The Silent Signs of Kidney Disease: When to See a Urologist

Your kidneys work quietly behind the scenes, filtering waste, balancing fluids, and keeping your body’s chemistry in check. But when they start to struggle, the warning signs can be subtle—so subtle that many people don’t recognize them until significant damage has occurred.

Kidney disease affects millions of people, yet it often goes undetected in its early stages. If left untreated, it can lead to serious complications, including kidney failure. Knowing the silent signs can help you take action before it’s too late.

Early Symptoms: What to Watch For

Unlike other health conditions, kidney disease rarely causes pain in the early stages. Instead, symptoms are often mild or mistaken for other issues. Here are some early warning signs to be aware of:

  • Fatigue and Weakness – If you’re feeling constantly drained, it could be due to a buildup of toxins in your blood. Healthy kidneys filter waste efficiently, but when they’re not functioning properly, toxins accumulate, leading to fatigue and difficulty concentrating.
  • Swelling (Edema) – The kidneys help regulate fluid balance. When they’re not working properly, excess fluid can cause swelling in the legs, ankles, feet, or even around the eyes.
  • Changes in Urination – Be on the lookout for:
    • Increased or decreased frequency of urination
    • Dark, foamy, or bloody urine
    • Difficulty urinating or feeling pressure
  • Persistent Itching or Dry Skin – A lesser-known symptom, this can indicate an imbalance of minerals in the body, which happens when kidney function declines.
  • Loss of Appetite and Nausea – Kidney disease can lead to a buildup of waste products that cause nausea, vomiting, and a reduced desire to eat.

Who’s at Risk? Common Causes of Kidney Disease

Certain conditions increase the risk of developing kidney disease, including:

  • High Blood Pressure (Hypertension) – The leading cause of kidney disease, high blood pressure can damage the delicate blood vessels in the kidneys over time.
  • Diabetes – Elevated blood sugar levels can harm kidney function, making diabetes a major risk factor.
  • Heart Disease – A strong link exists between heart and kidney health. Poor cardiovascular health can strain the kidneys.
  • Family History – If kidney disease runs in your family, you may have a higher risk and should be proactive about screening.
  • Frequent Use of NSAIDs – Overuse of nonsteroidal anti-inflammatory drugs (NSAIDs) like ibuprofen can contribute to kidney damage.

 

When to See a Urologist

If you’re experiencing any of the symptoms above—especially if you have risk factors like diabetes or high blood pressure—it’s time to consult a urologist. Early detection can help slow the progression of kidney disease and prevent complications.

How a Urologist Can Help

A urologist specializes in kidney and urinary tract health. They can:

  • Order blood and urine tests to assess kidney function.
  • Identify and treat underlying causes, such as high blood pressure or infections.
  • Recommend lifestyle changes or medications to slow kidney disease progression.
  • Provide guidance on managing conditions like kidney stones or urinary retention, which can affect kidney health.

Take Charge of Your Kidney Health

Your kidneys are vital to your overall health, and catching problems early makes a significant difference. If you recognize any of these silent signs, don’t wait—schedule an appointment with a urologist. Early intervention can help you protect your kidney function and maintain a healthier future.

 

 

When Should You Get a Prostate Exam?

Prostate health is an important aspect of men’s overall well-being, but it’s often overlooked until symptoms arise. Prostate exams are a key tool in detecting issues like prostate cancer or benign prostatic hyperplasia (BPH) early, allowing for timely and effective treatment. But when should you schedule your first prostate exam, and how often should you follow up? Let’s break it down.

What Is a Prostate Exam?

A prostate exam typically involves two main components:

  1. Digital Rectal Exam (DRE): During this physical exam, a doctor feels the prostate gland through the rectum to check for abnormalities like lumps, hardness, or enlargement.
  2. Prostate-Specific Antigen (PSA) Test: This is a blood test that measures the level of PSA, a protein produced by the prostate. Elevated PSA levels may indicate a problem, though they’re not always caused by cancer.

When Should You Get Your First Prostate Exam?

The general guidelines for prostate exams vary depending on your age, risk factors, and family history. Here’s what most experts recommend:

1. Average-Risk Men

If you have no significant family history of prostate cancer and no other known risk factors, you should discuss prostate cancer screening with your doctor starting at age 50.

2. Higher-Risk Men

You may need to start earlier if you are at higher risk for prostate cancer. Risk factors include:

  • Family History: Having a father, brother, or close relative diagnosed with prostate cancer increases your risk.
  • Ethnicity: African American men have a higher risk of developing prostate cancer and should consider beginning screenings at age 45.
  • Other Factors: Conditions such as obesity or a history of high PSA levels may warrant earlier and more frequent screenings.

3. Men Over 70

For men aged 70 or older, the need for routine prostate exams depends on individual health and life expectancy. If you are in good health and could benefit from early detection, your doctor may recommend continued screening. For others, the risks of screening and treatment might outweigh the benefits.

What Are the Warning Signs of Prostate Problems?

Even if you’re not yet due for a routine prostate exam, it’s essential to watch for signs of prostate issues, such as:

  • Frequent urination, especially at night
  • Difficulty starting or stopping urination
  • Weak or interrupted urine flow
  • Blood in the urine or semen
  • Pain or discomfort in the pelvic area

If you experience any of these symptoms, schedule an appointment with your urologist as soon as possible.

 

What Happens If a Problem Is Detected?

If your prostate exam or PSA test reveals an abnormality, don’t panic. Many prostate issues are non-cancerous and treatable. Your doctor may recommend additional testing, such as imaging, a biopsy, or further bloodwork, to determine the cause of the abnormal results and guide your treatment plan.

Why Prostate Health Matters

Prostate cancer is one of the most common cancers among men, but early detection dramatically improves outcomes. Regular screenings can catch potential problems early, giving you more options and better chances for successful treatment.

A Testament to Early Detection

Norm Ruebling’s life was forever changed thanks to early detection through routine PSA testing. When his results showed elevated levels, timely referral and expert care allowed him to catch his prostate cancer early.

Read Norm’s Story

Take Charge of Your Health

If you’re approaching the recommended age for prostate exams or have risk factors that put you at higher risk, it’s time to start the conversation with your doctor. Schedule an appointment with our urology team to discuss your screening options and ensure your prostate health is in good hands.

Your health is your greatest asset. Don’t wait to prioritize it!

 

 

Norm Ruebling’s Journey with Prostate Cancer: A Story of Faith, Music, and Perseverance

Many know Norm Ruebling for his infectious passion for music, often seen behind the drums at local spots like Murrays & Shiloh belting out classic tunes like Ain’t No Sunshine and Tennessee Whiskey.

Norm Ruebling

Photo: Norm Ruebling behind the drums

A well-known member of the Columbia community, Norm is also a co-owner of MO-X, an airport transportation company. He’s called Columbia home since 1971, where his journey began at Mizzou, first as an undergrad, then as a graduate student. His music career took off with years spent teaching and leading Marching Mizzou before he and his partner, Doc, started their own business, MO-X, after Tiger Air Express was sold. In October 2024, Norm and Doc celebrated the 25th anniversary of their business.

Norm Ruebling and his business partner Doc

Photo: Norm Ruebling and his business partner Doc

Despite his long and successful career, Norm’s greatest strength has always been his positive outlook on life. That mindset was tested in 2020 when a routine check-up at Urology Associates of Central Missouri brought unexpected news: Norm’s PSA levels were rising. But Norm wasn’t shaken. “I’ve always been a positive person,” he said, “I just thought, I’m going to take this as it comes.”

Norm entrusted  Dr. Steven Dresner, a urologist with Urology Associates of Central Missouri in Columbia — a division of Missouri Cancer Associates. He followed Dr. Dresner’s advice to keep an eye on his PSA levels. In January of 2020, his PSA levels reached a point where action was necessary. “Dr. Dresner sat down with my wife and me and clearly explained three options,” Norm recalls. “Option A was radiation, Option B was medication, and Option C was surgery.” After carefully weighing the pros and cons of each choice, Norm and his wife decided that surgery would be the best path forward.

“When faced with making decisions and weighing options, I evaluate the effects of each choice and determine which one we can live with,” said Norm.

In April of 2020, Norm underwent surgery, and Dr. Dresner successfully removed his prostate. For the next four and a half years, Norm continued regular monitoring of his PSA levels. His strong faith and positive attitude helped him cope with the challenges along the way, always adjusting his life and living it to the fullest. His wife often jokes that he acts like a kid, full of energy and vitality despite the obstacles he faced.

Norm continued regular visits with Dr. Dresner after his surgery. However, during a routine check-up, Norm’s PSA levels began to climb once again. This time, the treatment options were fewer. Recognizing the need for specialized cancer treatment, Dr. Dresner referred Norm to the radiation oncology team at Missouri Cancer Associates. The seamless partnership between Urology Associates of Central Missouri and Missouri Cancer Associates ensured a continuum of care, allowing Norm to transition smoothly from surgical to radiation treatment. The recommendation was to radiate the area around where his prostate had been removed.

Though nervous about this next step, Norm found comfort in the faces of the “Rad Gang,” as he calls them, at Missouri Cancer Associates. “Their smiles were infectious,” he said. “Every day during my 35 treatments, they made me laugh. Little things like helping me off the radiation table meant the world.” And music was always a constant. “I always sang three songs during my treatments,” Norm recalled. “I knew when the songs were done, so was I.” He sang I Did It My Way by Frank Sinatra, Still by Lionel Richie, and Till There Was You by The Beatles—the song chosen for the father-daughter dance at his daughter’s wedding.

When it came time for his 35th and final treatment, Norm had promised himself he wouldn’t cry. But as soon as he rounded the corner and saw his “Rad Gang” wearing MoX-branded t-shirts, he couldn’t hold back the tears. “I lost it,” he admitted. “I tried my best to capture what the team at MCA meant to me in a letter, but it still doesn’t come close to the care I received during those eight weeks. I couldn’t have done it without them.”

Missouri Cancer Associates

Photo: Missouri Cancer Associates “Rad Gang”

In December 2024, Norm had his blood work done. The results? A PSA level of 0.02, with no detectable signs of cancer. Norm was cancer-free!

Gratitude Letter-


Through his unwavering positivity, faith, and the dedicated care of his medical team, Norm continues to fill our favorite Columbia, MO restaurants and bars with the music we love to hear. His story is a testament to the power of resilience, hope, and a community that supports one another in every battle.

 

Norm Ruebling band HOME

Get to Know Urologist Dr. Hunter Nolen

Introducing Dr. Nolen to Urology Associates of Central Missouri!! After completing his medical education in Houston, Dr. Nolen went on to finish his Urology Residency at Oklahoma University Health Sciences Center. 

His clinical focus includes managing stone disease, urologic oncology, neurogenic bladder, voiding dysfunction, genitourinary infections, BPH, incontinence, fertility, and sexual dysfunction. His passion for urology, combined with his unique experiences in NCAA Collegiate Summer Baseball, sets him apart as a dedicated professional on and off the field.

Dr. Nolen is married to his wife who is a general surgeon in Columbia. In his free time, Dr. Nolen enjoys spending time with his wife at local music venues, hunting, fishing, rodeo, and college baseball.

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

A: The most common procedure that I perform, involves removing stones from different areas of the genitourinary tract including the bladder, ureter and kidney.

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

A: The most important thing patients can expect from me when they have an appointment with me is that they will be heard. In today’s world of fast paced medicine, we do not always get the opportunity to completely understand what the patient is going through without listening. In order to come up with any sort of treatment plan, it is important to know the patient’s expectations and to educate them on their options regarding treatment regimens.

Q: What is your favorite quote?

A: My favorite quote is “Man in the Arena” by Teddy Roosevelt

“It is not the critic who counts; not the man who points out how the strong man stumbles, or where the doer of deeds could have done them better. The credit belongs to the man who is actually in the arena, whose face is marred by dust and sweat and blood; who strives valiantly; who errs, who comes short again and again, because there is no effort without error and shortcoming; but who does actually strive to do the deeds; who knows the great enthusiasms, the great devotions; who spends himself in a worthy cause; who at the best knows in the end the triumph of high achievement, and who at the worst, if he fails, at least fails while daring greatly, so that his place shall never be with those cold and timid souls who neither know victory nor defeat.”

Q: If I wasn’t a urologist I would be….

A: Still working in the oil field as a mechanical engineer.

Q: What was your first car?

A: My first car was a navy Blue F-150 that I got in 2005, and I drove until 2023.

My first job was as a demolition foreman for Graham’s concrete in Denton,Texas.

Q: 3 words you’d use to describe yourself?

Efficient, loyal, prepared.

Photo: (Printed shirt + white dress)
Caption: Dr. Nolen with his wife Heidi at a wedding in Arizona.

 

 

 

Understanding the Spectrum of Urine Colors: What Your Pee May be Telling You

Urine colors can vary widely, and the shade of your pee may hold clues about your health. While many colors fall within the spectrum of what is considered normal, some variations maybe a cause for concern. In this blog post, we’ll explore the different colors of urine and what they might signify.

Urine Color Chart | Urology Associates of Central MO

Clear Urine:

Clear urine is an indicator that you’re well hydrated, but it could also mean an excess of water consumption. While occasional clear urine is generally not a cause for concern, persistent clarity might warrant a visit to the doctor, as it could signal liver problems like cirrhosis.

Yellowish to Amber Urine:

The typical color of urine ranges from light yellow to a deeper amber. This variation is a result of the natural pigment urochrome, which becomes more diluted as you drink water. Additionally, an abundance of B vitamins in your bloodstream can give your urine a neon yellow hue.

Red or Pink Urine:

Red or pink urine can be attributed to the consumption of certain foods like beets or medical conditions such as hematuria (blood in urine), enlarged prostate, kidney stones, or bladder and kidney tumors. Some medications may also turn your urine reddish, indicating the need for a consultation with a doctor.

Orange Urine:

Orange urine may be a sign of dehydration or issues with bile ducts or the liver. Medications, such as those containing phenazopyridine or sulfasalazine, can also cause this coloration. If you observe orange urine along with light-colored stools, it’s crucial to seek medical advice.

Blue or Green Urine:

Uncommon but intriguing, blue or green urine may result from certain foods, medications, medical procedures, or bacterial infections. It’s essential to identify the underlying cause, whether it’s a harmless dietary factor or a potential health concern like Pseudomonas aeruginosa infection.

Dark Brown Urine:

Dark brown urine often indicates dehydration but can also be a side effect of specific medications or result from consuming certain foods. In some cases, it may signal serious conditions like rhabdomyolysis, porphyria, or liver disease. Exercise-induced dark brown urine, known as exertional hematuria, is usually temporary but should be monitored if persistent.

Cloudy Urine:

Cloudy urine may be a sign of a urinary tract infection, chronic diseases, or kidney conditions. Pregnant individuals experiencing cloudy urine should be vigilant for signs of preeclampsia. Additionally, foamy or bubbly urine may indicate pneumaturia, potentially linked to serious health conditions like Crohn’s disease or diverticulitis.

Understanding the nuances of urine colors can provide valuable insights into your health, but it’s crucial to know when to seek professional advice. If you notice persistent changes in the color of your urine, especially when accompanied by other concerning symptoms such as pain, discomfort, or changes in urinary habits, it’s time to consult a healthcare professional.

Additionally, if you have any underlying health conditions or are taking medications that may impact urine color, discussing these with your doctor can help ensure a comprehensive assessment. Your body often communicates through subtle signals, and paying attention to these changes can empower you to take proactive steps towards maintaining your overall well-being. Regular medical check-ups and open communication with your healthcare provider will help you navigate any potential issues related to urine color and ensure timely intervention if needed.

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.

Introducing Dr. Philip Fish, Urologist at Urology Associates of Central Missouri

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.

Dr. Philip Fish, Urologist at Urology Associates of Central Missouri

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.

Candid Conversations with Mary Roberts: A New PA’s Journey at UACM

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.

First time suturing — learning on chicken breasts :)
First time suturing — learning on chicken breasts 🙂

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.

One of my favorite family photos! (The guy in the covered wagon doesn’t belong to us.)
One of my favorite family photos! (The guy in the covered wagon doesn’t belong to us.)

Mary and Brian: Enduring the challenges of PA school together! Fortunately, our relationship blossomed around the time I started my journey back to school.
Mary and Brian: Enduring the challenges of PA school together! Fortunately, our relationship blossomed around the time I started my journey back to school.

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.

The view from our hotel room window in Wengen, Switzerland. Wengen is just a short train ride away from Lauterbrunnen. In this picturesque village, cars are not allowed, creating a serene and peaceful atmosphere. The window offers a stunning view of the same breathtaking area as Lauterbrunnen.
The view from our hotel room window in Wengen, Switzerland. Wengen is just a short train ride away from Lauterbrunnen. In this picturesque village, cars are not allowed, creating a serene and peaceful atmosphere. The window offers a stunning view of the same breathtaking area as Lauterbrunnen.
This one is in Appenzell, Switzerland.
This one is in Appenzell, Switzerland.

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.

My nieces and me at MU homecoming in 2022
My nieces and me at MU homecoming in 2022

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.

Knowing Your Score Can Help You Get Back into the Game!

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.

What you can do to prevent Kidney Disease

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.

        An example of a Nutrition Facts food label that shows a Percent Daily Value of 5 percent of sodium per serving.

        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.

        Testicular Cancer: Myths and Facts

        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.