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, practiced 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 which 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 which have direct or indirect urological sequelae. 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 noninvasive).
The Cambridge Urology department
British urology in its current form came into being in 1945; before then, it barely existed as a specialty in its own right, being practised only by a few enthusiastic general surgeons. Urological procedures were normally carried out by surgeons who may, or may not, have had specific training in such procedures. However, it was becoming clear that urology had a stand-alone role to play and that there was a specific need to train specialist urological surgeons.
A group of surgeons, therefore, addressed this issue by founding the British Association of Urological Surgeons (opens in a new tab) in 1945; they oversaw the development of the specialty in the UK but, more importantly, paved the way for highly-trained surgeons to perform urological procedures to a high degree of competence.