Genital Hygiene is More in Rural than Urban Areas, Stones are Most Common in People After UTI”

There are several diseases which we designate as urological problems. Some are common in men and some in women. The commonest problem in India is uninary tract infection. After that comes stones which are common in both men and women, however, men have a higher rate of having stone diseases where women get more of infectious diseases which may pass on to men during sexual intercourse. Another disease which is common in men is that of the prostrate.
As a urologist, I would say that we have a high rate of uninary infections in our country. At any given time, you have got a fair number of patients in India at any given hospital which have infections of the urinary tract. Among these, Uroscepsis is life threatening.
The causes of Uroscepsis are hygiene related and to the surprise of many, the rural areas still fare better than their urban counterparts.
The reason being that the people in the rural areas use Indian system of toilets where upon cleaning their private parts after relieving themselves, the stool and other germs are washed down the drain. This may not happen sometimes in western toilets with the attached hand held jet pressures as while washing the private parts, they force the stool upwards and more towards the body.
This how stool particles get trapped in women’s private parts and may get sexually transmitted to men’s seminal vesicles. In men, the stool particles may get trapped in scrotum and the infections arising from there may get transmitted to women during sex.
Another big issue of genital hygiene which we face in our patients is the lack of awareness regarding cleanliness of the skin of penis after sex as the semen is often trapped in that region possibly leading to an infection. The kinds of advertisements of treatment of sexual problems we see on the walls alongside railway tracks is because they are rampant and happen due to lack of sexual hygiene.
We receive a lot of patients who have absolutely no awareness about hygiene and cleaning of the skin of their private parts. Out of sheer laziness, the youngsters are using Western mode of toilets with jets and by using jets they unknowingly invite infections. Many times these infections make their way into our prostrate which results in prostatitis. Further they go can cause cistisis and when they make their way to kidneys, they cause Pyelonephritis. The last two occur mostly in females.
Another common urological problem is stone disease. Many patients we receive are genetically predisposed to it. In men, we have occurences of stone diseases 3-4 times more than women. Stone diseases are cases of polygenic inheritance and atleast eight genes have to be there to be transferred from other patients so that one is predisposed to stone formation. But people who are more prone to stone formation in this part of the world have lot of crystallization. So people who drink less water have saturation, super saturation and eventually it leads to aggregation of these crystals and they ultimately form stones. Almost 80% of stones pass on their own and therefore we don’t call it a disease. We call them disease only when they are a source of infection or causing any obstruction in the urinary tract, unrinary bladder or urethra is detrimental to the health of the kidneys and to prevent any kind of damage to kidneys the stones should be removed at the earliest.

Role of Govt. Urology Treatment

Many challenges in the treatment of urological diseases can be met when the government takes an active interest in controlling it. The problem on the level of government is that our bugdet is too less. So government can play the role of improving the budget. Now the question is how are the government can help us with medical budget.
If you go to any developed world, the hospitals don’t have the kind of problems which we have in India. Hospitals there have to deal with heart disease, cerebral-vascular diseases, many types of cancer etc. Here we do have patients with such diseases but we have an additional burden of dealing with various types of infectious diseases also like Dengue, Malaria, Pnemonia, uninary tract infection.
These root cause of these infections are pollution, lack of hygiene and awareness.
Hence the intervention of the government to fight such infections diseases, many of which prove deadly, is very necessary. The government should try to  control these diseases both on national and state level. For instance, the much feared Dengue outbreak was controlled state-wise here where as the same problem is rampant today in states like Rajasthan. So, if we take an overall scenario, we have a lot of infectious diseases in our country.
Lastly, it can be said that all these dangerous infections are still preventable given we start creating awareness about them using simple terms. With more and more people knowing their share about genital hygiene, the fear of deadly infections like Uroscepsis could be dealt with effectively.
-Dr. Anil Varshney is MBBS, MS, PH.D, FIMSA (Urology). He is the director of Urology Department in Max Super Speciality Hospital, Shalimar Bagh
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