Adding Crews to the Crew!

There is always something fun going on at the Meyer household. With 5 boys, that’s to be expected right?

Before Matt Meyer met his wife Dee, he was already a father to three boys and thought he was done having children. However, when he and Dee started dating, everything changed. They knew they wanted children together and looked to Dr. Mechlin of Urology Associates of Central Missouri to get a vasectomy reversal done.

“I know going into that initial conversation with Dr. Mechlin, I was very nervous and scared of what might be said. Not to mention I was apprehensive about the surgery itself and the recovery. However, I do better when someone levels with me and gives me useful information.  Dr. Mechlin did just that. The surgery & recovery in my opinion was very easy as long as you followed the prescribed instructions. Dr. Mechlin was thorough with not only the percentages of success, but he gave additional options if things didn’t work as planned. My advice would be if having a family is a priority, you are in no better hands than Dr. Mechlin,” says Matt. 

Matt underwent his outpatient vasectomy reversal in 2015 and the procedure and recovery went smoothly. Matt and Dee married just months later and just like that, their son Grayson was born in 2017, followed by their son Crews in 2020.

“Patients who most benefit from a vasectomy reversal or those whose partners do not have advanced maternal age or known female fertility concerns. It is extremely rewarding to see couples like Matt and Dee who are able to conceive naturally after successful vasectomy reversal,” says Dr. Mechlin.

Dee says motherhood has always been a dream of hers, and she is so happy her dream has come true. 

“Having children is something I spoke honestly about with Matt from the day we met. We knew we had some challenges ahead, and we actually thought it would be tougher to get pregnant, but we have been very blessed that things worked out as well as they have. I can’t imagine life without Grayson & Crews so it has been wonderful to experience family life and having that opportunity,” says Dee

The Meyer family is still adjusting to being a family of 7, but they say they have learned to love the chaos. 

“Family life is pretty hectic. Juggling nap times, early bedtimes & then having Colten my 16-year-old in the house brings an extra flare. Compound that with COVID and having fewer options for family time outside the house, it does translate into more time hunkered in the house & playing in the front yard. Dee has done an amazing job with not only both little boys but being a great step-mom to the older boys,” says Matt. 

The older boys all adore their younger brothers and Grayson refers to little Crews as “his baby.” Matt and Dee say they will always be grateful to Dr. Mechlin for helping them add their two newest members to their crew.

To schedule a consult with Dr. Clay Mechlin, click here. 

Local insurance agent, Troy Lowery, decided to include PSA (prostate-specific antigen) screening in his yearly physical. His results warranted a referral to Urology Associates of Central Missouri for prostate cancer where he had a consultation with Dr. Stephen Dresner. Utilizing Da Vinci Robotic Surgery, Troy’s prostate cancer was removed and he was playing golf five days later. Watch his full story:

Prostate cancer survivor, James West’s urinary incontinence was greatly affecting his quality of life. At 82 years old, James thought he was too old to seek any sort of treatment. A consultation with Dr. Mechlin resulted in James becoming a candidate for an artificial urinary sphincter.

“I feel more like myself again. It was worth it after all.”

An artificial urinary sphincter is an implanted device which compresses the patient’s urethra to keep it closed except when voiding.  Stress Urinary Incontinence (SUI) can sometimes develop after prostate or pelvic surgery or secondary to damage to the nerves going to the muscles that control continence.

To make an appointment with our male incontinence specialists, please call 573-499-4990. We offer 5 convenient locations to serve you better.

Experiencing erectile dysfunction? It could be a warning sign of an underlying condition.

Age and psychological state are often blamed for erectile dysfunction (ED), but did you know that ED can actually be a warning sign for other more serious health conditions? Erections rely on healthy blood flow, so abnormal blood flow (leading to ED) often indicates an underlying issue. If you’re struggling with ED — and an estimated 12 million U.S. men currently are — here are some factors to consider.

Heart disease

Blood flow relates directly to the heart, so that’s an important place to check if you’re experiencing ED. A study published by the American Heart Association Journal Circulation studied roughly 2,000 racially diverse men with no history of heart disease or stroke. Forty-six percent of those men, with an average age of 69, reported experiencing ED symptoms. After four years, 115 of those men with ED symptoms had died from heart attack, cardiac arrest or stroke. That equated to 6.3 percent of the study participants who experienced ED compared to 2.6 percent of the participants who didn’t experience ED.

According to the study’s leader, Dr. Michael J. Blaha, director of clinical research at Johns Hopkins Ciccarone Center for the Prevention of Heart Disease, an ED diagnosis “is associated with a twofold increase in heart attacks, strokes and cardiovascular death beyond traditional risk factors.”

That’s not to say that cardiovascular disease always leads to ED — or that everyone experiencing ED also has cardiovascular disease. But because erections occur when vessels in the penis become engorged with blood, any disease affecting blood flow could impact a man’s ability to have an erection. This could be because of heart disease such as hypertension or atherosclerosis. It could also be due to medication taken to combat high blood pressure. Talk to your doctor if you have this concern.

Low testosterone

Healthy blood flow isn’t the only factor to a dependable erection. Testosterone is a major factor in men’s sex drives and ability to have an erection. And low testosterone levels, in turn, can signal a lot more than frustration in the bedroom. Thyroid problems, pituitary gland irregularities, liver issues as well as underlying problems within the testes are all known to lower testosterone levels. It’s worth noting that low testosterone is also caused by aging. Your doctor can recommend testosterone-replacement therapies if this is an appropriate treatment for you.

Diabetes and other diseases

Uncontrolled diabetes can lead to nerve damage, which often manifests in extremities such as hands and feet. But it can affect the genitals, too, leading to ED — especially in those who are overweight and have high blood pressure. Spinal cord injuries and diseases of the central nervous system such as multiple sclerosis could also be to blame for ED symptoms.

Psychological issues

According to WebMD, 90 percent of the time, ED is due to a physical issue, but psychology can be to blame for performance anxiety. Although not as typical, stress, lack of sleep or depression could be the causes. If you suspect this is the case for you, ask your doctor about a nocturnal tumescence test to check.

As with any medical condition, ED is worth a call to your doctor. It might be the call that identifies early onset of a more serious issue in need of attention. And even if your ED isn’t the sign of a more serious issue, there are numerous treatment plans to help. 

According to the National Health and Nutrition Examination Survey, 1 in 11 people in the U.S. will get a kidney stone. Formed from a hard collection of salt and minerals (mainly calcium or uric acid) inside the kidney, they can travel through the urinary tract causing pain and discomfort in their wake. They vary in size — some too small to even notice, some so large they’re impossible to pass on their own. Although they can occur in anyone no matter their health, kidney stones are more common in men, people with diabetes and those who are overweight.

So what are the common symptoms? Read on to find out.

1. Belly and back pain. The Healthcare Cost and Utilization Project reports that kidney stones account for an estimated 1.3 million emergency room visits each year. Why? Because they can be incredibly painful. As the kidney stone moves from the kidney to the narrow ureter, pressure builds up in the kidney. This sends pain signals to the brain. As the kidney stone moves, the pain changes location — often suddenly and with varying degrees of intensity — sharp, often burning pain radiating from your side to back to belly to groin area. Although larger stones can be more painful to pass than smaller ones, the level of pain doesn’t necessary indicate the size of the stone. Even small stones can be extremely painful depending on how the stone is moving down the urinary tract.

2. Burning when you urinate. When the kidney stone moves from the ureter to the bladder, you’ll likely feel sharp pain when you urinate. Some people mistake this symptom for a urinary tract 
   infection (which you could have in addition to the stone — this occurs in about 8 percent of individuals with acute kidney stones), but the kidney stone symptoms will likely intensify.

3. Blood in the urine. Known as hematuria, this symptom could accompany numerous health issues, but in the case of kidney stones, blood in the urine could be red, pink or brown. It could also be microscopic, in which case your doctor can test for it.

4. Nausea and vomiting. Kidney stones can trigger nerves in the GI tract, which is why nausea and vomiting are common symptoms. This can also be your body’s way of responding to intense pain, according to the American Academy of Family Physicians. 

5. Sudden need to urinate — and then difficulty going. Another sign that the kidney stone has moved into the lower part of the urinary tract is the sudden need to urinate. But with a kidney stone blocking the flow of urine, you might only be able to go a small amount at a time. Note that if the urine flow stops altogether, it’s considered a medical emergency, and you should see your doctor right away.

6. Fever and chills. If you have fever or chills with your kidney stones, it means you’ve likely developed an infection in your kidney or the urinary tract. Keep in mind that any time you experience pain and a fever higher than 100.4°, you should see your doctor.

Kidney stones are common, but that doesn’t mean you have to go it alone. Treatment options will depend on the size of the stone, but most stones can be addressed in a urologist’s office rather than the ER. Your urologist can address your pain immediately and schedule imaging to see what’s going on.

If you are experiencing kidney pain or suspect you might be suffering from kidney stones, contact our office to be seen by a specialist.

Kidney stones are a relatively common medical condition that sends over 500,000 Americans to the emergency room each year. Luckily, most cases are treatable at home and exit the body with time. Nurse Practitioner, Jeremiah Hays, and Physician Assistant, Hank Rainbolt are here to answer any question you might be searching the internet for in regards to kidney stones. 

How Does a Patient Know They Have a Kidney Stone? 

Rainbolt: So the hallmark symptom that we normally talk about in kidney stones is that unilateral flank pain, or in other words that one-sided low back pain that can be found right under your ribs. It is usually pretty strong and severe. You may also have some nausea, vomiting, blood in the urine, and maybe some other urinary symptoms, but those aren’t always the cause. If it is a kidney stone, more than likely you’ll feel it, and if that is the case then we can have you seen here. 

What is a Kidney Stone? 

Hays: [A kidney stone] is a buildup of minerals and salts that accumulates in the kidney(s) overtime from filtering your blood, making urine, and once you have a kidney stone — one of two things can happen. It can move and you pass it, and you don’t even realize it. The other scenario would be what we would help you with, which is that [the stone] continues to grow and moves to where it obstructs the flow of urine, which results in swelling of the kidney and that causes that unilateral flank pain. 

What Should Someone Do If They Think They Have a Kidney Stone? 

Rainbolt: So if the patient feels the symptoms that we talked about earlier, the majority of stone episodes can be seen here in the clinic. So you can call in and get a same-day appointment with us here at the Urology Associates. We can address your pain immediately, we can schedule imaging because that’s really the only way to know if you do have stones, which is to see it on an image. If you do have severe pain, 8 out of 10, 9 out of 10, the worst pain of your life, or if your nausea and vomiting isn’t going away, then we’d ask that you go to the ER, other than that, most cases can be seen here. 

What Are The Treatment Options for Patients? 

Hays: There are two main ones that depending on the size of the stone, the density of the stone, and the location of the stone, that we usually go with. The first [option] we normally go with, we would take a little telescope to go up through your bladder into the ureter that connects your kidney to your bladder and either grab the stone or zap it with a laser and then take the little pieces out. The second most common treatment is shock wave therapy, where we would blast the stone with shock waves until it breaks up and kind of turns it into gravel, and then over the course of a few weeks, you just pass little pieces of gravel. Both these procedures you’re completely asleep for, you don’t feel any of it, and then we wake you up and you’re good to go. 

How Do Patients Prevent Kidney Stones? 

Rainbolt: That’s the golden question. One in 10 Americans will experience a kidney stone once in their lifetime, and if you’re one of those lucky one in ten, then you’re already at a greater likelihood of developing another stone. So if that’s the case, once you’re healthy, once you’ve passed the stone or we’ve removed it, we’d like to see you again in the clinic so we can run a simple urine test and a simple blood draw and we can measure those levels and see what exactly is causing you to develop stones in your system. Then we develop and tailor a customized treatment plan for you to prevent any future stones. 

Need to See a Urologist? 

If you are experiencing kidney pain, or suspect you might be suffering from kidney stones, contact our office to be seen by a specialist. 

Patients experience rapid recovery through the use of robot-assisted procedures.

In 2008, Boone Hospital Center added a new technology to its repertoire, da Vinci, a robotic system that allows surgeons to perform surgeries with minute precision. These systems are operated through hand and foot controls that surgeons use to guide the slim robotic arms during procedures. Since offering the da Vinci Surgical System as an alternative to traditional “open” surgery, Steven Dresner, MD has performed over 500 laparoscopic procedures alone. The majority of these surgeries have been radical prostatectomies, the removal of the prostate used to treat early or localized, aggressive prostate cancer, but other urologic surgeries on the kidney, bladder, ureter, adrenals, and lymph nodes can be done as well. Boone also offers patients the option of robotic-assisted laparoscopic hysterectomies.

How does a surgeon perform a laparoscopic procedure?

Laparoscopic surgery is a minimally invasive technique. The procedures, which may be full-sized surgeries, are done through small puncture marks instead of large incisions. Small tubes fit into the punctures and small instruments fit through the tubes and accomplish the surgery. Full-sized surgery without the full- sized incision!

Robotic assistance takes laparoscopic surgery to the next level. The very small instruments have full range of movement, like a human wrist, and are controlled by a “robotic” or computerized link from the surgeon’s hands to the instrument, like a video game avatar.

In regular laparoscopic surgery, “what the surgeon controls with his hands are relatively simple tools that point straight forward, and they tweeze, cut, cauterize, or hold,” says Dr. Dresner. “The robotic instruments are wristed, meaning they move in four different degrees of freedom, so that when the surgeon puts his hands in the robotic console, every single movement the surgeon does with his hands in space is precisely imitated or replicated by the tiny little instruments inside the patient.”

This means that the robotic instruments can reach into places that can’t be reached with regular surgical instruments. Dr. Dresner explains that typical surgical instruments are great for places like high in the abdomen where there is plenty of space to work, but also surgeries down deep in the pelvis, underneath the pelvic bone. Closed-off spaces also greatly benefit from the increased mobility and agility that robotic assist can provide.

“With early detection and diagnosis, my treatment with Urology Associates had me back playing golf in two weeks after my surgery.” – Troy Lowery

What’s the recovery time look like? 

In addition to giving surgeons extra mobility in tight quarters, the laparoscopic camera provides a magnified view in three dimensions allowing for better visualization, meaning the surgery is more precise, with less blood loss and a more intricate repair. The recovery is drastically easier on the patient, taking about a third to a half of the time it would take to recover if there was an open incision. 

Patients are typically in the hospital only one day, and are back to full activity in about a month, rather than two or three months. Patients also report much lower pain levels after surgery. Dr. Dresner has even had one patient go home the same day as the procedure. 

“It is important to note that even though there is less blood loss and more precision, the doctors who perform open surgery will eventually see the same results, including rates of cancer control or cure,” says Dr. Dresner. “The recovery period, however, doesn’t really compare. Patients feel so much better so much faster with laparoscopic surgery.” 

By Tiffany Schmidt

Credit to https://www.boone.org/

I suffer from bladder leakage. Is there any hope for me to return to my normal way of life?

This is usually what we hear from the men walking into our office each day. Unfortunately, it often takes them awhile to work up the courage to make an appointment to see a Urologist. Although stress urinary incontinence (SUI) is a common problem, especially among men who had prostate cancer treatment, it remains a sensitive topic that men don’t like to talk about. However, it shouldn’t go ignored because bladder leakage can have a significant impact on a man’s emotional health, social relationships and physical activity.

We would like to debunk myths around SUI and urge men to talk to a doctor about the urinary issues they face.

Myth: Urinary incontinence is inevitable with age.

Sure, aging can increase the risk for incontinence, but many elderly individuals maintain normal bladder control. Instead, SUI is a common side effect of a urological procedure, pelvic trauma or condition affecting nerve functionality. Men may experience SUI after prostate cancer treatment and surgical treatment for an enlarged prostate (BPH). Studies suggest that as many as 50 percent of men report leakage immediately following surgery for prostate cancer and up to 16 percent of men will continue to have SUI one year after surgery.^1,2

MYTH: Incontinence is the same for everyone.

There are three common types of urinary incontinence. The first being SUI, which occurs when physical movement or activity puts pressure on the bladder, such as coughing, laughing, sneezing or heavy lifting. The second is urge incontinence, also known as overactive bladder, which causes an overwhelming need to urinate that may prevent reaching the toilet in time. Lastly, mixed incontinence is present when a man suffers from symptoms of both SUI and urge incontinence.

Myth: Urinary incontinence cannot be treated in older adults.

Most cases of SUI can be cured or improved. It’s a matter of men speaking with their urology specialist about their symptoms. Absorbent products are probably the most well-known option out there. Other non-surgical options include a condom catheter that is placed on the penis so urine can flow into a drainage bag and a penile clamp, which controls leakage by applying constant pressure upon the penis. More long-term treatment options include an artificial urinary sphincter (AUS) and male sling. An AUS implant is completely concealed within the body and mimics a healthy sphincter, the muscle that controls urine flow. It allows the individual to urinate when desired.³ A male sling is placed within the body and acts as a hammock, repositioning the urethra and providing support to surrounding muscles to help restore normal bladder control.⁴

Myth: Urinary incontinence is rarely a problem for men.

Urinary incontinence is seen as being more common among women. However, this may be because men often go undiagnosed because they are more reluctant to discuss their symptoms with family members or doctors. The reality is that more than 1 out of every 10 men experience urinary leakage at some time in their lives.⁵

Myth: Incontinence is embarrassing, but not serious.

Incontinence itself is not life-threatening, but it can be a very uncomfortable condition that can have a significant impact on a man’s emotional health, social relationships and physical activity. Often it can cause a man to isolate himself or limit his social life, especially exercise and leisure activities, which could lead to feelings of depression.

Myth: Absorbent products are the only option to manage urinary incontinence.

For some, absorbent products may be the best way to manage their condition. However, sometimes more than behavioral or nonsurgical treatments are needed to return to a normal life and regain confidence. I can’t emphasize this enough – men should speak with their doctor about their symptoms and ask questions about medications and procedures.

At Urology Associates of Central Missouri, expert help is available to improve the quality of life for those with bladder control problems. Patients have the opportunity to be evaluated by experts in treating all aspects of male and female urinary incontinence in people of all ages.  It very important to determine which type of leakage or “incontinence” a person has in order to determine the best treatment for them.

To make an appointment with our male incontinence specialists, please call 573-499-4990. We offer 5 convenient locations to serve you better.

Dr. Clay Mechlin

Myth Buster’s for erectile dysfunction (ED)

Although erectile dysfunction (ED) is a common problem, it remains a taboo topic that men don’t like to discuss. However, it shouldn’t go ignored because ED can be an early sign of more serious health condition like diabetes or heart disease. We urge men to educate and understand changes in the ability to get or maintain an erection and would like to debunk myths around ED.

Myth: ED is no big deal.

ED can be an early sign of a serious health problem – potential high blood pressure, diabetes or heart disease. In order to have an erection, a man needs to have healthy blood vessels and nerves. Diabetes is a disease that attacks blood vessels and nerves so it is common for men with diabetes to experience ED. Likewise, if blood vessels are blocked by coronary artery disease it can limit the flow of blood to various parts of the body. The arteries supplying blood to the penis are much smaller than the ones supplying blood to the heart. As a result, heart disease may first show itself as difficulty achieving an erection.1

Myth: ED is a natural part of getting older.

ED is not an inevitable part of aging; it is contingent on your health and lifestyle. That is why it is important to identify the underlying issues that could be causing ED.

Myth: If I can get an erection, I don’t have ED.

Men tend to think that if they can get an erection, they do not have ED. The reality is, ED can present itself as erections that cannot be maintained or in erections that aren’t firm enough.

Myth: Viagra is the only treatment.

The first step to treating ED is identifying the underlying issues that could be causing it. Once more serious conditions are ruled out; medication is usually the first line of therapy. However, up to 50 percent of men with ED do not respond to pharmaceutical treatments and require a different option, especially men with diabetes and heart disease.2-5 Other treatment options include:

Injections: A needle is used to inject medication directly into the penis. The medication allows blood to flow into the penis, creating an erection.

Vacuum Erection Devices: A plastic cylinder is placed over the penis, and a pump (manual or battery operated) creates a vacuum suction within it, drawing blood into the penis to create an erection. A stretchable tension band placed at the base of the penis helps maintain the erection.

Intraurethral Suppositories: An applicator containing a small pellet is inserted into the urethra and the pellet is released. The pellet dissolves and increases blood flow to the penis, creating an erection.

Penile Implants: A medical device is implanted in the penis, contained entirely within the body that allows direct control of both the timing and duration of an erection. For more information on penile implants. 

Myth: My ED must be psychological.

While depression or anxiety can cause ED, the condition most often has a physical cause. Some depression medications may bring on ED. 6 However, suddenly stopping antidepressants is very dangerous and the issue should be resolved with a doctor.

1. Jackson G, Rosen RC, Kloner RA, et al. The second Princeton consensus on sexual dysfunction and cardiac risk: new guidelines for sexual medicine. J Sex Med. 2006 Jan;3(1):28-36.
2. VIAGRA™ Prescribing Information. Pfizer Inc. Revised January 2010:8-9.
3. CIALIS™ Prescribing Information. Lilly USA, LLC. Revised 2011:18-20.
4. LEVITRA™ Prescribing Information. Bayer HealthCare Pharmaceuticals Inc. 2011:19-20.
5. Walsh TJ, Hotaling JM, Smith A, et al. Men with diabetes may require more aggressive treatment for erectile dysfunction. Int J Impot Res. 2014 May-June;26(3):112-5.
6. Shabsigh

To attend one of our FREE Men’s Health Seminars please check out our current scheduled events and sign up to attend!

Dr. Bud Murphey wants patients to learn from his experience with early prostate cancer detection.

By Madison Loethen

Nathaniel “Bud” Murphey, MD, of Boone Medical Group Ashland is well known in his community and is loved dearly by his patients. He has practiced medicine for more than 35 years in mid-Missouri and has been in Ashland for over 20 years. While he’s known for caring for the health of many, some may not know that the doctor recently overcame a major health scare himself.

Dr. Murphey has a family history of prostate cancer, so he knew he had an elevated risk of developing the disease. He made sure to get regular prostate-specific antigen (PSA) tests.

A PSA test is a blood test that screens for a protein produced by both cancerous and non-cancerous tissue in the prostate. If a patient’s PSA levels are high, prostate cancer could be a reason.

“My tests always came back a little bit high, but then, over a period of six months it increased dramatically, and we knew what the problem probably was,” says Dr. Murphey.

Dr. Murphey was treated at Urology Associates of Central Missouri by Michael Cupp, MD.

“The PSA test, while imperfect, is still our best tool for early prostate cancer detection. Many of the weaknesses of the test are being actively addressed, and we continue to recommend intelligent use of PSA testing,” says Dr. Cupp.

Dr. Murphey underwent biopsies after receiving his results, which confirmed he did have prostate cancer.

“I just thought, ‘Rats. We have to fix it,’” says Dr. Murphey.