Saint Louis University Hospital and SLUCare physicians were ranked No. 33 in their treatment of kidney diseases and disorders in U.S. News & World Report's "America's Best Hospitals," 2001. The hospital and SLUCare were ranked no. 40 in their treatment of urologic diseases and disorders.

Nephrology
SLUCare nephrology specialists offer a wide range of diagnostic and treatment services for kidney and urinary tract diseases and disorders, including dialysis and kidney transplantation.

Click here for more information on kidney transplantation.

Urology

SLUCare physicians offer some of the latest in diagnostic as well as medical and surgical treatment techniques for both cancerous and benign prostate conditions. Areas of particular interest include urologic oncology, infertility, endourology, urodynamics and incontinence, impotence and renovascular hypertension.

The SLUCare Center for Research and Treatment of Prostate Disorders at Saint Louis University Hospital
The SLUCare Center for Research and Treatment of Prostate Disorders at Saint Louis University Hospital offers a wide range of diagnostic and treatment options for men experiencing the symptoms of benign prostate disease and other disorders of the prostate, including cancer.

Education: Your Best Defense
If you are a man age 50 or older – or if you are a woman with a husband or other close male relative or friend who falls into this age group –it is important for you to learn about prostate disease. Prostate disease is a condition that causes problems with urination and sometimes leads to cancer. You should know that:

 - Benign prostatic hyperplasia affects men over the age of 45
   and increases with frequency with age.
 - Nearly 25 percent of men 60 to 69 years of age have enlarged
   prostates.
 - More than 90 percent of men in their 70s have prostatic
   enlargement at death.
 - Prostate cancer is the most commonly diagnosed malignancy
   in American men, and it is the second leading cause of
   cancer death, exceeded only by lung cancer.

Fortunately, early diagnosis and treatment can help you avoid or reduce the problems associated with prostate disease. This Web page will help you understand the disease and its cause, the treatment options available to you, and the expert help you may call upon through the SLUCare Center for Research and Treatment of Prostate Disorders at Saint Louis University Hospital.

What is the Prostate Gland?
Found only in men, the prostate gland is about the size of a walnut and surrounds the neck of the bladder and the urethra, the tube that carries urine and semen out of the penis. It is located in front of the rectum, behind the penis' base and under the bladder. Its purpose is to produce some of the seminal fluid that protects and nourishes sperm cells, and it helps fight against infection in the genital urinary system.

What is Prostate Disease?
As men reach middle age, cells within the prostate gland begin to grow more rapidly, causing the gland to enlarge. The precise cause of this rapid cell growth is still not fully understood, but it may lead to two complications:

Benign prostatic hyperplasia (BPH): BPH occurs when an enlarged prostate gland compresses the urethra and blocks the normal passage of urine. Its symptoms may include:
- Increased frequency of urination during the day and night.
- A sudden urge to urinate.
- Difficulty starting to urinate.
- Stopping and starting of flow during urination.
- Weak flow of urine.
- Sensation of incompleteness in emptying the bladder.

Although generally not a life-threatening disease, if left untreated BPH may lead to irreversible bladder or kidney damage.

Prostate Cancer: Prostate cancer develops from prostate gland cells and, if undetected, the cancer cells may spread to other parts of the body. Some prostate cancers grow slowly, although some may develop and grow rapidly. Since some men with prostate cancer have no symptoms until the cancer is well advanced, it is important for men 40 and older to undergo periodic testing for the disease. Tests used to detect prostate cancer are:
- Prostate-specific antigen blood test (PSA), which measures PSA, a protein made by prostate cells.
- Digital rectal exam (DRE), often done as part of an annual physical exam. Many prostate cancers start in the part of the gland reached through a rectal exam.
- Transrectal ultrasound (TRUS), which uses sound waves that create an image of the prostate gland on a video screen. When the PSA or DRE indicate an abnormality, TRUS helps in guiding a biopsy needle into the correct area of the prostate for a specimen.

Treatments for BPH
Depending on the severity of BPH, treatments may include:
 
 - In mild cases, modifying fluid intake, avoiding caffeine and
   regular monitoring by a urologist.
 - Drug therapies to ease the symptoms of an enlarged prostate.
 - When effective, these drugs relax the bladder muscles,
   allowing easier urination, or they shrink the size of the prostate
   itself.
 - Transurethral resection of the prostate (TURP), a surgical
   procedure to remove the prostatic urethra along with a
   substantial portion of the diseased tissue within the prostate.

Targis™ Therapy: A Major Advance in Treatment
A recent breakthrough in treating BPH is Targis Therapy, a nonsurgical, outpatient procedure requiring no anesthesia. The therapy provides long-lasting results and minimum patient discomfort. Here's how it works:

The one- to one-and-a-half hour, outpatient treatment is performed by a urologist, who inserts a flexible treatment catheter into the urethra. A microwave antenna inside the catheter delivers precisely targeted microwave energy, which creates high temperatures and destroys the diseased prostate tissue. Simultaneously, the catheter cools and protects the adjacent urethra and healthy tissue, thereby minimizing discomfort, complications and recovery time.

Extensive studies at major clinical sites around the world have documented long-term success and high patient satisfaction with the results of Targis Therapy. The SLUCare Center for Research and Treatment of Prostate Disorders at Saint Louis University Hospital is one of only a few centers in St. Louis that offers Targis therapy.

Diagnosing Prostate Cancer
Should the PSA or DRE tests indicate the possibility of prostate cancer, a biopsy – a surgical procedure that removes a sample of tissue for examination – is performed. If cancer is found in the specimen, the cancer is graded to estimate how fast it is likely to grow and spread. In addition, more tests are performed to discover how far the cancer has spread in the prostate and if it is in nearby tissues or other parts of the body. Called staging, these findings help determine the treatment options.

Prostate Cancer Treatment
Depending upon the stage the prostate cancer is in, treatment options may include:

  - Surgery, either TURP or a radical prostatectomy, in which the
   entire prostate gland and some surrounding tissue are removed.
 - Cryosurgery, a treatment for localized prostate cancer that
   freezes the cancer cells with a metal probe.
 - Radiation therapy, in which high-energy rays or particles are
   used to kill cancer cells.
 - Hormone therapy, which lowers the levels of male hormones.
 - Chemotherapy, used for patients whose cancer has spread
   outside the prostate and for whom hormone therapy has failed.

If You Need Help – Call on the Experts
Saint Louis University Hospital and its SLUCare physician partners have the expertise for evaluating your risk for prostate disease. The SLUCare Center for Research and Treatment of Prostate Disorders at Saint Louis University Hospital offers you a wide range of advanced diagnostic and therapeutic treatments for BPH and prostate cancer. The center is part of SLUCare Clinical Services' division of urologic surgery, recently recognized as one of the best in the country by U.S. News & World Report. Working with SLUCare for Men, a highly specialized program offering comprehensive health care for men, the center provides you with education, treatment and care should you be diagnosed with prostate disease.

For those who have already been diagnosed with prostate cancer, the center can provide second opinions. And patient support groups are offered to help with rehabilitation. In addition, the center's director, Robert Moore, MD, is a specialist in urologic laparoscopy and minimally invasive treatment of BPH, including Targis therapy.

Dr. Moore completed his fellowship in endourology, urologic laparoscopy and surgical robotics at the prestigious Johns Hopkins University in Baltimore, and he completed residencies in urology and general surgery at Texas A&M University Health Science Center in Temple, Texas. Dr. Moore is certified by the American Board of Urology and serves as associate professor of surgery at Saint Louis University School of Medicine. He is the author of numerous manuscripts, book chapters and abstracts.