most cancers tend to primarily affect older patients, but testicular cancer is different. It mainly strikes men in their teens, 20s and 30s. So, though it is unusual among all men, Dr. Iliff tells us, “It is the most common cancer in men between the ages of 15 and 40.”

Myth #2: Sexual behavior can lead to testicular cancer.

FACT: Doctors say there is no concrete evidence to back up this idea. Human immunodeficiency virus (HIV) may present a slightly higher risk for developing testicular cancer, but it is a very small “slightly higher” risk.

• A family history, or any history – If a male relative in close relation to you (such as a father or brother) has been diagnosed with testicular cancer, you’re at risk, too. If you’ve had testicular cancer in one testicle already, you have a much higher chance of seeing it show up in your other testicle as well.
• Health conditions – Having a hernia or mumps (from the virus that leads to a severe swelling of glands) can increase the chance you’ll develop testicular cancer. Repeated trauma to the scrotum area may also be a factor.

Myth #3: Testicular cancer is hard to treat.

FACT: “Testicular cancer is the single most curable solid cancer, with a cure rate of more than 95%,” Dr. Iliff says. It’s frequently caught early, but even if discovered at a later stage, this type of cancer is highly curable.

Myth #4: If I get testicular cancer, I won’t be able to have children after.

FACT: “This is true only in very rare cases,” says urologist and infertility specialist Dr. Mechlin. In the majority of cases, only one testicle is removed, so there is little change to fertility and sex drive.

What we do want men to know is that most testicular cancers are found by men themselves or their partners. Men should perform a self-examination once a month.

Click here for information on how to do testicular self-examination.

Looking for more information on testicular cancer?

Risk Factors: Health history can affect the risk of testicular cancer. Click here to view the risk factors of testicular cancer.

Signs and Symptoms: Signs and symptoms of testicular cancer include swelling or discomfort in the scrotum. Click here to learn more about signs and symptoms of testicular cancer.

Screening and Detection: Tests that examine the testicles and blood are used to detect (find) and diagnose testicular cancer. Click here learn more about tests and procedures for testicular cancer.