ABSTRACT
"Disease in an individual has personal and immediate family stress and certainly has undesirable effects on the socio-economic health of the country. Urological diseases share this general attribute but have peculia characteristics that make it stand out. Most of the patients seen in the urological clinic are senior citizens; towards the evening of their lives. The majority present with urinary tract obstruction from either disease of the prostate or lower urinary tract narrowing from scarring due to infection or trauma (urinary stictures). This touches an area of significant sensitivity from the cultural point of view. Most societies in our country lead a puritan image to old age; thus patients with genitourinary complaints sometimes fear to present themselves lest they are regarded as having venereal diseases. Genitalia are also accorded awesome privacy and mentioning the genetal parts in public is regarded as taboo and in some cases a breach of this etiquette was punishable in some of our societies. Disease of these parts therefore is presented to the medical personnel with a lot of reluctancy and this is compounded by the fact that the sufferers are in most cases dependent socio-economically thus lacking the priviledge of presenting themselves to their doctors without involving a third party who would normally facilitate treatment. Urology disease is mainly a problem of the elderly with rather reduced physiological reserves; their treatment calls for extensive clinical examination and widely varied laboratory investigations. This is aggravated by the late manner of presentation with complications; thus rendering the whole work up a very expensive affair. In the developed world; prostate enlargement with symptoms is regarded as a ""quality of life"" disease but in the third world where it presents with late complciations it is a ""life threatening"" disease; therefore; requiring more extensive investigation. This highlights the irony of the poor paying more than the rich."