Urology at the Yale School of Medicine has historical roots that date back to the early 20th century when urology became officially accepted as a medical specialty in the United States.
In Europe, urology as a distinct medical specialty began at the advent of the cystoscope, which was designed by Dr. Max Nitze of Vienna, Austria at the end of the 19th century. Although an awkward instrument at first, it improved significantly after Thomas Edison’s invention of a small incandescent carbon filament bulb, which replaced 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 gained recognition 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 Dr. Nitze designed the first cystoscope.
A separate section for urology was created at Yale when the Chief of Surgery, Dr. Samuel Harvey, recruited Dr. Clyde Leroy Deming from Johns Hopkins to develop the section and serve as Chief of Urology. 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 six months, Deming’s practice was limited to referrals from surgeons whose patients had venereal disease, and only occasionally for cystoscopic consultation. Within two years, the urology section at Yale grew immensely, performing nearly 600 cystoscopies annually. Dr. Deming soon expanded his practice to incorporate urologic surgery, which included the early use of radium to treat cancers of the prostate and bladder.
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 when 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. A number of leaders in academic urology have been trained at Yale as a result of the residency program, including John Libertino, Edward McGuire, Martin Schiff, Demetrius Bagley, Rodney Appel, John Colberg, and Michel Pontari.
Dr. Deming would remain as Chief for the next 34 years, during which time he performed more than 3,000 perineal prostatectomies for benign disease, and published more than 100 articles on urology. After his retirement in 1955, Dr. B. Marvin Harvard became Chief, arriving from the Ochsner Clinic in New Orleans. Dr. Harvard would proceed to establish an official three-year urology training program that was approved by the ACGME and the Residency Review committee.
In 1967, Dr. Harvard was succeeded by Dr. Bernard Lytton, who had trained in England in General Surgery and Urology. Dr. Lytton, along with Dr. Howard Levitin, a nephrologist, would go on to open the first dialysis unit in Connecticut. This unit made it possible to begin a program in renal transplantation at Yale. Later that same year, Dr. Lytton would perform the first kidney transplant in Connecticut. For the next 15 years, all vascular access for dialysis, as well as renal transplants, was carried out by the urology service under the supervision of Dr. Martin Schiff, Jr., a faculty professor at Yale. During his tenure as Chief of Urology, 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, who had been part of the urology section at Yale since 1967, was appointed Chief of Urology. He trained at Columbia Presbyterian, and initiated the Pediatric Urology program. He 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. Dr. Weiss' laboratory was later expanded to study signal transduction and the role of nitric oxide as a neurotransmitter. Dr. Weiss has also explored the role of survivin with 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, the Urology section officially became a department within the Yale School of Medicine, and Peter G. Schulam, MD, PhD, who was on faculty at UCLA and received his training at Johns Hopkins and Baylor, was appointed the inaugural Chair of Urology.