What Is a Urologist?

Urologist Education, Training, and Certification Overview

A urologist is a physician who has specialized expertise and skill regarding problems of the male and female urinary tract and the male reproductive organs. Due to the variety of clinical problems encountered, awareness of internal medicine, pediatrics, gynecology, and other specialties is necessitated of a Saint Louis, MO urologist.

Urology is classified as a surgical subspecialty. A urologist with advanced qualifications in surgical treatment may be a fellow of the American College of Surgeons (FACS).

Specialties Within Urology

The American Urological Association has pinpointed eight subspecialty areas:

• Pediatric urology
• Urologic oncology
• Renal transplantation
• Male infertility
• Urinary tract stones
• Female urology
• Neurourology
• Erectile dysfunction (ED, impotence)

Board Certification for Urologists

To be certified by the American Board of Urology, the urologist must satisfy specified educational and examination requirements.

Education Information for Urologists

Urologists will need to graduate from an approved medical school and carry out an ACGME accredited urology residency program that is a minimum of 5 years in length. One year must be spent in general surgery, 3 years in clinical urology, and a minimum of 6 months in general surgery, urology, or a clinical discipline pertinent to urology. The final year of training will need to be spent as a senior/chief resident in urology with appropriate clinical responsibility under supervision.

Examinations for Urologists

After completing graduate education, Saint Louis, MO urology surgeons may make an application for certification by the American Board of Urology( ABU). Applicants approved by the Board to enter the certification process need to finish both a Qualifying Examination (Part I) and, following passing this examination, a subsequent Certifying Examination (Part II).

Common Conditions Treated by Urologists

• benign prostatic hyperplasia (BPH) or enlarged prostate
• cancers of the urinary tract (such as kidney cancer, bladder cancer, prostate cancer, and testicular cancers)
• infertility in women or men
• interstitial cystitis
• kidney stones
• urinary incontinence; overactive bladder
• prostatitis
• sexual dysfunction (like erectile dysfunction)
• urinary tract infections

Our Doctors

Metropolitan Urological Specialists' team of staff and physicians in Saint Louis, MO are committed to offering you the very best medical care. Our physicians are experienced, board-certified Urologists who are involved in ongoing medical education in order to provide you with the latest and most advance healthcare. Our trained staff is also dedicated to continuing education and committed to being responsive to you. Metropolitan Urological Specialists: high quality health care from dedicated professionals.

• Dr. Steven Bigg
• Dr. Michael de la Paz
• Dr. Robert Feit
• Dr. Laurence Gelstein
• Dr. J. Perry Lovinggood
• Dr. Michael Marcus
• Dr. Cathy Naughton
• Dr. Jay V. Patel
• Dr. Thomas Scully

Using Interstim Therapy To Treat Bladder and Bowel Incontinence

Interstim Therapy was FDA approved in the late nineties to treat urinary urge, retention, and urgency/frequency.  It was authorized in 2011 for bowel accidents (fecal incontinence).

What exactly are annoying bladder symptoms?

• Leakage of small or large quantities of urine
• Urinating frequently
• Urinating urgently
• Waking up at night to urinate
• Incapacity to totally empty the bladder, or may be unable to urinate at all (retention)

Exactly what are bothersome bowel symptoms?

• Fecal leakage
• Fecal smearing
• Diarrhea
• Constipation

Just how prevalent are urinary control issues?

• Over 33 million people (1 in 6 adults) suffer from urinary control issues within the United States alone.
• These problems may impact men and women.
• It might affect people of all ages; it is not simply a normal aspect of aging.

Just how prevalent are bowel control problems?

Over 18 million people or 8.3% of adults endure signs and symptoms of bowel control.
In fact, this affliction is very likely more widespread than reported as a result of the uncomfortable nature of the condition.

Exactly what are the factors behind bothersome bladder and bowel symptoms?

There might be multiple causes; like injury, adverse side effects from particular medications, neurologic diseases, infection, bearing offspring, pelvic pain, and others.

How would I know if Interstim Therapy is right in my situation?

You need to visit a doctor with a special interest, training, and knowledge about Interstim Therapy.  Dr. Naughton, one of Metropolitan Urological Specialists' physicians and voted Best Doctor in St. Louis for ten straight years since the year 2007, concentrates on the management of bothersome bladder and bowel symptoms and has one of the greatest experiences with Interstim Therapy in Missouri.

Interstim Therapy has 2 phases:

• Test trial period to determine if the treatments are right for you—Percutaneous Nerve Evaluation (PNE)
• Permanent Interstim Implant

Before placement of the permanent implant, your doctor may suggest a Percutaneous Nerve Evaluation (PNE). PNE is an easy office test which gives you an opportunity to test two temporary leads (or wires) within the pelvic nerves.  Using local anesthesia in an office setting, two temporary leads are put on each side of the pelvic nerves.  The leads are taped to the rear and connected to an external battery the size of a beeper.  The patient will have the opportunity to test both leads within the next three to five days to determine if there are any alterations to the bladder or bowel symptoms.  We consider a 50% improvement in symptoms a positive test, making the individual a candidate for implantation of the permanent device.

What to know about the Percutaneous Nerve Evaluation (PNE) Procedure

• Please get there half an hour prior to your slated meeting time.
• You might drive yourself to the procedure; nevertheless, it is much better to have somebody drive you to and from the procedure.
• This procedure is completed in the office under local anesthesia within 10-15 minutes.
• A light snack or meal is okay two hours before the procedure.
• Get rid of aspirin and ibupfren products (Motrin, Alleve, etc) for no less than five days prior to your procedure.
• Let our scheduler know whether you are taking blood thinners, such as Coumadin (warfarin), Xaralto, etc.
• No baths or showers are allowed during the test period.  You can take sponge baths and clean your hair in the sink.
• Refrain from heavy lifting or excessive bending throughout the trial.
• If you aren't able to tolerate the PNE, there's also an option to carry out the trial phase in the operating room with anesthesia.  This is known as a "Stage 1" procedure. You and the physician will decide if a Stage 1 procedure is appropriate for you.

What you need to expect on the day of the PNE procedure

• You will meet a medical assistant and representative(s) from Medtronic; the device company.
• You will be directed to lay on your stomach.  The medical assistant will wash your back and buttocks.
• Your doctor will perform the procedure with the aid of the Medtronic agent.
• The Medtronic agent and the medical assistant will fasten the leads to your back and wipe off the cleaning solution on your back and buttocks before you get dressed.
• Following the procedure, you are going to consult with the Medtronic representative to review voiding and bowel diary guidelines and set up contact plans with the representative to talk about changes in your urinary system and bowel function during the trial period.
• You'll make an appointment to see the doctor in 3-5 days in the office prior to leaving to take away the leads and talk about the outcomes of your trial.

What you should know regarding the permanent Interstim implant procedure

If you experience a greater than 50% improvement in urinary or bowel symptoms with your PNE, then you're a candidate for the full Interstim implant device.  This is an outpatient process under sedation lasting 15-20 minutes.  The battery and permanent lead is inserted all underneath the skin.  You will not be able to get a body MRI following the implant.  A brain MRI however is safe with the Interstim implant.  The battery will last 5-12 years following placement.

If you've got any queries about the Interstim therapy or anything more related to bladder problems, arrange an appointment with one of our offices in the St. Louis area, such as Washington, Florissant, and Creve Coeur, MO.

A Saint Louis Beginner's Guide to Varicoceles

A varicocele is a swelling in the blood vessels over the testicles. It's just like having varicose veins within the legs. The inflammation takes place when an excessive amount of blood collects inside the veins. A varicocele oftentimes takes place around the left testicle.

Precisely what are the symptoms?

A varicocele frequently produces no symptoms at all. Or it might cause an aching or heavy feel within the scrotum. The pain could be more intense later during the day or right after standing for a substantial period. You may even see inflamed blood vessels beneath the skin in the scrotum.

How's it identified?

Typically a varicocele is identified in the course of a physical exam. A testicle with enlarged blood vessels may be more tender. A varicocele is occasionally clinically diagnosed during examination for fertility issues. If you've got discomfort but your doctor can't feel any enlarged veins, an ultrasound exam might be done.

A varicocele can reduce sperm count. Whenever blood collects in the veins over the testicles, changes occur that decrease the number and the quality of the sperm.For men who're infertile, about 40 % to 50 percent willhave a varicocele. Typically, sperm count increases after treatment.

Treatment Solutions

About one in 6 men have a varicocele. Generally, a varicocele isn't serious. Your doctor might wait and watch the issue. If you have pain, should the veins come to be unattractive, or should you and your sex partner are having difficulty conceiving a baby, the doctor may advise surgery or another procedure to shut off the enlarged blood vessels.

Watchful waiting

If you don't have pain and you and your partner aren't attempting to become pregnant, your physician might suggest just watching the issue for a time. Make sure you keep all your appointments. If the veins do not become bigger and they don't trouble you, you possibly will not need additional treatment.

Surgery (Varicocelectomy)

Your doctor may advise that you get varicocelectomy surgery in the St. Louis, Missouri area to treat enlarged veins around the testicles. Oftentimes, surgery is performed with a laparoscope (a lengthy, thin, telescope-like device).

• First you are given anesthesia so you can stay relaxed. You might be asleep.
• One or more small cuts are made in the groin or stomach.
• The blood vessels are then tied up or sealed off.
• The incision is closed with sutures, staples, or surgical tape.

Varicocele Embolization

Instead of surgery, your physician may suggest varicocele embolization.

• First you are given anesthesia so you remain comfortable.
• Then a tiny incision is made in the groin or side of the neck.
• A tiny tube is moved through the cut.
• Led by x-rays, your doctor passes the tube into the varicocele.
• A little coil is sent through the tube. This is to block blood flow to the varicocele.
• The tube is completely removed. In most cases, stitches are not necessary.

Metropolitan Urological Specialists is proud to offer this and other informational materials about urological health. If you have any more questions for them, stop by one of their offices in St. Louis, Washington, or Florissant, Missouri.