urology
The Urology (from the Greek οὖρον , ouron :, urinary ') is a section in the (operating) medicine. It deals with the urinary and urinary drainage organs, i.e. with the kidneys , bladder , ureters and urethra in both sexes. Urologists treat also also diseases of the genital organs of man, ie the testes , epididymis , vas deferens , seminal vesicles , the penis and the prostate , and thus cover areas of Andrology from. Naturally, there is overlap with nephrology , gynecology , neurology , oncology , venereology and surgery .
Treatment spectrum
The task of urology is the diagnosis and treatment of diseases of the urinary organs and the male genital organs. This includes conservative and operative endourological, laparoscopic and open urological therapies as well as stone fragmentation or laser treatments for cutting and vaporizing unwanted tissue.
Belong to the operational spectrum
- the treatment of prostate tumors with sensitive, nerve-conserving surgical techniques to remove growths while maintaining erectile function and continence.
- Operations on the external genitals
- transurethral resections of benign prostate growths and bladder tumors
- minimally invasive laparoscopic surgery of the retroperitoneum (posterior abdominal cavity)
- percutaneous stone remediation
- the laser treatment of renal pelvis tumors
- Corrective procedure for incontinence
- conventional organ-preserving kidney tumor surgery
- radical retropubic or perineal prostatectomy
- the cystectomy (complete removal of the urinary bladder) with the creation of a urinary diversion and a replacement bladder from the small intestine
- the extracorporeal shock wave lithotripsy of kidney stones
History of urology
Urology evolved from surgery in the 20th century. In Germany, Alexander von Lichtenberg and the Danzig surgeon Arthur Barth and Heinrich Klose pioneers of the tray. With Hermann Kümmell , Ernst Roedelius , Henning Brütt and Hans Junker , Hamburg was a urological stronghold in northern Germany. Carl Erich Alken held the first German chair for urology in Saarland . In Sweden the first chairs were only established after the surgeon Einar Ljunggren retired .
Antiquity and antiquity
Already in Egypt around 1000 BC . Were known BC urinary catheter . These early forms were made of bronze . The operation of bladder stones is also known here.
In ancient Greece one also deals with urological diseases. Hippocrates of Kos was the first to classify urination disorders and differentiate between dysuria (painful urination), stranguria (dropwise urination) and ischuria ( urinary retention ). He also describes in detail the formation of bladder stones. In his opinion, surgical removal is not advisable for the doctor , so the doctor undertakes in the Hippocratic oath not to cut any stones. In addition, he also deals with kidney diseases and their therapy up to surgical kidney exposure and removal in the case of purulent inflammation with abscess formation . Since he is denied anatomical studies on corpses for religious reasons, his teachings are based on the precise observation of those who suffer.
The first anatomical description of the prostate comes from Herophilos of Chalcedon around 300 BC. This description was based on the dissection of corpses . Ammonios of Alexandria improved around 250 BC The technique of stone operation using a perineal cut through prior crushing and subsequent recovery with a hook. Its nickname "the lithotome" comes from this.
The Roman doctor Celsus (approx. 25 BC to 50 AD) rediscovered the teachings of Hippocrates and describes in his works the technique of bladder stone removal and catheterization with metal urinary catheters.
Aretaios of Cappadocia (81–138) classified the different types of kidney inflammation and suggested urinary diversion using a catheter as therapy . In addition, in the event of failure, he recommends a perineal incision with opening of the urinary bladder for urine drainage. The first description and therapy recommendation for urethral constrictions comes from Heliodoros (around 120–150). He attributes it to tumors that are supposed to be removed by scraping out.
Galenus (around 131 to 201) from Pergamon finally brings together empirical medicine, based on observation and analysis of the patient, and dogmatic medicine, which relates to anatomical changes as the cause of diseases. He attaches great importance to the urine inspection for the diagnosis of diseases. The morning urine is checked for density , color , smell , taste and sediment and evaluated depending on the symptoms and gender. His works were taken up by Arabic medicine from the 5th century onwards, returned to Europe through this in the Middle Ages and were regarded as a standard that should not be questioned until the 17th century. The humoral pathology , which goes back to Hippocrates and was further developed by Galen, lasted as a disease concept until the 19th century.
In late antiquity, Oreibasios (325–403) from Pergamon describes the dilatation of the urethra with indwelling catheters made of tin and lead , and Paulos of Aigina (6th / 7th centuries) improves the stone operation again by feeling the stone over the anus and over it removed a lateral perineal incision. This method would last into the 17th and 18th centuries.
Urology in Greco-Arabic Medicine and in the Middle Ages
In the Middle Ages, the teachings of Galen were seen as the basis of medical practice. There are no significant innovations in the field of urology. In the tradition of Hippocrates, the doctors and surgeons of the Middle Ages refused to operate on stones. This is left to stone cutters and midwives. On the other hand, uroscopy (urination) leads to an expansion of diagnostics based on the nature of the urine, which has become visible in extensive writings.
Avicenna from Bukhara reproduces Galen's teachings in his Canon medicinae , but also describes the kidney dilatation and its consequences in detail. For the first time he recognized the independence of bladder stone disease and used supple leather tubes reinforced with lead. Albucassis from Córdoba (11th century) deals intensively with the catheterization of the urethra, the bladder irrigation and the bladder stone operation (which he does not perform himself), as described by Paul of Aegina. He published his knowledge in a 30-volume medical encyclopedia , which became a standard surgical work for centuries. Peter von Argelata (Pietro di Argelata, Pietro d'Argellata; † 1523) is one of the few surgeons in Bologna to perform stone operations himself. Arculaneus von Padua describes the hydrocele and varicocele as well as their therapy for the first time and gives precise information on the treatment of urinary retention .
The early modern period (16th to 18th centuries)
After the period of extensive stagnation in the Middle Ages, significant medical progress took place from the 16th century - not least due to the printing press and the partial permission for anatomical studies on corpses. The rejection of stone operations by surgeons completely waned by the beginning of the 18th century.
Discoveries in anatomy, pathology and pathophysiology
Significant anatomical studies and discoveries were made and published by Leonardo da Vinci (1452–1519), the Brussels anatomist Andreas Vesalius (1514–1564) and his successor Eustachi (1500–1574).
In the field of anatomy of the urogenital tract delivered Etienne La Riviere from Paris with the description of the seminal vesicles , Marcello Malpighi (1628-1694) with the unveiling of the functional mechanism of the kidney by the discovery of renal and Lorenzo Bellini (1643-1704) with the discovery of Renal tubules essential knowledge.
This new age in anatomical research is due to the invention of the microscope . The microscopic structure of the kidney was gradually clarified by Frederik Ruysch (1638–1731), Ferrein (1693–1769) and Philip Verheyen (1648–1710). In 1684 Mery first described the urethrales gland, later attributed to William Cowper . The Dutch researcher and microscope maker Antoni van Leeuwenhoek (1632–1723) described sperm for the first time in 1677 .
The anatomist Giovanni Battista Morgagni (1682–1771) is considered to be the founder of pathology - and thus also of the pathology of the urogenital tract . With his five-volume work De sedibus et causis morborum (“From the seat and the causes of diseases”) he laid the foundation for scientific research in 1761. He examined and analyzed the different variants of urethral constriction , classified the urinary bladder tumors and discussed the causes of urinary retention and urgency . Here he discovered prostatic hyperplasia . In addition, he discovered and described kidney tumors , examined kidney suppuration and noted the compensatory enlargement of the kidney in the case of loss or absence of the second.
The French surgeon Jean-Louis Petit (1674–1750) and his student Pierre-Joseph Desault modernized clinical surgery by studying the causes of the disease, discussing symptoms and differential diagnosis, and starting clinical demonstrations at the bedside. The surgeon and friend Desaults François Chopart (1743–1795) published in 1791 a paper on the treatment of diseases of the urinary tract.
Development and improvement of therapy
The development has been advanced primarily through the increasing involvement of surgeons in urological operations. While stone cutters and midwives performed urological operations for a long time , this was done by surgeons until the beginning of the 17th century.
The main efforts are made in the field of stone and urethral surgery, since stone disease is a very common and sometimes fatal disease. The big problem, however, is the high mortality from infections and blood loss. The latter learns from the French military surgeon and personal physician Heinrichs II and Charles IX. Ambroise Paré (1510–1590) a radical improvement. He introduces the clamping and tying off of blood vessels in surgery. He is considered to be the inventor of the ligature technique for hemostasis, which is still used today . He publishes his findings on gonorrhea , urinary stones and urinary retention in his works . He also deals with the narrowing of the urethra, which in his opinion is a consequence of gonorrhea.
The main cause of the development of bladder stones, prostatic hyperplasia, is unknown until it was described by Morgagni in 1761. Therefore, the surgical technique for stone removal will first be further developed. The previous technology has not been further developed by Aegina since Paul. At the beginning of the 16th century, this method of small stone surgery was further refined and improved with special instruments. It is described as a major stone operation by Marianus Sanctus (1489–1550) in his book Libellus aureus . Of note is the amount of special instruments like here curette , pliers ( forceps ), urethral probe (so-called. Explorator) and a special knife. This technology is gaining acceptance across Europe.
The Provencal doctor Franco (1500–1560), who operates according to this method, developed the new technique further and for the first time described the removal of stones via an abdominal incision, the so-called cesarean section . However, this method is hardly followed up at first. It was not until the middle of the 18th century that the Paris surgeon Jean Baseilhac (1703–1781) adopted this technique, which until then had only been practiced in exceptional cases. Since Baseilhac already enjoyed a good reputation as a stone surgeon, not least due to the development of a special lithotome for crushing stones in the urinary bladder, this method prevailed and became the standard.
Despite all the modernization of the surgical technique, 255 out of 812 stone patients in the Paris hospitals Hôtel-Dieu and Charité died in the middle of the 18th century , according to statistics from the time. In addition, an anesthetic was not performed.
However, kidney surgery remains an exception. Although Bauhin successfully removes stones from a kidney, the flank incision is mostly only performed to relieve pus . Further reports of successfully performed kidney stone removals come from Johann Georg Schenck von Grafenberg , Domenico de Marchetti (1626–1688) in 1663 and Lafitte from 1734.
The modern age until the end of the Second World War
The great technical advances in the 19th and 20th centuries lead to rapid development in the therapy and diagnosis of urological diseases. In addition to the new materials such as rubber , improved steel and the possibilities of industrial production, the discovery and use of electricity , X-rays as well as the discovery and application of nitrous oxide (previously: nitrous oxide) ( laughing gas ), chloroform and ether for anesthesia play a decisive role. The most important development, however, is that of hygiene and antisepsis , whose father is Louis Pasteur (1822–1895). In the same way, the beginning of microbiology by Robert Koch is significant.
Improvement of stone therapy and development of the improved urinary catheter
In the first half of the 19th century the focus was still primarily on the therapy of urinary stones and the improvement of treatment options. An important step was the development of special and flexible urinary catheters . Thus developed Louis Auguste Mercier (1811-1882) a double-curved catheter made of rubber with a rounded tip. The first urinary catheter with a collection bag was invented by Reybard (1790–1863). Finally, Nélaton (1807–1873) developed a soft, straight urinary catheter made of vulcanized rubber. This created relatively gentle means for urinary diversion . With special, very thin probes and catheters, it was possible to create a urine drainage even with urethral strictures . The therapy of the urethral stricture also underwent a fundamental change through the development of special instruments for internal urethral slitting by the surgeon Maisonneuve (1809–1897). This new surgical method began to prevail over the previously customary external slitting. The removal of bladder stones was initially a very risky operation. With his lithotripter, the French doctor Jean Civiale (1796–1867) developed a forceps-like device for breaking up and removing stones via the urethra. The first lithotripsy (operative stone breaking) was carried out by him in 1823. Even so, complications and deaths continued. The most famous is Halles . Not least because of his experience and his academic defense of the method, Civiale received a few beds at the French Hospital Necker as a gift. The first urologist in England was Sir Henry Thompson (1820-1904), who came from Suffolk and, in contrast to his teacher Civiale (and B. v. Langenbeck), was able to remove the bladder stone of the Belgian King Leopold I in 1863 using the lithotripsy developed by Civiale and invented the two-lens probe for locating gonococcal infections. Another improvement is the suction developed by the Harvard doctor Bigelow. This allows the stones to be removed immediately after they have been broken up. This new procedure is called litholapaxy .
The evolution of endoscopy
The most important development in urology, urological endoscopy, goes back to the Frankfurt doctor Phillip Bozzini . In 1806 he presented the first endoscope with candle lighting. This development was initially not pursued any further. It was not until 1826 that Segalas (1792–1875) first tried to use it on patients. He uses a urinary bladder mirror, which is illuminated by two candles. The French doctor Antonin Desormeaux (1815 to 1882), who worked as a surgeon in Paris, presented an endoscope in front of the Academy of Medicine in 1853 that used a mixture of alcohol and turpentine oil for lighting. With it he carried out numerous examinations of the urethra and the urinary bladder and in 1865 published the textbook Traite de l'endoscopie . The breakthrough came with the Dresden doctor Maximilian Nitze (1848–1906) with the first electrically illuminated cystoscope , which he presented in Vienna in 1879. He published his textbook on kystoscopy in 1889 and the cystographic atlas in 1894. With cystoscopy , the precise examination and classification of diseases of the urinary bladder begins. At the same time, special ureteral catheters are being developed to probe the ureters . Since it is difficult with the classic cystoscope, however, Joaquín Albarrán (1860–1912) from Paris developed a special cystoscope with a mechanically angled tip in 1897.
The employees of Carl Joseph Gauß at the Würzburg University Women's Clinic, Franz Hoff and Theodor Carl Neeff, presented the first usable endoscopically made color photographs of the interior of the bladder in 1938. Their procedure was further developed in 1951 by Heinz Drescher, an employee of Horst Kremling .
Kidney surgery
The surgeons now began to turn to the surgical treatment of kidney diseases. Numerous diseases have been discovered and described. In 1827, the ectopy of the kidney was first described by Heusinger and in 1841 the solitary renal cyst and hydronephrosis (water sac kidney ) were first described by Rayer . He described kidney tuberculosis two years earlier. Robert Koch discovered the tubercle bacterium in 1882 and subsequently succeeded in recognizing it in urine. Kidney tumors had been known since the 17th century, but have now been examined more closely. This is how Grawitz described hypernephroma in 1883 .
The Heidelberg surgeon Gustav Simon (1824–1876) was the first to remove a kidney in 1869 due to urinary fistula formation with complications after he had tried the operation on thirty dogs. In 1871 he removed an ulcerated, stone-bearing kidney, but the patient died of an infection. Henry Morris achieved the first nephrolithotomy (removal of stones from the kidney) in 1880. The first partial nephrectomy to remove kidney stones and abscesses was achieved in 1889 through the further development of surgical techniques, in particular hemostasis, and the introduction of wound drainage .
Tumor surgery also slowly began to develop. Wolcott attempted to remove a kidney tumor in 1861, but the patient died of an infection. Overall, this intervention is often not survived for long, particularly due to the late tumor stage, high blood loss and infections. However, development continued. Albarran performed the first kidney and ureter removal, known as a nephroureterectomy, in 1898. As early as 1887, Czerny performed the first partial nephrectomy for a sarcoma . In contrast to the difficult surgery for kidney cancer , benign tumors were often successfully removed.
In addition to the kidney removal, the first plastic operations on the kidney have already begun. While at the beginning there was a tendency towards removal of a water sac kidney, more and more attention was devoted to organ-preserving surgery. At the end of the 19th century, Trendelenburg (1886), Ernst Küster (1891), Fenger (1892) and Israel (1896) undertook renal pelvic surgery (this removes the causal constriction and reconnects the ureter and renal pelvis). Albarran made an important contribution in this area in France.
The beginning of prostate surgery
As already described by Morgagni in the 18th century, prostatic hyperplasia (benign prostate enlargement ) is now identified as the cause of bladder stone formation and micturition disorders. Although bladder stones can be treated better, as explained above, the prostate has not yet been operated on. Initial attempts at removal via the urethra are unsuccessful. In 1885, Goulay performed the first removal via an abdominal incision. In America this method is adopted by Goodfellow (1855–1919). On November 21, 1900, the London doctor Freyer (1852–1921) succeeded in the first complete removal of the prostate adenoma via an incision in the lower abdomen and the opened urinary bladder . Despite the great loss of blood, the patient recovered. This method was further developed in the following decades. Particular attention was paid to hemostasis. The Viennese professor of urology Theodor Hryntschak (1889–1952) played a key role in this. This method has survived to this day, although it is rarely used. Another way is the Millin method. The urinary bladder is not opened, but the capsule of the prostate. This operation was tried out in 1908 by the doctor from Stockum in Rotterdam and taken over and perfected by the British doctor Terence Millin in 1943. In Heidelberg in 1889 , von Czerny performed the first prostatectomy (complete removal of the prostate and seminal vesicles ) for a prostate carcinoma . He chooses access over the dam. In 1898, Fuller performed this procedure for the first time using an abdominal incision.
The use of X-rays in urology
Wilhelm Conrad Röntgen discovered the X-rays named after him in 1895. This is how the development of radiology began . As far as urology is concerned, the "retrograde pyelography" developed by F. Voelcker and Alexander von Lichtenberg was presented for the first time in 1906 , whereby the renal pelvis calyx system and the ureters were shown with a collargol solution. However, there were very serious side effects. In 1927 Maurice Chevassu depicted the ureters and renal pelvis with contrast medium, which was introduced directly into the ureter orifice as part of a cystoscopy . In 1929 von Lichtenberg reintroduced pyelography , ie the representation of the draining urinary tract via contrast agent introduced into the vein , into diagnostics. On September 28, 1929 urological conference in Munich by Alexander von Lichtenberg and Moses Swick the experts convincing Urogramme were on the 9th German first (by the by the chemist Arthur Binz discovered and Curt Räth Uroselectan the kidney) and for the first time useful radiographs demonstrated . This opened up new ways of diagnosis. The X-ray photograph was first performed by the Nuremberg urologist Eduard Pflaumer during a kidney stone operation. Axial computed tomography, introduced in 1973, also made further improvements possible in urology.
The establishment of a new subject
The rapid development in urology led Felix Guyon (1831–1920) to found his own urology department in Paris . In 1890 he took over the first chair for urology. In Germany, Maximilian Nitze completed his habilitation in 1889 and became an associate professor of urology at the Charité in 1900. At the 78th meeting of the Society of German Natural Scientists and Doctors in Stuttgart in September 1906, the "German Society for Urology" is founded. The specialist in urology is established in 1924. It was not until 1970, however, that the university independence of urology was established in an agreement with the German Society for Surgery.
Development after the Second World War
The introduction of new examination methods such as sonography , computed tomography and nuclear medicine examinations lead to a considerable improvement in the detection and treatment of urological diseases. The discovery of penicillin and the further development of antibiotics reduce the infection rate and thus the mortality drastically. New surgical procedures such as radical prostatectomy or radical cystectomy (removal of the urinary bladder) with bladder replacement are being developed. The first successful kidney transplant is performed in 1956. The progress in the field of endoscopy enables the development of transurethral resection for the treatment of benign prostatic enlargement and urinary bladder cancer . In 1980, at the Großhadern Clinic in Munich, kidney stones were first smashed from the outside and quickly became the standard (see the section on “ Extracorporeal shock wave lithotripsy ” in the “Kidney stone” article). New, tiny endoscopes enable the kidney and ureter to be inspected. The chemotherapy and radiation therapy significantly improving the treatment of tumor diseases. Eventually, laparoscopy made its way into urology in the 1990s, the first laparoscopic nephrectomy was performed in 1991, and the first laparoscopic prostatectomy was performed in 1992. The laparoscopic technique was further developed through the use of a surgical robot (Da Vinci operating system), which is mainly used in urology. Specialization is also advancing steadily in urology. In a still young urological specialty, neuro-urology, all disorders of the urinary and genital tract are treated that were caused by an injury or disease of the nervous system. Patients with paraplegia are particularly affected, but also patients with multiple sclerosis, Parkinson's disease or after a stroke. Further special disciplines in urology are andrology (teaching the reproductive functions of men), pediatric urology (congenital diseases) and the gynecological urology and urogynecology (including the treatment of urine ) promoted in Germany, especially by Walter Stoeckel (Berlin) and Karl Burger (Würzburg) - and fecal incontinence as well as changes in the position of the genital organs of women).
Medical specialist for Urology
As Urologist one is a specialist in urology referred. This designation can be used by anyone who has acquired specialist medical expertise in the field of urology after completing the prescribed training time and training content.
In order to work as a specialist in urology after completing a medical degree in Germany , a total of five years of medical training is required. At least 48 of the 60 months of further training must be completed in the field of urology at a further training facility approved by the relevant state medical association with an approved further trainer. Correspondingly, further training times outside of clinical-urological training that can be counted towards further training result, whereby according to Section 4, Paragraph 4 of the Model Training Regulations (MWBO), the minimum duration of a creditable further training segment must be six months:
- 12 months inpatient care in surgery
- 12 months in a different subject
- 12 months outpatient care, e.g. B. at a resident urologist.
According to MWBO, the training content is divided into
- Knowledge, experience, skills and
- Detailed examination and treatment procedures.
The performance of a certain number of operations and procedures must be proven using reference numbers (OP catalog). In addition, the content of personnel interviews to be held at least once a year between trainers and doctors in further training should be documented. The medical associations as well as the German Society for Urology, the Professional Association of German Urologists and the German Society of Residents in Urology offer an extended logbook . It structures the specifications of the MWBO in a practice-relevant manner and defines a uniform, modular (sample) curriculum for German urology. If the conditions are met, the registration for the specialist examination can be submitted to the responsible state medical association.
Associations
In 1972 the European Association of Urology (EAU) was founded. With Thaddäus Zajaczkowski and Dirk Schultheiss , she is exemplary in the history of the subject.
In Germany there is the Professional Association of German Urologists e. V. (BvDU), the German Society for Urology (DGU) and the Southwest German Society for Urology.
Austria: Austrian Society for Urology and Andrology
Switzerland: Swiss Society for Urology (= Société suisse d 'urologie) The' Swiss Society for Pediatric Surgery 'has five working groups; one of them is the 'Swiss Society for Pediatric Urology (SwissPU)'
statistics
According to the statistics portal Statista , 5635 urologists were working in Germany in 2014.
See also
literature
- Evert Dirk Baumann : About the diseases of the kidneys and urinary bladder in ancient times. In: Janus , Volume 37, 1933, pp. 33-47, 65-83, 116-121 and 145-152.
- Johanna Bleker : The History of Kidney Diseases. Mannheim 1972 (= medical historical series of the study series Boehringer Mannheim , 2)
- Jürgen Konert, Holger Dietrich: Illustrated history of urology . Berlin 2004.
- Horst Kremling : History of the gynecological urology. Munich / Vienna / Baltimore 1987.
- Dirk Manski: Urologielehrbuch.de , Stadtbergen: Dirk Manski 2017, ISBN 978-3-946441-00-7 .
- Jürgen Sökeland , Harald Schulze, Herbert Rübben, Carl-Erich Alken: Pocket textbook urology , 14th edition, G. Thieme Verlag, Stuttgart, New York 2008, ISBN 978-3-13-300614-9 .
- André Dufour: History of Urology , in: Illustrated history of medicine , German adaptation by Richard Toellner , Salzburg 1980–1982 and as a special edition ibid. 1986, III, pp. 1394–1447.
- Dirk Schultheiss (ed.): Streiflichter from the history of urology . Berlin 2000.
- Hubert Frohmüller : 35 years of experience in urology. The development of the subject in personal experience. (Farewell lecture on June 24, 1996) In: Würzburger medicalhistorische Mitteilungen 24, 2005, pp. 570–579.
- Henry Meige: Les urologues. In: Archives générales de médicine. 1900.
- Herny Meige: Les urologues dans l'art. In: Aesculape. New Series, Volume 18, No. 3, 1928, pp. 54-67.
- Camille Vieillard: L'urologie et les médicins urologues dans la médicine ancienne. Paris 1903.
- Brigitte Lengersdorf, Cord Matthies, Annegret Nietz, Denise Oppermann, Alexander Haese, Sabine Bröker and Anke Baumgarten: Urologie , in: Margret Liehn, Brigitte Lengersdorf, Lutz Steinmüller, Rüdiger Döhler : OP-Handbuch. Basics, instruments, operating procedures , 6th, updated and expanded edition. Springer, Berlin Heidelberg New York 2016, ISBN 978-3-662-49280-2 , pp. 446-524.
Web links
- Portal of the professional association of German urologists
- Bavarian State Medical Association for specialist training (PDF file; 242 kB)
Individual evidence
- ↑ Urology range of services, April 9, 2015 ( Memento from March 10, 2016 in the Internet Archive )
- ^ Rüdiger Döhler, Heinz-Jürgen Schröder and Eike Sebastian Debus: Surgery in the North. For the 200th meeting of the Association of North German Surgeons in Hamburg 2017 . Kaden Verlag, Heidelberg 2017.
- ↑ See for example Willy Braekman , Gundolf Keil: The 'Vlaamsche Leringe van orinen' in a Lower Franconian version of the 14th century. Marginal notes on the structure of the medieval urinary tract. In: Niederfränkische Mitteilungen. Volume 24, 1968, pp. 75-125.
- ↑ Hans Joachim Schneider (Ed.): Urolithiasis: Etiology - Diagnosis. Springer Science & Business Media, Berlin / Heidelberg / New York 2012, p. 250 f.
- ^ D. Urquhart-Hay: Sir Henry Thompson, the first English urologist. In: British Journal of Urology. Volume 73, 1994, pp. 345-351.
- ↑ Barbara I. Tshisuaka: Thompson, Sir Henry. In: Werner E. Gerabek , Bernhard D. Haage, Gundolf Keil , Wolfgang Wegner (eds.): Enzyklopädie Medizingeschichte. De Gruyter, Berlin / New York 2005, ISBN 3-11-015714-4 , pp. 1396 f.
- ^ Franz Hoff, Theodor Neeff: The cystoskopische color photography and their achievements. In: Zentralblatt für Gynäkologie. Volume 63, 1939, pp. 1672-1683.
- ↑ Heinz Drescher: The current status of intravesical color photography in gynecological urology. In: Zentralblatt für Gynäkologie. Volume 75, 1953, pp. 1481-1486.
- ^ Horst Kremling: Würzburger Contributions to Gynecological Urology. In: Würzburg medical history reports. Volume 5, 1987, pp. 5-11, here: p. 7.
- ↑ Horst Kremling: On the history of urological x-ray diagnostics. In: Würzburg medical history reports. Volume 6, 1988, pp. 5-19; here: p. 8.
- ↑ Maurice Chevassu: L'Exploration anatomique des lésions chirurgicales du rein au moyen de l'urétéro-pyélographie rétrograde. Masson, Paris 1932.
- ↑ Moses Swick: Representation of the kidneys and the urinary tract in the X-ray image by intravenous introduction of a new contrast substance, the uroselectans. In: Klinische Wochenschrift 8, 1929, p. 2087
- ↑ Alexander von Lichtenberg, Moses Swick: Basics and implementation of the intravenous representation of the urinary tract. In: Zentralblatt für Gynäkologie. Volume 53, 1929, p. 3387.
- ↑ Arthur Binz: History of the uroselectans. In: Journal of Urology. Volume 31, 1937, pp. 73-84.
- ↑ Horst Kremling (1988), p. 9
- ^ Horst Kremling: Würzburger Contributions to Gynecological Urology. In: Würzburg medical history reports. Volume 5, 1987, pp. 5-11, here: p. 6.
- ^ Horst Kremling: Eduard Pflaumer (1872-1957). A pioneer in urology. In: Würzburg medical history reports. Volume 14, 1996, pp. 81-84; here: p. 84.
- ↑ D. Manski, online textbook of urology
- ^ Horst Kremling: Würzburger Contributions to Gynecological Urology. In: Würzburg medical history reports. Volume 5, 1987, pp. 5-11, here: pp. 7 f.
- ^ Article in the urologist directory
- ↑ www.uroweb.org
- ↑ www.urologenportal.de
- ↑ Uro.AT
- ↑ Urologie.ch
- ↑ SwissPU ( Memento of the original from February 10, 2016 in the Internet Archive ) Info: The archive link was inserted automatically and has not yet been checked. Please check the original and archive link according to the instructions and then remove this notice.
- ↑ Number of employed doctors in Germany by doctor group in the years 2010 to 2014
