Letter FromPatient

Hi Dr. Chong, Keith and Felicia:

I am doing very well thank you. I intended to write a short note but once I started writing I could not stop.

Keith / Felicia : I have to thank the STB for alerting me to the existence of a Uro-Gynaecological speciality and Dr. Chong. I refer to an advertisement in the Silk Air flight magazine, Feb. 2008. I called Dr. Chong and made an appointment the day I got back to Singapore. I have gone into some detail below, so you may not need to interview me, however, I would like to see the final copy you intend to use before you use it.

Unlike most people with stress incontinence I had sought treatment before visiting Dr. Chong. I had discussed my problem with an Urologist at Gleneagles and his suggestions were unconvincing and far from satisfactory – he suggested narrowing the urinary tract exit by injecting collagen or similar material, he further suggested that the TVT was a new, untried, procedure. I also noticed that all his patients were male and his secretary and nurse were quite surprised to see me. Dr. Chong – Do most Urologists tend to be Andrologists?

My gynaecologist at Mt. Elizabeth, who I have been seeing since 1996, had earlier suggested I do kegle exercises, and that my condition could be easily resolved by exercise especially since I had not had any children. She is a good gynaecologist but made the above suggestion without doing any test or examination. Neither my Gynaecologist of 13 years nor the Urologist I first visited alerted me to the existence of Uro-Dynamic Studies, tests which could determine the severity of my stress incontinence and help determine the course of treatment. So learning about the Uro-Gynae specialty was a godsend. Thanks again STB.

It seems to me that the Uro-Gynaecological speciality is not common nor well-known and that neither Urologist nor Gynaecologists are knowledgeable in this dual specialty space – at least this is my observation. Neither set of specialists, Urologist or Gynaecologists, seem to be able to give helpful advice on the issue of stress incontinence, even to a patient like me who was motivated to find answers.

Dr. Chong you are only listed under gynaecology on the Gleneagles website, perhaps a cross-listing in urology indicating your dual specialty will be helpful
http://www.parkwayhealth.com/DoctorSearch/?txtSpecialty=Urology&txtHospital=Gleneagles&postback=true&txtName=&Go=Search

In light of the above I am happy to help educate stress incontinence sufferers in any way I can, except I don't want my name to be revealed. I have been a professor for the last 20 years in the US and Singapore and have taught a few thousand students – I would not like them to know the details of my private life. Perhaps you should just describe me as "a busy, 40+ business professional who travels extensively."

Having said this, it is precisely the crux of the matter. Stress incontinence is socially embarrassing! In fact, I think many sufferers see incontinence as a sign of physical and mental deterioration and social and personal failure, something that happens to old bedridden people with Alzheimer's or dementia NOT to active, successful professionals who travel the world. Most people with whom I have spoken do not know that there is a difference between urinary incontinence and stress incontinence with different origins and treatment.

Since my operation I have raised the issue with 5 close female friends who are 40+ and moderately overweight . Four admitted that they have had stress-incontinence for at least 2 years or more. All were well educated professionals but none of them had discussed the issue with any one till I raised it with them using my surgery as a starting point. They were relieved that there was a simple "relatively painless" solution, even if the solution was in Singapore and they were in India. There appear to be a few uro-gynaecologists scattered around India (Google hits) but it was not clear what was their experience in treating stress incontinence they seemed more focussed on reconstruction of the vagina and surrounding areas.

Finally, a few nosy individuals were surprised that I was going from India to Singapore for surgery. Don't people come from Singapore to India for surgery? These were not people with whom I wanted to discuss my private life so I didn't satisfy their curiosity.

Pls. feel free to use details from this email for purposes of informing and educating the public BUT please ensure that my name is not used, also, I would like to see the final copy you intend to use before publication