What is Urology?

The Urology Department is involved in the surgical and other types of treatment of diseases of the urinary tract. These include cancer of the prostate, testis, bladder and kidneys; stone disease; and all aspects of bladder dysfunction and incontinence.

Diseases of the genitourinary tract have been recognized for thousands of years. The mummified body of a child, probably at least 5000 years old and discovered in Egypt, was found to contain a large bladder stone. Circumcision was probably the first surgical procedure ever performed on a regular basis and bladder stones were recognized by Hippocrates.

"Stone cutters", or travelling lithotomists, practised bladder stone removal throughout Europe in the 17th century. The diarist Samuel Pepys graphically described removal of his bladder stone by a lithotomist and survived the ordeal; many were not so lucky. However, urology as a specialty in its own right was only instituted in 1890 with the appointment of Felix Guyon in Paris as the first Professor of Urology.

Important Developments

No history of the development of urology is complete without mention of the contribution made by equipment companies. The mainstay of urology has always been telescopic examination of the urinary tract that was, until the 1950s, necessarily crude. Early attempts at transmitting light down rigid telescopes were nothing if not innovative, ranging from candles to battery-driven lamps, but were fraught with the dual problems of clarity and reliability.

The crucial breakthrough, in the mid-1950s, was the development of the Hopkins® rod lens system. This revolutionized urology by providing robust, versatile, reliable and sterilizable endoscopic equipment and "cold" light sources which allowed high-quality visualization of the interior of the urinary tract. The later addition of fibreoptic (flexible) endoscopes and endoscopic video cameras further enhanced operative urology. Such equipment was instrumental in the establishment of urology as a bona fide specialty in the 20th century.

The Status of British Urology

The speed at which urology has developed in the 20th century has been astonishing, even to those working in the field; current work patterns bear little resemblance to those from only 10 years ago. 50% of all congenital abnormalities are urological and 25% of GP consultations are for urological disorders. Stone disease remains common in developed and pre-industrialized countries whilst prostate disease affects 75% of men over the age of 50.

The ageing population will, as they live longer, become more likely to develop systemic diseases that have direct or indirect urological consequences. For example, urological tumours have now become one of the leading causes of cancer death in the male population. Urologists, therefore, have a constantly changing role to play by combining the science of urology with developments in techniques, diagnostics and treatment (both invasive and non-invasive).

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