PRECONGRESS WORKSHOP, 2002, April 11th - Budapest, Hungary.

History of pediatric urology in Hungary

A Csontai, Budapest - Hungary

Hungary is the second country in the Europe after France, where urological surgery began to be endependent and separate from general surgery. Excellent Hungarian urologists did a pioneering job in diagnosis as well as in surgical interventions. Until the 1950’s there had been only rather limited resources for urological treatment of the newborns and children.

The reasons for these were: the lack of well qualified experts, no background of anaesthesiology and intensive treatment, no endoscopy instruments.
At the Urology Clinic of Budapest University of Medical Science, it was Vondra who dealt with paediatric urology for the first time. Among his activity as special team grew up, which mastered the profession at an ever increasing level. The rapid development of diagnostic and surgical operation technique had its effects on the paediatric urology as well. In 1973, in Heim Pal Children’s Hospital, Budapest, the first independent paediatric urology department was established with 13 beds. The head of this new unit was Jozsef Toth. A team of experts, able to handle special tasks excellently, was brought up under his direction.
Since 1988 the department works with 30 beds and performs the most state –of –the art open and enoscopic operations in the country with full diagnostic background. However, there are no more paediatric urology departments in Hungary most of the cases are done by paediatric surgeons.

Genitalia, gender and surgery-A historical perspective

A J Casale M.D., Indiana - USA

The presentation is a review of how western civilization has regarded intersex states since antiquity and relies on the depiction of intersex in art, mythlology and law.
The dichotomy of public fascination of the concept of intersex is contrasted with intolerance of the individual born with ambiguous genitalia in many societies.
These intersex is contrasted with intolerance of the individual born with ambiguous genitalia in many societies. These issues are followed throughout history to the present.
Paralelling the changing attitudes of society for the past century is the development of genital surgery for intersex. The lecture highlights the major contributions to the development of surgical reconstruction of ambiguous genitalia up to the present.
This is a very visual lecture that relies on classic art and original surgical illustrations from historical documents.

History of pediatric urology in Czech Republic

R Kocvara, Prague - Czech Republic

The roots of paediatric urology in the Czech lands may be recognized since the second half of the 19th century. In 1892, prof. Maydl from Praha implanted the trigone of the exstrophied bladder into the sigmoid colon, some of his patients were followed-up more than 50 years after the operation, the method is still being cited in the literature. In 1894, prof. Kukula published an extensive monograph "About the lithiasis of the urinary bladder in Bohemia" that concerned young boys. In 1923, dr. Chocholka proposed a new method for hypospadias repair, that was modified by Marion later on, and in 1931, prof. Petrivalský from Brno modified orchiopexis operation using subdartos scrotal pouch. In 1951, prof. Bedrna from Hradec Králové published a monograph "Paediatric urology", that was fairly unique in this time and was translated into Polish. Prof. Kucera proposed original modification of the flap pyeloplasty (1968). When children hospitals were founded, some paediatric surgeons started practising paediatric urology (prof. Kafka junior, Dr.Faflová, prof. Stefan, prof. Krolupper). The hypospadias and epispadias repairs were successfully performed by plastic surgeons, prof. Burian, prof. Karfík, and Dr. Farkaš who published an outstanding monograph "Hypospadias" in English in 1967. In the same year, desmopressin was synthesized by Zaoral and co-workers in our country and has become widespread used in the treatment of nocturnal enuresis all over the world. Czechoslovakia was the first country in Europe where paediatric urology was recognized as a certified subspecialty of urology (in 1981) thanks to the support of leading urologists prof. Hradec, prof. Kucera and Slovak prof. Zvara. Thereafter, eight paediatric urology centres have been created in the Czech Republic starting a new era, the most important personalities of this foundation process were prof. Dvorácek and prof. Krolupper from Praha, prof. Stefan from Hradec Králové and prof. Utíkalová from Olomouc.
Since 1991, meetings of the Paediatric section of the Czech Urological Society are being held annually.

History of hypospadiology. From east to west

S.N. C Buyukunal, Istanbul - Turkey

There is nothing new in hypospadias not previously described!
In this study historical evaluation of chordee problem, modalities for urethroplasty, urethral elongation techniques, local pedicled flap procedures from 1st and 2nd centuries until 20th century is studied.
Two hand-written manuscript, 2 textbooks from the beginning of 20th century, paper presentations and journals were reviewed. According to this scientific data, a strong relation between the old Egyptian and Greek civilization and the first penile surgical procedures is found.
Galen was the first one to use the term of “hypospadias”. Helidorus and Antyllus were the first surgeons to correct hypospadiac meatus by partial glanular resection.
Albucassis from Cordoba (963-1013) was the first one who treated hypospadiac stenotic meatus in small children. Sabuncuoglu Serafeddin (15th century) was the first author of a surgical technical atlas with descriptive miniatures of pediatric urological procedures.
Ambroise Pare (16th century) was the first one who described chordee problem with its details.
XIXth century was the golden age of hypospadias surgery. Dieffenbach, Thiersch, Bouisson, Duplay, Wood, Van Hook, Nove-Josserand, Beck and Hacker were the most prominent figures.
XXth century was the time for stabilization and modification of these techniques of XIXth century. Ombredanne, Bevan, Mathieu, Denis Browne were the pioneers.
We may conclude that most of the techniques of reconstructive procedures had been developed by the efforts and works of innovative surgeons of previous centuries. Recent improvement is due to the incredible efforts done by old masters.