Development of urology in India

Urology is one of the oldest medical specialties practiced and finds its mention in texts by Sushruta (4th century BC) and Hippocrates.1,2 Sushruta, the father of Indian surgery, in his text Sushrut Samhita, described various urological diseases as well as instruments for the treatment of stone disease.1,2 Initially, in India, the general surgeons interested in Urology were treating patients of urological diseases. After gaining independence in 1947, some surgeons who had training in Urology in the United Kingdom and the United States of America, on their return, started the practice of urologic surgery. They were the pioneers who gave the concept of the "Urology Section" in the Association of Surgeons of India (ASI) in 1960. The birth of the "Chapter" took place in 1961 at the meeting held in Baroda, Gujarat. The first sectional meeting was held in 1962 at Christian Medical College (CMC), Vellore, Tamil Nadu. Initially, there were only 32 members in the "Chapter", comprising mostly surgeons. Dr. G. M. Phadke was the first Chairman, and Dr. B. N. Colabawalla was Honorary Secretary-cum-Treasurer.3 Each one of the 32 members started sowing the seeds of Urology in their respective places of work. The prime objective at that time was to spread the gospel of Urology as a specialty throughout the country. Yearly Urology section meetings were organized during the ASI conference till 1970. DEPARTMENTS OF UROLOGY The first independent department of Urology was established at Saint George's Hospital, Mumbai, in the year 1961–1962 with Dr. B. N. Colabawalla as its Head. This was followed by CMC, Vellore, Government Medical College, Madras, All India Institute of Medical Sciences (AIIMS), New Delhi, in 1965 and Postgraduate Institute of Medical Education and Research (PGIMER), Chandigarh, in 1966. Gradually, departments and units were established at several medical colleges across the country. UROLOGY IN THE ARMED FORCES Urology departments/units in some of the Command Hospitals started around 1970. Brig. DD Joshi, Dr. Trilochan Singh, Brig. B. Rautray, Dr. Mohan Kumar started urological surgery in these hospitals. The army officers received Urology training/residency on deputation, mostly at PGIMER, Chandigarh and AIIMS, New Delhi. Diplomate National Board (DNB) programmes started in the Army Hospital (Research and Referral), New Delhi and the Command Hospital, Pune, around 1986, and independent Urology departments were created. POSTGRADUATE UROLOGY TRAINING Presently, the postgraduate urology training program is for 3 years, leading to the award of Magister Chirurgiae (M.Ch.). The first M.Ch. Urology training program started at CMC, Vellore, followed by the Government Medical College, Chennai.4 Dr. C. C. Chinnaswamy was the first M.Ch. awardee of the country. The National Board of Examinations have also recognized many government and private hospitals for training in Urology. Its postgraduate training program is of 3 years, leading to the award of the DNB degree. At present, there are more than 111 centers in the country that are recognized for postgraduate M.Ch. Urology training while there are more than 88 DNB centers that offer DNB Urology training.5 BIRTH OF THE UROLOGICAL SOCIETY OF INDIA "Urology Section of the Association of Surgeons of India" was rechristened into the "Urological Society of India" (USI) in 1971. Since then, Urology as a specialty started growing fast, and today, the membership of the Society (USI) has grown to more than 6000 members. The USI is a vibrant association that holds its annual conference usually in the month of January or February every year, alternating in each of the four zones. Typically, it is attended by more than 2500 delegates. The Society established the "Urology Gold Medal" in 1972 for a distinguished urologist for his services to Urology. The Annual Conference hosts the late Dr. Himadri Sarkar Memorial Oration (started in 1979), late Dr. G. M. Phadke Memorial Oration and Dr. Pinnamaneni Endowment Lecture and Gold Medal (started in 1986). The Annual Conference also hosts guest lectures by nominated members of various associations like the Societe Internationale d'Urologie (SIU), American Urological Association, European Association of Urology and Urological Association of Asia (UAA). The society has its website www.usi.org. The USI elections were held during the annual conferences by physical voting, followed by electronic voting since the year 2017. The USI Headquarters Office was established in New Delhi in the year 2016. The Society created four zonal chapters in 1992 with the idea of spreading urology to each corner of the country. The Annual Conference of the zonal chapters are now held every year, and each zone is growing fast with an attendance of around 500–600 delegates. The development of Urology in India can be divided into three eras. First from 1960 to 1980 as a struggling stage to get it separated from the general surgeons. Second era, where it was well established as a separate, recognized specialty of medicine. The 3rd era, from 2000 onwards, saw the explosions of technical advances and development of subspecialties in Urology. INDIAN JOURNAL OF UROLOGY The society started the Indian Journal of Urology in the year 1984, which was regularly published twice a year (now 4 issues). The regular periodicity and the high quality of the Journal are due to the hard work of its editors – Dr. Mahendra Bhandari (1984–1994), Dr. Shashidharan (1995–2002), Dr. Santosh Kumar (2002–2004), Dr. Nitin Kekre (2004–2013), Dr. Rajeev Kumar (2013–2024). The journal is fully funded by the USI, is open access and has no fees at any stage of publication. It is the sole PubMed Central® and SCOPUS-indexed urology journal from the Indian subcontinent. SUBSPECIALTY SECTIONS Since 2000, there has been rapid development of sub-specialties of Urology such as Pediatric Urology, Renal Transplantation and Renovascular Surgery, Neuro-Urology, Reconstructive Urology, Uro-oncology, Andrology and Male Infertility, Laparoscopic Surgery, and Robotic Surgery. There are centers of excellence in the country, which specialize in these specialties and offer patient care that matches anywhere in the world. The USI in 2022 started six sections for the promotion of subspecialties, with their own bylaws, office bearers, section membership, and annual meetings. SEPARATE WINGS OF UROLOGICAL SOCIETY OF INDIA USI has started three separate wings: Board of Education/Indian School of Urology was started in the year 2017 for the promotion of educational activities and Research. Uromat is a hands-on training programme for postgraduates and is done regularly twice a year. The USI guidelines for the management of urological diseases have been made for seven topics and are available on the USI website6 The Youth of USI wing started for the young Urologists of the country below 45 years of age in 2020. The first chairman was Dr. Dilip Mishra followed by Dr. Zeeshan and Dr. Abhishek Singh The Women of USI wing was started for women Urologists of India in 2023. Dr. Raj Maheshwari was the first chairperson of the group. SOME OTHER UROLOGICAL ASSOCIATIONS IN INDIA Robotic Urology Forum was started with the idea of the development of Robotic Surgery in 2017. This was the initiative of Dr. Yuvaraja, and the founding chairman was Dr. N. P. Gupta. It has regular conferences every year and is becoming popular among urologists interested in robotic surgery Society of Genito-Urinary Oncology was started in 2022 with the concept of involvement of all the disciplines involved in the management of Genito-Urinary cancers. Dr. Jagdish Kulkarni was the first chairman. It organises regular annual conferences and has started research collaborations, etc. COLLABORATIONS WITH INTERNATIONAL UROLOGICAL ASSOCIATIONS The Indian Section of SIU was started in the early 70s. Dr. D. K. Karanjawalla was the first National Delegate, followed by Dr. S. D. Bapat, Dr. N. P. Gupta and Dr. Mahesh Desai. Various International Urology conferences have been held in India. Millennium International Urological Conference in the year 2000, 22nd World Congress of Endourology in 2004, 9th Asian Congress of Urology in 2008 and 44th SIU Annual Conference in 2024. Dr. Mahesh Desai (2011-12), Dr. Sanjay Kulkarni (2019-20) and Dr. Rajeev Kumar (2023-24) have held the posts of President of SIU; Dr. N. P. Gupta of the UAA in 2008-10; Dr. Madhu S. Agrawal became the President of the SAARC Association of Urological Surgeons (South Asian Association for Regional Cooperation) in 2020. Financial support and sponsorship: Nil. Conflicts of interest: There are no conflicts of interest.