Urology at Yale has its roots almost as early as urology’s acceptance as a specialty in the United States.
In Europe, urology as a distinct specialty began at the advent of the cystoscope, designed by Dr. Max Nitze from Vienna, at the end of the 19th Century. Although an awkward instrument at first, it gained improvement after Thomas Edison’s invention of a small incandescent carbon filament bulb was able to replace the cumbersome water-cooled platinum wire bulb in the original design. With this improvement, the cytoscope became more widely used in Europe in 1889 for performing genitourinary surgery. In the United States, urology was accepted as a specialty in 1910 when Dr. Hugh Hampton Young was appointed Professor of Urology at John Hopkins hospital.
One of Young’s early trainees, John W. Churchman, came to Yale in 1913 as an Assistant Professor of Surgery and performed the first cystocopy in New Haven – only 25 years after Nitze designed the first cystoscope.
Shortly after World War I, a separate section for Urology was created at Yale when Chief of Surgery, Samuel Harvey, recruited Dr. Clyde Leroy Deming from Johns Hopkins to develop the section. Three small rooms were designed for cystoscopy and sigmoidoscopy in order to promote urology and proctology. At that time, the main focus of urology was to treat venereal diseases, so for the first 6 months, Deming’s practice was at first limited to referrals from surgeons whose patients had venereal disease and only occasionally for cystoscopic consultation. Gradually, cystoscopic diagnosis became appreciated, and within 2 years, the Urology Section at Yale became well established with nearly 600 cystoscopies performed annually. Deming enlarged his practice to incorporate urologic surgery, including the early use of radium to treat cancers of the prostate and bladder. Dr. Deming remained as Chief for 34 years, during which time he performed over 3,000 perineal prostatectomies for benign disease and published over 100 articles on urology.
Residency in urology began in 1924, under Dr. Deming, when a third-year surgery resident elected to specialize in urology and spent one year on urology service. Urology residents continued to be appointed for the next ten years whenever surgical residents expressed interest. By 1934, there were regular assignments of a urology resident for an extra year of service after the completion of their general surgery training.
Over the years, a number of leaders in academic urology have been trained at Yale, including John Libertino, Edward McGuire, Martin Schiff, Demetrius Bagley, Rodney Appel, John Colberg, and Michel Pontari.
After Deming retired in 1955, Dr. B. Marvin Harvard, who trained at the Mayo Clinic and had been on the faculty at the Ochsner Clinic in New Orleans, became Chief and established a three-year urology training program that was approved by the ACGME and the Residency Review committee.
In 1967 he was succeeded by Dr. Bernard Lytton, who had trained in England in General Surgery and Urology. Dr. Lytton, along with Dr. Levitin, a nephrologist, opened the first dialysis unit in Connecticut. This unit made it possible to begin a program in renal transplantation at Yale. In December of 1967, Dr. Lytton performed the first kidney transplant in Connecticut. All the vascular access for dialysis, as well as the renal transplants, was carried out by the urology service for the next 15 years under the supervision of Dr. Martin Schiff, Jr., a faculty professor at Yale.
Dr. Lytton implemented many urologic programs at Yale and introduced brachitherapy for prostate cancer, percutaneous nephrolithiasis, ureteroscopy and continent urinary diversion.
In 1987, Dr. Robert Weiss was appointed Chief of Urology. He trained at Columbia Presbyterian, joined the section in 1967 and initiated the Pediatric Urology program. He had established an active research laboratory investigating ureteral and bladder smooth muscle activity at the molecular and biochemical level, and was the first urologist to receive a NIH Merit Award. This was expanded to study signal transduction and the role of nitric oxide as a neurotransmitter. Recently he has become interested in the role of survivin in bladder cancer and the use of nanoparticles for drug and siRNA delivery to treat bladder diseases. In collaboration with Radiology, he devised a method of assessing the degree of renal obstruction by the estimation of renal blood flow using Doppler ultrasound.
In 2012, Urology was made a department at the Yale School of Medicine. Peter Schulam, M.D., Ph.D., who trained at Johns Hopkins and Baylor in Houston, Texas, and was on the faculty at UCLA, was appointed the inaugural Chair of Urology. He has been successful in recruiting a number of new faculty and is expecting to expand the department further following the merger of Yale-New Haven Hospital and Smilow Cancer Hospital with the Hospital of St. Raphael.