Lack of availability of trained female urologists

Urinary problems in females under-reported and under-treated

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"Urinary problems in females are generally under reported and under treated - mainly on account of the lack of trained female urologists available in the field - and also due to reluctance of female patients to consult a male urologist." This was stated by Dr Nuzhat Faruqui, Instructor and Consultant Urologist, Department of Medicine at Aga Khan University Hospital (AKUH). Speaking at a programme held at AKUH's Clifton Medical Services, under the Hospital's 'Signs, Symptoms and Care' series, she referred to the common belief that female urinary problems are part of the aging process, and clarified that in fact mostly these are not due to aging alone. With proper evaluation, most patients can be cured, treated or adequately managed with significant improvement in the quality of life.

Dr Faruqui said in her talk on "Common Urinary Problems in Females" that female urinary tract disorders include stone diseases, and kidney and other tumors. Expert evaluation includes complete history and physical examination. Urodynamics (bladder function test), imaging studies and additional bladder studies such as cystoscopy may be required.

Explaining urinary incontinence - uncontrolled leakage of urine causing hygienic and social problems, Dr Faruqui said that this could be caused by any of several factors such as trauma, surgery, childbirth or post-menopausal hormonal loss. Diabetes, stroke, multiple sclerosis or spinal cord injury may also lead to this condition.

Different treatment options are available to treat this condition, including behavioral treatment and specific exercises. Referring to surgical treatment, Dr Faruqui informed that all the stated procedures are performed at AKUH. She advised that most problems are easy to diagnose and treat with conservative measures, and if not reported in a timely manner could lead to serious impairment in the quality of life.

The programme's second speaker, Dr Nazia Riaz, Consultant Breast Surgeon at AKUH said in her talk on benign and malignant breast diseases that in spite of there being widespread acceptance of the value of regular breast cancer screening, inaccessibility to health care and lack of awareness are some of the major factors responsible for diagnosis at an advanced stage. Breast cancer may be detected either by radiological screening (mammograms), or a physical examination. Dr Riaz stressed the importance of proper breast self-examination and screening mammograms from age 35 or earlier, as this greatly helps in early detection and treatment. She concluded by strongly emphasising that professional advice be sought for proper evaluation and management.

Dr Imrana Masroor, Consultant Radiologist and Head of Ultrasound Section, Department of Radiology, AKUH, said in her presentation on 'Breast Imaging for Cancer Screening' that breast cancer is a leading cause of cancer mortality among women, and figures suggest that this was the most common female cancer - at 34.6 per cent. She indicated that timely screening or mammography has shown a decrease in mortality from this condition by 63 per cent.

As part of its outreach programme and societal commitment to creating awareness of early diagnosis and timely treatment, AKUH has organised over 230 'Signs, Symptoms and Care' programmes in Karachi, Hyderabad and the UAE, benefiting more than 45,000 people. Similarly, Aga Khan University Hospital's Patient Welfare Programme offers financial assistance to those patients who are unable to afford the medical cost of treatment. In 2005, more than 74 per cent of all patients treated at AKUH were from low to middle-income groups. Since the inception of this welfare programme in 1986, over Rs. 1.6 billion has been disbursed to more than 300,000 needy patients.

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