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The history of urology starts with written documents making express reference to procedures, practices and descriptions of morbid processes related with the male genitourinary tract. Oddly, the most recent prehistoric period, the superior Paleolithic (from approximately 40.000 years to 12.000 years ago; the longest period since our species entered the history of humanity) also has graphic documents expressing how the human being understood the physiologic phenomena and how he observed the pathologic processes of this organism. The representations with genitality expressions enable us to understand the meaning of erection from the Paleolithic perspective, and even the possible existence of a culture based on preputial retraction or rituals of circumcision. Several urologic disorders such us phimosis, paraphimosis, discharge, priapism, and even scrotal mass appear represented at that time and constitute the first sign of knowledge of what can be called primitive urologic knowledge.
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OBJECTIVES: To perform a study on the surgical work of Abulcasis in the field of urology, to know the surgical tools and different techniques used, as well as the innovations applied to solve some features of urological diseases.METHODS: The part on urology from the book XXX by Tasrif, the edition from Strasbourg in 1532 was reviewed and translated from Latin.RESULTS: The author does not refer much to the clinical features of the various pathologies of the genitourinary apparatus; he focuses instead on the surgical treatment of them. The author usually used the “cautery” mainly to control hemorrhage in various operations. Some of these surgical practices are being used nowadays.CONCLUSIONS : Abulcasis was the first doctor born in Spain that studied the surgical treatment of urological diseases and performed a graphic study on the tools used. He introduced technical innovations on different operations and described for the first time the vesical lithotomy on women, and vesical and urethral lithotripsy.
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In the Middle Ages medical texts the notes about personal hygiene are scarce and they are dedicated to the Kings or the aristocracy. In his work Regimen sanitatis ad inclytum regen Aragorum, Arnaldo de Vilanova underlines six things that are necessary for cleanliness, among which he includes his well-known proposition Conservatio juventute preservatio senectute. We compared his text with those from other authors with references to the issue and, once examined, Vilanova’ s work stands out. Doctors in the middle ages were already interested in aging and propositions considered today as modern are found described in various works from that period.
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OBJECTIVES: To make known, comprehensively, an almost unknown episode in the life of Dr. Francisco Diaz (1527-1590), surgeon of the king Philip II, and author of the first urology treaty in the history of medicine. To our knowledge, to date there were few references about the participation that, as an expert, Francisco Diaz had to have in the inquisitorial process against Elena de Cespedes, a presumed hermaphrodite accused by the Inquisition because being a woman married another one pretending to be a man. The trial was carried out in Toledo in 1587 and had great impact in that time, because the accused, dressing with male clothes and usurping the prerogatives of a man, had gotten by fraud titles and favours which were forbidden for women, the title of surgeon among them. Except for the reference by Folch Jou and Burshatin, both short and incomplete, no other author or biographer of the famous surgeon had cited this episode of his life, which to our judgment could mean a great damage to his reputation. METHODS: We reviewed the works by the two afore-mentioned authors, all the works and biographies about Dr. Francisco Diaz that we could found, and microfilmed and transcript the whole bundle 234, expedient 24, from the section Inquisition at the National Historical Archive in Madrid, corresponding to Elena de Cespedes (alias Eleno) (> 500 pages) to obtain the greatest amount of data about the accused and the performance of Dr. Francisco Diaz. RESULTS AND CONCLUSIONS: Francisco Diaz was requested, as an expert, by the Vicar of Madrid to per- form the examination of the genitourinary organs to give or not marriage license to that woman saying she was a man. In his report in the year 1586, surprisingly the urologist declared that the petitioner was a man. As it would be demonstrated during the trial, the accused, who alleged being hermaphrodite in her defense, had been able to deceive the expert with her tricks altering her genital morphology. Thanks to her surgical knowledge she had mutilated herself surgically closing her vagina and placed a device to simulate she was a male. At the end, after the opinion of the counter experts of the Inquisition Francisco Diaz had to retract, confirmed that the accused was a female, and accused her of witchcraft to save his responsibility. Nevertheless, in the work we conclude that the accused was a male transsexual, which, in part, would excuse the urologist’s error 400 years later.
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OBJECTIVES: The study of the anatomical works written by Martín Martinez and his relationship with urology. Also, the appreciation of his open scien-tific mentality and scepticism in a historic environment imbued of a scholastic spirit and dogmatism.METHODS: Several Martin Martinez’s works were re-viewed, mainly the treaty Complete human anatomy, entire text obtained from the electronic page of the Com-plutense University library, and also the words from other authors of his time.RESULTS: The medical and philosophical personality of Martin Martinez and his influence in the medical knowledge in the Spanish Court during the first quarter of the 18th century are ascertained. The importance he had as Professor of anatomy in the functioning and deve-lopment of the Madrid’s Anatomical Amphitheater in the General Hospital and his positive repercussion on the training of students and surgeons of that time and poste-rior years is appreciated. Writing his works in Spanish contributed to it.CONCLUSIONS: Although he cannot be considered an outstanding scientific personality in comparison with authors from other European countries, he must be re-cognized for his great merit with his open mind and his labour against dogmatism in front of the blocked-in-ser-vility medical mentality, and also in the study of classic authors from previous centuries.
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The study of the urological activity in the Andalusian occident is contained in the printed and handwritten “Observations” of the records of the Royal Society of Medicine of Seville and the Royal College of Surgery of Cadiz. They encompass the period from 1693 to the first third of the 18th century. By the first of October 1701, the “Veneranda” gathering consolidates and Philip V gives the “royal warrant”. The “Royal So-ciety of Medicine and Other Sciences of Seville” starts its medical-surgical path. It should be reminded that all the Andalusian surgery and specially the one from Ca-diz (through the Royal College of Surgeons) was present in the Royal Society. Ordoñez de la Barrera, Sánchez Bernal, Fray Ambrosio de Guibeville, Juan Lacombe, Pedro Virgili and many others were founders of this ex-traordinary event.Surgical training and, by extension, urological training had their root and basement in the anatomical amphi-theaters (Seville 1731 and Cadiz 1728), which were considered ungodly by the Church.José Celestino Mutis (1750-53) and Pedro Fernandez Castilla (1741) excluded the university from this new movement.There was and intense relationship between Navy sur-geons and the Royal Society, being members since its foundation: Guibeville (1719); Sánchez Bernal (1719); Gregorio Arias (1729); Gaspar de Pellicer (1729); Lacombe (1730); Fernández Castilla (1741); Calero (1789). The main protagonist was Luis Montero, real paradigm with projection to the next century, having a neat French influence altogether with Ramos, both of them being Beaumond’s alumni ( an anatomist of recog-nized prestige).
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OBJECTIVES: Gaspar Casal (Gerona, 1680, Madrid, 1759) made most of his medical work in Oviedo (Asturias, Spain), where he lived for thirty-four years, before his return to Madrid as a doctor for the Royal House. Fruits of this work is the book “Natural and medical history of the Principality of Asturias” (Madrid, 1762), considered the best exponent of the Spanish medicine of the 18th century, and where the “disease of the rose”, known later as pellagra or hypovitaminosis B, was first described in. METHODS: Study of the life of Gaspar Casal and analysis of “Natural and medical history of the Principality of Asturias”, speculating on the knowledge about nephro-urologic and external genitalia diseases that can be deduced from the text. RESULTS: Casal knows and treats kidney lithiasis, relating it either to joint diseases and gout, or to dietetic excess and sedentary life in some of his patients. Other diseases coursing with poliuria and oedemas, are compatible with the nowadays diagnosis of infectious or degenerative nephritis. He rarely uses a bladder catheter for cases of stranguria and anuria , probably including some patients with anuria and others with urinary retention in the term “renal ischuria or high suppression”, although he also uses the term “vesical ischuria” for the last ones. He treats the symptoms disuria-stranguria and haematuria, with empiric therapy, and, as it may be deduced from the text, some local surgeons didn’t use or know to alleviate those symptoms with urethral catheterisation. He attends an epidemics of mumps, with orchitis in male patients, that were treated with bloodletting, although he stood against the misuse of phlebotomy in several diseases. Only occasionally he orders surgical treatment for several testis diseases.CONCLUSIONS: “Natural and medical history of the Principality of Asturias” reflects the spectrum of diseases that conforms the day-to-day working schedule of a Spanish family doctor in the beginning of the 18th century, that is to say: diseases resulting from dietary shortage, infective, parasite, degenerative and vascular-cerebral diseases in older patients. From the nephrourologic point of view, it is very interesting to read about the knowledge on stone diseases and lower urinary tract symptoms, that were treated as recommended by the classic authors, with physical therapy and empiric formulas, rarely with bladder catheterization. To a lesser degree, the results of the medical treatment of orchitis and the surgical treatment of some testis diseases are also depicted.
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The famous painter Francisco de Goyay Lucientes (1746-1828) suffered during his life one orseveral diseases, the nature of which has not been deter-mined with certainty. The partially documented morbidepisodes that happened during the years 1792-1793in Seville and Cadiz, 1819 in Madrid, and 1825 inBordeaux could be related. In the latter one, the urolo-gical signs and symptoms the distinguished patient pre-sented have been demonstrated.The objective of this paper is to propose the hypothesisof neurosyphilis’ dorsal tabes responsible for the voi-ding disorders he presented in Bordeaux in the springof 1825, having as a resource Goya’s “diplomatario”,with the letters and documents that have been collectedand made known to date , with the purpose of using aninductive-deductive method for their study and interpre-tation, setting an interrelation between these valuablesources with both the medical knowledge of the periodand the current, particularly in urological features, andreviewing the available bibliography on that topic, withthe natural reserve about giving a retrospective diagno-sis which cannot be completely true due to its inherentcharacteristics.In the same way, and as a complement, we include abrief review of some circumstances and characters thatsurrounded the artist in France to help to incardinate andbetter understand the personality of Goya, already oldand sick at that time
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The present work describes the figure of Dr.Federico Rubio y Gali, pioneer and promoter of Spa-nish Medicine during the 19th century, as well as the repercussion of his scientific talent in the development of modern urology. It is also mentioned the creation of the Free School of Medicine and Surgery of Seville, as concretion of his educational vocation and contribution to the teaching of urological knowledge.
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OBJECTIVES: We present a biographical sketch of Dr. Suarez de Mendoza, one of the first urologists trained as so in the Necker Hospital in Paris with Dr. Guyon, who opened the field to the creation of this speciality in Spain, and first official professor of the subject of in the Faculty of Medicine of Madrid.METHODS: We reviewed his academic expedient in the National Historical Archive and search for data about his presence in Spain in the Faculty of Medicine and Medical College of Madrid. From the Royal Decrees we obtained information about the Free School of Medicine, and the creation of medical specialities in the University study plans; finally, we analyzed his written works.RESULTS /CONCLUSIONS: We consider Dr. Suarez de Mendoza one of the personalities giving entity to Urology in our country, for his education, for the amplitude of his knowledge, and for his wide experience, as professor of the subject in the Spanish University, as author of a great number of published works, and as inventor of his contributions to the development of anesthesia and urology. His treaty, the first in Spanish covering in detail the innovations in urological examination methods, enables us to know and value the progressive advance and evolution of knowledge in urology.
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OBJECTIVES: After the death of Professor Francisco Romero Aguirre (Zaragoza 6/7/1918-6/28/2006) we want to make known his great teaching vocation, so that we covered his link with University from the start of his studies to his professorship as first professor in urology in the Spanish University (1961), and his work at the chairmanship of the Professional Postgraduate School of Urology in the University of Zaragoza.METHODS: We reviewed his biography, his edited works and publications of the Urology Chair at the University of Zaragoza, and obtained as many references as we found about his teaching activity.RESULTS: From the start of his academic training he kept a constant union with University and cooperated in all disciplines he had relation with before he got the responsibility of teaching urology. His university spirit and great formation had the chairman of surgical pathology see the convenience of separating urology from the common trunk of surgery, a proposal that, being accepted by the staff meeting of the Faculty of Medicine of Zaragoza and submitted to the Ministry resulted in the designation of urology as an independent subject in the degree of medicine. His labour as responsible was marked by work and continuous achievements in his classes, many publications, doctorate and urological monographic courses carried out, thesis and memories directed, all of which enabled him to create to the Professional Urological Specialization School, the culmination of more than 40 years dedicated to teaching in the university.CONCLUSIONS: We find Prof. Romero’s life completely dedicated to University and teaching. His wide urological and propedeutical formation made him a person who joined the necessary conditions and abilities to take the responsibility and carry out a satisfactory performance as responsible of teaching urology in the school of medicine of Zaragoza, a subject which thanks to his virtue and good performance was for the first time elevated to the level of independent subject.
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We present a summary of the most interesting works and commentaries by Dr. Narciso Serrallach Mauri, presented in Urological Records, a journal edited under his direction continuously from 1913 to 1935, annually or every six months. The state-of-the-art urological topics of the time rising the highest interest can be found in the journal, as well as in the publications and activities of the medical societies where he carried out his professional urological activity. We also emphasize the evaluation of his activity in relation to the estate of science and society at his time.
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OBJECTIVES: To show the beginning of spinal and epidural anesthesia in our country and the contributions of Spanish urologists. METHODS: We reviewed books and writings of History of Medicine, Urology and Anesthesia and Doctoral thesis about spinal and epidural anesthesia. RESULTS: In the 20th century, surgeons also gave the anesthetic drugs to the patients. Spinal and epidural anesthesia were used for the first time in 1900. A lot of Spanish urologists like F. Rusca Doménech, J.M. Batrina, M. Barragán Bonet, R. Lozano Monzón, L. Guedea Calvo, Gil Vernet, Fidel Pagés Miravé, V. Sagarra Lascu- raín, Gómez Ulla, etc, did research, writings in scientific journals and Doctoral thesis about anesthesia.
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Our work is based on 11 field notebooks with his notes and descriptions of macroscopic and microscopic anatomic preparations. There is also one notebook with several handmade drawings on black lead pencil, reproducing the microscopic anatomy of the bladder neck; there are also five 60 x 40 cm prints with histologic drawings, several histologic preparations, as well as several letter papers with Dr. Salvador’s letterhead in his various institutional aspects.
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In this paper we describe the history of the development of rigid ureterorenoscopy. It started in 1979 and today is a reality in most urological departments of the world.From the first ureterorenoscope with a extraordinarily large caliber and no dilation or operative systems, the current technique have developed, so that from hydraulic water pump to laser fragmentation have enabled to make ureterorenoscopy a common procedure for the resolution of urinary stones, extraction of foreign bodies in the ureter or kidney, treatment of stenosis, diagnosis of unilateral hematuria and endourological treatment of selected urothelial tumors.
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OBJECTIVES: The author describes his first steps in laparoscopic surgery and the sources of some of his ideas. He thanks his father’s influence and the technical stimuli that catalysed his scientific curiosity. For the benefit of young urologists at the beginning of their careers he shows how the frustrations of working with the early instruments became the vital challenges that inspired creative solutions.METHODS: His urological surgeon father inspired in his young son a passion for his calling. He developed an immediate and compelling interest in the shape and function of urological instruments like, for example, Freyer’s lithotripter and the Iglesias resectoscope. Books of urological history and the works of pioneer urologists fascinated him. Watching José María Gil Vernet operate particularly impressed him and he says that Gil Vernet was the first urologist he saw using a laparoscope to diagnose an abdominal testicle. While working in an Oxford University hospital in 1985, he designed a balloon device to dissect the retropubic space. This procedure was the precursor of what several years later became extraperitoneal surgery. The following year, he read the manual of Semm’s laparoscopy and later described a laparoscopic varicocelectomy. In 1993, he published the first description of a laparoscopic radical cystectomy and ileal conduit. In 1997, he adapted a surgical robotic system with a master-slave arm to carry out firstly a transurethral resection.RESULTS/CONCLUSIONS: He says that a good idea is beyond price because it helps the inspired individual to make true a long-held ambition and achieve the signal success that lifts him out of the mud of mediocrity.
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OBJECTIVES: We can say that in military hospitals, pioneer institutions in health-care in our country, approximately 25% of the pathology over the second half of the 19th century would correspond to sexually transmitted diseases (STD,) with hospital wards dedicated to these diseases , initially associated with genitourinary diseases. The “military drip” or blennorrhagic ure thritis was a venereal disease with great incidence and prevalence in the pre-antibiotic era. This article reviews the diagnostic and therapeutic methods employed by Spanish military doctors during such period.METHODS: In the introduction we state the relationship between the knowledge of the time and the environment in which military doctors developed their professional activity. We make reference to military health-care journals, vehicle for their worries and demonstration of the level of theoretical and practical knowledge they were distinguished for. Based on their service records and publications we refer the urologists from the military health-care system that showed a greater interest in the field of urethral diseases, talking about the methodology they used for diagnosis and treatment of blennorrhagic urethritis.RESULTS AND CONCLUSIONS: Military health-care at the end of 18th century and the beginning of the 19th century joined a group of professionals who demonstrated talent and perseverance in the treatment of “military drip”.To know the concepts for the diagnosis and treatment of urethritis improves our perspective in the knowledge of these pathologies, and confirms us in the evaluation of the advances available for us today, thanks to the addition of efforts of our predecessors.
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We give a historical outline of urinary lithiasis with emphasis in the alternative therapeutic options to surgery.We expose the previous steps that led to the birth of extracorporeal shockwave lithotripsy and its implementation in our country.
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Mechanized procedure for the treatment of female stress urinary incontinence. Retropubic fixation of the vagina with a stapler specifically designed, using the pubis’ symphysis as the site for anchoring. We intend to demonstrate the physiopathologic rationale to achieve continence by anchoring the urethra. In our elementary conditions for research and development we could not design the suitable procedure, although the idea was presented to international companies.We summarize the development of the instrument until it was operative, filming one operation which was presented to the Hispanic-American Congress in Madrid 1992.The instrument was patented in the Spanish Office of Patents and Trademarks in July 1992 with the category of invention patent because there were no previous mechanized procedures for vaginal fixation.
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Carlos Younger de la Peña (1920-1996) was one of the representative urologists of his time, both in urology as a whole and particularly in urology in Madrid, during the 40 years between 1945 to 1985. His professional training was linked to the department of urology in the “La Princesa” Hospital chaired by Dr. Pedro Cifuentes Díaz first and Luis Cifuentes Delatte posteriorly. The important influence of French urology led Carlos Younger to complete his studies in the departments of urology chaired by professors J. Cibert (Lyon),Truc (Montpellier) and Couvelaire (Paris). When he returned from France he completed his doctoral thesis with the title “Experimental study on the ureterosigmoidostomy type Coffey I” directed by Prof. J. Garcia Orcoyen in 1957. His first publications started in 1946 and he ended with almost 100, including communications to various speciality congresses and meetings. Established in his private clinic in the Ferraz Street in Madrid he alternated his professional practice between Social Security patients and the Red Cross Central Hospital. At the end of his life he had collected near to 10.000 patients’ clinical records.He was member of various scientific societies (among them the International Society Of Nephrology) and received various awards such as the one from the Pediatric Surgeons Association for his work on “bladder exstrophy “and the one from the Medical Academy of Valladolid for his study “Vascular renal hypertension”. In 1961 he performed the second renal transplant in Spain. His professional interest was preferentially focused on uro-oncology, pediatric urology, gynecologic urology, and endoscopic surgery. He left many disciples with the same interests. The professional life of Carlos Younger de la Peña, in the period of time under analysis, is much significant as a reflex of the evolution of urology and urologists over half a century.
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OBJECTIVES: With the occasion of the Centenary of the Constitution in 1907 of the International Society of Urology, initially named Association, we point at the topics treated and analyze the presence of the Spanish urologists in the foundation act as well as their role and contributions in the meetings during the 20th century.METHODS: We obtained the data from the information in various periodic publications, from the memories of some participant urologists and from the meeting records.RESULTS: We obtained notes from the foundation meeting of the International Association and two congresses, and also from the 25 congresses of the Society. We mainly extract data from the records edited by the meeting secretary, about the assistance of Spanish urologists and their contribution with conferences or communications and also about the relevance they have had holding positions within the organization.CONCLUSIONS: From 1907 the presence of Spanish urologists both in the Association and the International Society of Urology has been a constant. During the first half of the century, a time when our Urology was in a period of consolidation, the people in charge of the main urology departments in big hospitals in our country where the ones that could transmit their experience, with a level and quality comparable with the rest of Europeans. During the second half, once the nations recovered from wars, the scientific activity continued with an increasing Spanish contribution, which extended all over the country with the creation of the net of Social Security hospitals. They had hierarchical urology departments that performed study and analysis of their case series and started clinical and experimental research, significantly increasing the number of Spanish communications, mainly in congresses celebrated in Spanish speaking or European cities. As a consequence of their participation, three of the 25 meetings organized during the 20th century have been held in Spain. The Spanish presence in the directing boards of the society was favoured by the presence of Dr. Salvador Gil Vernet to consecutive periods.
