by Nicole Achs Freeling
When treating her young urology patients for problems like bedwetting and bladder infections, Urology Associates of North Texas pediatric urologist Leslie McQuiston, MD, a top expert in the field, finds it helps to have a mother’s perspective.
“I’m a mom, so I understand how moms worry,” says Dr. McQuiston, who recently gave birth to her second son. “I take care of every little person I meet just like I would my own two boys.”worry,” says Dr. McQuiston, who recently gave birth to her second son. “I take care of every little person I meet just like I would my own two boys.”
Such a quality is placing female urologists like Dr. McQuiston in increasingly high demand. Yet, in this dominantly male field, female urologists “are still few and far between,” says Urology Associates of North Texas urologist Diane West, MD, whose practice centers mostly on adult women and men.
But the numbers appear to be on the rise, driven largely by patient demand. Many people — men, women, and children alike — find women easier to talk to about their most intimate health issues. Of the eight female urologists who are in private practice in the North Texas area, six are on the Urology Associates of North Texas staff.
Marie-Blanche Tchetgen, MD, whose areas of expertise include urinary incontinence and other voiding dysfunctions, as well as female pelvic floor reconstruction, is one of these dedicated physicians. Dr. Tchetgen has practiced at Urology Associates of North Texas since 2002.
Putting Patients at Ease
“People are dealing with a lot of embarrassing problems,” Dr. West says. “You really have to be able to talk to them and make them comfortable.” Women may not want to discuss things like leakage, incontinence, and sexual dysfunction with a male physician. They may also feel uncomfortable getting a pelvic exam from a man.
Male patients, meanwhile, are getting more comfortable with the idea of a female physician. Dr. McQuiston recalls the first year she conducted a prostate screening clinic with another physician, who was male. His line was a lot longer, as many of the men were willing to wait to see him.
“Then the guys coming out of my room would talk to those in line and say, ‘Hey, that wasn’t so bad.’ The next year, my line was the longer one and the guys would say, ‘I’m waiting for her,’” says Dr. McQuiston.
Not Just a Guy’s Problem
Having more women in the field does more than provide greater choices for patients. It is also helping push to the forefront urological health issues, which had not been widely known or discussed in the past.
“Incontinence never used to be discussed (at conferences), and now it’s a major topic,” Dr. West says. “This is now becoming true of urinary tract infections (UTIs) and similar complaints.”
People often think of urology as centered on problems of the prostate and male reproductive system. But this is a largely false perception. There are a number of common urological problems that affect women, and as they gain greater attention, more treatment methods are developed to deal with them.
Women are much more likely than men to get UTIs. Some experts estimate that 43% of women between 14 and 61 years old have had at least one UTI. Serious infections can cause kidney problems and, in pregnant women, premature labor.
Just like men, women are increasingly seeking medical advice for sexual dysfunction. Some of the causes — mainly pelvic pain and discomfort during intercourse — may be due to urological problems. Women have also caught up to men in terms of incidence of kidney stones.
But perhaps the most common problem for which women see a urologist is incontinence. Women make up about 80% of the estimated 13 to 19 million Americans who experience this problem, which can affect people of all ages but is estimated to affect one in six people over 40 years old.
The number of treatment options for addressing this highly curable condition has greatly expanded and includes lifestyle changes, medication, and surgery. But many people never seek medical help.
For some patients, a female physician may make the difference between a highly debilitating medical condition and never seeking treatment.
Balancing Work and Family
Dr. West was the only woman urologist in private practice in the North Texas area when she began. She says her practice flourished almost immediately. “There is a demand, and being a woman was a big benefit when starting.”
But choosing urology was not just good for her professionally. It is also extremely rewarding emotionally.
Dr. West decided to go into urology in medical school when she discovered she enjoyed it more than many other areas of surgical specialty.
“To my surprise, I really enjoyed doing the rotations,” she says. “The urologists were all happy. Urologists are said to be a more laid-back group than many other specialists. That may, in part, be because the work they do generally has positive outcomes,” Dr. West says.
Urology is fairly straightforward in that most of the conditions have known causes. Kidney stones, incontinence, bladder infections, and even most of the cancers urologists see are treatable and curable.
Dr. McQuiston and Dr. West agree that, although most female medical students do not consider urology, it is an excellent field for women.
There are fewer emergencies than in other surgical specialties like general surgery, orthopedics, and neurosurgery, making it easier to keep regular hours and maintain a reasonable balance between work and home life.
“When I’ve worked with female medical students, they’ve often said to me, ‘I never would’ve thought of being a urologist until I met you,’” McQuiston says. Now, perhaps, more of them will.
Women Urologists of UANT