Clinical Overview & Personal Reflection

Breaking the Silence on Female Proctological Health

For over 14 years in surgical practice across Vidarbha, one reality has confronted me repeatedly: women suffer longer, bear deeper pain in silence, and present with significantly more advanced anorectal pathology than men.

This disparity is rarely biological. It is social, cultural, and emotional. When an anorectal condition like piles, an anal fissure, or a fistula develops, women in our communities frequently delay seeking medical consultation for months—and occasionally years—solely out of profound embarrassment at the prospect of being examined by a male surgeon.

The Access Gap in Vidarbha and Rural Maharashtra

In our regional healthcare landscape, specialized female surgeons with MS degrees in Shalya Tantra (Surgery) are exceptionally rare. As a consequence:

  1. Self-Medication & Complications: Women rely on counter laxatives, steroid ointments, or quack pastes until chronic fissures develop fibrosed sentinel tags or fistulas form secondary extensions.
  2. Postpartum Neglect: Haemorrhoidal thrombosis and severe constipation following childbirth are accepted as "inevitable normal burdens" rather than treatable clinical problems.
  3. Loss of Dignity: When forced by excruciating pain into emergency care, women often experience cold, hurried examinations that exacerbate trauma and anxiety.

The Architecture of the Female Care Unit

At Shri Manmukund Hospital, Amravati, I created the Dedicated Female Care Unit to dismantle this barrier completely:

1. Absolute Modesty and Clinical Privacy

From the consultation desk to the examination couch, female patients interact exclusively with female nursing staff and myself. Examinations are conducted with proper draping, warm ambient lighting, and unhurried clinical explanations.

2. Dual Specialty Integration

My clinical training bridges both Anorectal Shalya Tantra (Ksharsutra, laser, fissure management) and Stri Roga (Ayurvedic Gynaecology, Uttarbasti, Garbhsanskara). This integration is crucial because pelvic floor dysfunction, chronic constipation, and gynaecological disorders (such as uterine prolapse or postpartum laxity) frequently coexist.

3. Patient Accompaniment

We explicitly encourage patients to bring their mothers, sisters, or husbands into the consultation room. Transparency removes fear, fosters family support, and ensures that home dietary instructions are embraced collectively.

Core Conditions Managed at the Unit

  • Female Proctology: Grade 1–4 Piles, Acute & Chronic Fissures (Parikartika), Complex Fistula (Bhagandar), Pilonidal Sinus.
  • Infertility Interventions: Specialized intrauterine Uttarbasti for tubal blockages and thin endometrium.
  • Maternal Health: Masanumasik Garbhsanskara and postpartum perineal healing (Sutika Paricharya).
  • Pelvic Health: Chronic pelvic congestion, dyspareunia associated with pelvic floor hypertonicity, and recurrent leucorrhoea.

A Message to Women Suffering in Silence

If you have been enduring rectal pain, bleeding, or pelvic distress because you cannot bear the thought of a male examination: your pain is real, your modesty is sacred, and you do not have to live with this condition.

You are warmly welcomed to consult in an environment where your dignity is guarded as fiercely as your clinical recovery.

Dr. Swati Tongale, MS (Ayurveda) Shalya Tantra, is Chief Ayurvedic Surgeon and Lead of the Female Care Unit at Shri Manmukund Hospital, Amravati.