User:Rathiram/Sandbox

UROGYNECOLOGY INDIA

"There is no more distressing lesion than urinary incontinence-A constant dribbling of the repulsive urine soaking the clothes which cling wet and cold to the thighs, making the patient offensive to herself and her family and ostracizing her from society" –  Howard A.Kelly, M.D,1928 Disorders of the bladder and bowel as well as sexual dysfunction are common in adult women. While most of these ailments are not life threatening, they severely impair Quality of life (QOL) in the affected. As the aging population grows, thanks to advances in health care, prevalence of pelvic organ dysfunction also increases. Women are increasingly less willing to accept incontinence or prolapse as a normal part of ageing Expectations for a high quality of life, have led to greater public awareness and help seeking behaviour among women in the west. Sadly, these social albeit health issues are swept under the bed in our country. Why talk about a new specialty now? Well, demographics of our current population trends reveal a staggering 25-70% of adult women suffering from urinary incontinence and a further 20% from genital prolapse. Also 11% have a lifetime risk of undergoing surgery for either prolapse or incontinence and of these 30% will have a second surgery within three years. The population of middle aged women amongst whom these problems are common is also on the rise. A new speciality was definitely on the cards to address these issues. Coexistence of dysfunction of urinary and bowel control is a well established fact and hence treating pelvic floor problems was a challenge. Traditionally, clinicians who address these problems are Urologists, Gynecologists or Colorectal surgeons. Fragmentation of health care duties among these specialists led to significant gaps in providing comprehensive treatment for pelvic floor dysfunction. This led to patients being subjected to serial surgeries because of lack of identification of problems in an adjacent organ system of the pelvic floor. To give an example:  A woman who has uterine descent could also have urinary leakage which involved the bladder. The subspecialty of Urogynecology and Pelvic Reconstructive Surgery was born out of the necessity to address these issues comprehensively. Having substantiated the need for Urogynecology it is important to note that a pelvic floor team is required to address all pelvic floor problems. A Colorectal surgeon, A Sexual dysfunction specialist, A Gastroenterologist, A Physiotherapist and A Continence nurse are all part of the pelvic floor team. Urinary incontinence and or pelvic organ prolapse greatly impair quality of life and should not be tolerated as a normal process of aging. Women should come out of the closet and seek help, as this wonderful speciality is now available.