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UROLOGY, THEN….AND NOW: From Open Surgery to Modern Practice

 

In the early phase of my career as a General Surgeon, nearly one-third of my workload comprised urology, mainly urinary stones and prostatic enlargement. In UROLOGY, THEN….AND NOW, the contrast is striking. Open procedures such as ureterolithotomy, pyelolithotomy, nephrectomy, and partial nephrectomy were routine. Large incisions ensured access but resulted in significant morbidity, blood loss, and prolonged hospitalization.

Prostatic surgery in the 1960s–70s relied on clinical assessment alone. Freyer’s transvesical prostatectomy was common, though bleeding and sepsis were frequent. Gauze packing, suprapubic drainage, and later Foley catheter traction were used to control hemorrhage. Despite precautions, mortality from blood loss and septicemia remained a concern, and hospital stays often exceeded ten days.

The introduction of Millin’s retropubic prostatectomy reduced blood loss and shortened recovery. Encouraged by improved outcomes, I pursued MCh Urology at PGI Chandigarh in 1981. Training provided exposure to complex open surgeries, while endoscopic procedures were limited.

From 1983–1993, my work with paraplegic patients at Command Hospitals transformed my understanding of bladder management. Clean intermittent self-catheterization replaced indwelling catheters, reducing complications and improving quality of life.

Those ten years were professionally fulfilling, shaping my academic growth and lifelong commitment to patient care.

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