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Why The Urologist Is Usually A Man, But Maybe Not For Long

If you need to see a urologist, the odds are very good that your doctor will be a man. Only about 8 percent of the practicing urologists are female, according to a poll from WebMD that includes gender distribution among medical specialties.

The fact that there are few female urologists might not seem shocking – urologists spend a lot of time looking at penises. But they also treat a wide variety of urinary tract and kidney health problems in both men and women.

"It's not all male genitalia!" says Dr. Leslie Rickey, a practicing urologist and associate professor at the Yale School of Medicine. "It's the kidneys and the urinary tract. And as you may or may not be aware, there are a lot of women leaking urine out there."

Rickey is the president of the Society for Women in Urology, an organization dedicated to supporting and promoting women in urology. It started in the 1980s with just a handful of women. Even though both the society and the number of female urologists have grown, there's still room to improve.

"I think people are blind if they don't think gender disparity exists in most fields," says Rickey, explaining that she doesn't think the issue is unique to urology. "You want to be on a level playing field, and I don't know if the playing field is level, really."

Indeed, a quick glance at the WebMD data finds that although urology has the biggest gender disparity, other specialties aren't far behind. Just 9 percent of orthopedists are female, as are 12 percent of cardiologists. It's not until you get to pediatrics and OB-GYN that you see real parity, with the specialties split 50/50 between women and men.

Rickey says that the number of women entering urology is growing: of the people training to be urologists now, 25 percent are women. But the growth is slow. It's unusual to have more than one female in a urology practice, even though women are an asset, says Rickey. "I think it's beneficial to have a female because people will seek [her] out." She also says that women often hesitate to come to the doctor with urinary tract problems. "If men had something falling out of their penis they would go to the urologist immediately."

And a lot of that hesitation comes from a misconception of the field. Most people know that urologists treat male problems like prostate cancer and erectile dysfunction. But they also work with people who have kidney cancers, kidney infections, kidney stones and urinary incontinence. And that last one affects mostly women.

"That was my mom's reaction: 'Isn't that old men and penises?' " recalls Rickey. "And I said 'No, no, no, there are vaginas, too.' " If her words sound crass, that's part of the fun. "Urologists tend to have a really good sense of humor – I mean, you're dealing with penises and vaginas." She laughs.

For Dr. , a urologist in Houston, her peers were part of the draw. She had initially wanted to be a gynecologist, but the personalities in the field made her hesitate. "Some gynecologists are tough to get along with," she says. "A lot of the women were harder to get along with than the guys."

Pramudji really likes the surgeries that she gets to perform as a urologist, but she also remembers really liking the other urologists she met during a fellowship. And she really likes her colleagues now. "They're very smart, but they're also very genial and they have a great sense of humor."

Pramudji is a little unusual in the field — she actually only sees women. But she says she misses having men as patients. It's more a matter of who chooses to see her. "As soon as the women learned that there was a female urologist, they just flocked," she says. "And I thought it was a conspiracy within my group that they were giving [me] all the female patients."

When she decided to leave and start her own practice, she made female urology her focus. "For women it's just so nice to have a women-only place," she explains. "I could just see a need for that and a niche."

All three urologists say that a big draw for them was the connections they could form with patients. "You follow these patients forever," says Ellen Goldmark, a urologist with offices in Wheaton, Rockville and Germantown, Md. "You form a relationship. And that was important to me, too, because I like patients. It was important for me to connect with patients."

With more female urologists, patients will have more choice in who gets to be their doctor. It doesn't matter whether the patients are more comfortable around males or females, as long as people with urology problems find someone they trust to provide care.

Copyright 2021 NPR. To see more, visit https://www.npr.org.

Poncie Rutsch