urology(redirected from Genitourinary disorders)
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a clinical discipline that deals with diseases of the ureters, urinary bladder, and urethra, with injuries, abnormalities, and tumors of the kidneys, and with diseases of the male genitalia. Originally a branch of surgery, urology became an independent discipline in the 20th century.
In ancient times there was some knowledge of urologic diseases; techniques used by early physicians included perineal lithotomy, the crushing of kidney stones, and catheterization of the urinary bladder. However, only in the 19th century did urology become established as a branch of medical science. In 1869 the German surgeon G. Simon was the first to remove a kidney successfully. The French physician J. C. F. Guyon directed the world’s first urologic clinic in Paris and founded the first urologic society. Other contributions to progress in urology were made by the French urologist L. A. Mercier, the Cuban surgeon J. Albarran y Dominguez, the English surgeon H. Thompson, the Irish surgeon P. Freyer, and the Austrian surgeon L. von Dittel. Further advances in urology were made after the invention of the cystoscope by the German surgeon M. Nitze (1879) and the discovery of X rays, which made X-ray contrast studies possible.
New techniques of diagnosis and treatment were developed in the 20th century, including chromocystoscopy (F. Voelcker and E. Joseph, Germany, 1903), retrograde pyelography (A. von Lichtenberg and Voelcker, Germany, 1906), transurethral electro-resection (J. McCarthy, USA, 1926), intravesical electrocoagulation (E. Beer, USA, 1927), and excretory urography (M. Swick and von Lichtenberg, Germany, 1929). G. Marion in France and J. Israel in Germany developed new types of kidney operations. In 1943 the Dutch urologist W. Kolff was the first to make clinical use of an artificial kidney to control renal insufficiency.
Numerous advances in urology were made in Russia during the 19th century. I. F. Bush invented new urologic instruments, I. V. Buial’skii developed new methods for surgery of the urinary bladder, and N. I. Pirogov described the topographic anatomy of the urogenital organs. The first urologic clinic in a Russian hospital was founded in Odessa in 1863 by T. I. Vdovikovskii, and a urologic clinic was established at Moscow University in 1866. Urologic clinics were founded in the late 19th century at hospitals in St. Petersburg, Kharkov, and Kiev. F. I. Sinitsyn published works on castration as a method for treating tumors of the prostate (1893) and on seminal cysts (1900).
The founder of scientific urology in Russia was S. P. Fedorov, who developed the new surgical procedures of subcapsular nephrectomy and transvesical prostatectomy and founded the Russian Urologic Society in St. Petersburg in 1907. In the early 20th century, B. N. Khol’tsov invented surgical procedures for treating fistulas and strictures of the urethra and for removing tumors of the urinary bladder.
The Soviet surgeons A. V. Vishnevskii and P. D. Solovov developed operations for strictures of the urethra, and A. V. Martynov and S. R. Mirotvortsev devised techniques for transplanting ureters to the intestine. The world’s first attempt to transplant a kidney from a cadaver was made by Iu. Iu. Voronoi in 1933. Other major contributions to Soviet urology were made by V. M. Mysh, R. M. Fronshtein, N. F. Lezhnev, V. A. Gorash, Ia. G. Gotlib, A. P. Frumkin, A. P. Tsulukidze, A. A. Chaika, A. Ia. Pytel’, and A. Ia. Abramian. Because of the high level of development attained in urology in the USSR, 61.9 percent of the persons in the armed forces with injuries of the urogenital tract and 66.1 percent of those with urologic diseases were able to return to duty during the Great Patriotic War (1941–45).
Modern urologic research focuses mainly on inflammatory urologic diseases, mainly pyelonephritis; tumors of the urogenital organs; nephrolithiasis; and acute and chronic renal insufficiency. Effective methods of diagnosis, including angiography and radioisotope scanning, facilitate further progress in urology. Modern methods of reconstructive and plastic surgery include replacement of a ureter or of the urinary bladder with segments of the intestine; polymer prostheses; and transplantation of a ureter to a different area of the urinary bladder or intestine. The first successful transplantation of a kidney from a living donor was performed in the USA by D. Hume (1953) and in the USSR by B. V. Petrovskii (1965). A kidney from a cadaver was transplanted in the USSR by N. A. Lopatkin and Iu. M. Lopukhin (1966).
Specialized branches of urology include phthisic urology, oncologic urology, and gynecologic urology. Allied fields of medicine such as nephrology and sexual pathology are developing in close association with urology.
Major foreign urologists include M. Campbell, F. Hinman, and W. Leadbetter (USA), J. Ferguson (Great Britain), R. Kiiss and R. Couveaire (France), C. Alken (Federal Republic of Germany), F. de Gironcoli and G. Ravasini (Italy), M. Mebel (German Democratic Republic), A. Babies (Hungary), T. Burghele (Rumania), and V. Zvara (Czechoslovakia).
The International Society of Urology, founded in 1907, holds an international congress every three years. The European Society of Urology was founded in 1973. International journals specializing in urology include Urologia Internationalis (Basel, since 1955), European Urology (Basel, since 1968), and International Urology and Nephrology (Budapest, since 1969). In the USSR, the All-Union Society of Urology was founded in 1972, and the First All-Union Congress of Urology was held the same year in Baku. The journal Urologiia (Urology) began publication in 1923; since 1966 it has been called Urologiia i nefrologiia (Urology and Nephrology).
REFERENCESFedorov, S. P. Khirurgiia pochek i mochetochnikov, fascs. 1–6. Moscow-Leningrad, 1923–25.
Opyt sovetskoi meditsiny v Velikoi Otechestvennoi voine, 1941–1945 gg., vol. 13. Edited by A. P. Frumkin. Moscow, 1955.
“Otechestvennaia urologiia za 50 let Sovetskoi vlasti.” Urologiia i nefrologiia, 1967, no. 5.
Rukovodstvo po klinicheskoi urologii. Moscow, 1970.
Pytel’, A. Ia., and N. A. Lopatkin. Urologiia. Moscow, 1970.
Encyclopédie française d’urologie, vols. 1–6. [Published under the direction of A. Pousson and E. Desnos.] Paris, 1914–23.
Campbell, M. F. Principles of Urology. Philadelphia-London, 1957.
Cibert, J., and J. Perrin. Urologie chirurgicale. Paris, 1958.
Handbuch der Urologie, vols. 1–15. Edited by C. E. Alken [et al.]. Berlin-Göttingen-Heidelberg, 1958–75.
N. A. LOPATKIN and A. L. SHABAD