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A SHORT HISTORY OF SCANDINAVIAN UROLOGY. By Jaakko Elo

PREFACE

The collaboration between the Scandinavian countries has been intense for a longer period. The first gatherings which Scandinavian Surgeons attended, were the Congresses of Scandinavian experts in Natural sciences. This society worked from mid 1800, having its meetings regularly.
The surgical techniques developed, especially after the general anaesthesia was introduced in Massachusetts General Hospital in 1847 by Morton,. and it became necessary to ground national surgical associations.

THE NATIONAL SURGICAL ASSOCIATIONS

In Denmark a private Surgical Society was founded 1771, but the Danish Society for Surgery was founded by Rovsing and Tscherning in 1908. The Swedish Surgical Society was born 1893, and The Norwegian Association in 1894 on the initiative of Kristian Jervell.
The Finnish Surgical Society was founded very late, 1925 by Richard Faltin.

THE NORDIC SURGICAL SOCIETY (NKF)

NKF was founded by Eilert Adam Tscherning who was professor in Copenhagen. The energetic Norwegian Surgeon Kristian Jervell was backing Tscherning. The first meeting of NKF was in Gothenburg July 6th, 1893. The seventh meeting on August 10th 1907, two years after the dissolution of the Union between Norway and Sweden, stated that NKF was the first international Society of Surgeons in the world. The Surgeon of Chief in Oslo (Kristiania at that time), G.Naumann, stated that by nature the Scandinavians are cooperative. This spoke for a keen feeling of Scandinavian countries to belong together. From 1891 it was already clear that the Society would be grounded. There was a preliminary meeting April 28th 1891 in Hôtel Rydberg in Stockholm. In this meeting a Finnish professor in Surgery H v. Bonsdorff was present. So Finland has been represented in the Society from the very beginning although at that time it was a Grand Duchy of Russia which in 1917 became free in the tumults of the Russian revolution.

SEPARATION OF UROLOGY FROM GENERAL SURGERY.

International:
The separation of urology from surgery started in France when Felix Guyon in 1867 was appointed as first Professor of Clinical Urinary Tract Diseases at the Necker Hospital. Guyon was an organizer by nature, who was responsible for the creation of Association Francaise d`Urologie.
In 1907 Guyon also created Association Internationale d`Urologie, which changed its name to Societé Internationale d`Urologie in 1921.

Sweden:
The separation of urology from surgery has mostly been a slow process. In Scandinavia it was first established in Sweden. It became clear that the specialty should be independent from surgery and there should be Professors of Urology in every University Hospital. Gustaf Giertz understood that surgeons would not do much for the development of urology. The urologists should be the initiators in this respect. The foundations of societies and promotions for education in urology should give the best results. The first urological clinic was established in Sahlgrenska Hospital, Gothenburg in 1945; with Hans Ekman as Chief. He became associate professor in urology in 1960. Gustav Giertz became the first professor in Stockholm, at Karolinska in1967. Then came Gösta Jönsson in Lund, and Lennart Andersson in Umeå (1969).

Finland:
Professor Ali Krogius (1864-1939) studied Urology at Necker as a disciple of Guyon 1889-1890 and he gave lectures in urology to medical students as professor of Surgery (1901-1929) He published his lecture Notes in 1898 which appeared as a textbook in 1909. New editions were published in 1922 and 1930.
Arvo Elfving was ass.professor in urology from 1931 until 1946, giving lectures on urology for the students. Ass. professor Pauli Tuovinen (1903-1965), who became the Chief-Surgeon of Maria Hospital in 1950, was declared as specialist in urology in 1951 and he grounded a ward for urological patients and started to educate surgeons in urology. There were two residents at a time. Ass. Professor Jukka Oravisto started an urological department first in the old Surgical Clinic in 1963 under the government of the II surgical clinic, and later moved to the Meilahti Hospital when it was ready in 1965.

In Finland Olof Alfthan (1925-2000) got the Professorship in Urology in the University of Helsinki and Teuvo Tammela at the University of Tampere in 2000. The speciality was officially recognised from the beginning of 2001. Until then it was a subspecialty of surgery.

Norway:
The first Norwegian professor in Urology was Per Åge Höisaeter (1938-), who was appointed at Haukeland Hospital in Bergen in 1984.
Sten Sander (1932-) became professor of Urology at Aker Hospital, Björn Klevmark (1926-) at Rikshospital and Kjell J. Tveter (1936-) at Ullevål Hospital. All the three named the same year 1985.

THE NATIONAL SOCIETIES OF UROLOGY:

Swedish Association of Urology was founded in Gothenburg 1950. John Hellström was elected as chairman, Einar Ljunggren as Vice-chairman and Gustaf Giertz as Secretary.

Finnish Urological Association was founded December 10th,1954. The preliminary meeting had been held November 23th 1954. The initiator Pauli Tuovinen was elected the first Chairman and Aulis Korhonen Vice-Chairman. Jukka Oravisto was elected Secretary of the Association.

The Danish Society for Urology was founded November 11th, 1961. Jens Christoffersen was elected the first Chairman, Erling Schroeder the Vice-Chairman and Kjeld Trautner Secretary for the Society.

Norwegian Urological Association was founded October 31st 1962 on the initiative of Ragnar Andersen. Knut Höeg was elected Chairman, Thorolf Gjersvik Vice-Chairman and Knut Hatteland secretary of the Association.

Icelandic Association of Urology was grounded by three urologist: Sverrir Haraldsson, Egill Á.Jacobsen and Ölafur Örn Arnarson, who had gathered 1976 in Reykjavik. This Trio the Chairman, Vice-Chairman and Cashier sat 19 years on their posts!

SCANDINAVIAN ASSOCIATION OF UROLOGY (SAU)

The cooperation between the Scandinavian urologists started as a "urology travel club". When Olaf Powlsen from Bispebjerg Hospital in Copenhagen met Gustav Giertz in Stockholm in January 1950 the "Travelling Club" was born. The Club grew further, when members from the other Scandinavian Countries were admitted.
The last meeting of the club was in Helsinki 1956. Before this meeting on August 31st Pauli Tuovinen and Jukka Oravisto had written a letter to the other urologists in the club to propose the foundation of the Scandinavian Association of Urology.
There were unanimity between the Danish J C. Christoffersen and Finnish urologists to establish the Scandinavian Association of Urology, but the Norwegian Ragnar Andersen was more sceptical. He answered that as there is not yet a National Association in Norway, the time is not ripe to found a Scandinavian Association. However, if the urologists in other countries were for the foundation, the Norwegians would also join. The Swedish representative G. Giertz was postitive to the foundation, but he hesitated because he found that there was already so many associations. Åke Fritjofsson mentions in his "Nordisk Urologisk Förenings Historia 1956-1996" that Giertz and Hellström did not consult other Swedish colleagues on the case and neither did the representatives for the other countries.

The Scandinavian Association of Urology was founded in the sauna of Professor Tuovinens summer house in Ojakkala, Finland. Perhaps the heat of the finnish sauna had melted the sceptical doubts about the success of the new Association. During the previous night Giertz had written the rules of the Association. Gustav Giertz was elected the chairman and Jukka Oravisto the secretary.

In 1976 Island joined to the family of SAU.

The first Congress of SAU was arranged in June 1957 in Stockholm. President of the Congress was John Hellström. The social part ended with a cocktail party arranged by Gustav Giertz and his wife at their villa in Djursholmen. After the gathering there was a bankett at Restaurant Stallmästargården.
Since then the SAU has had its congresses every other year.
The official languages of the congresses were Scandinavian (the Finns , however, were expected to speak either Swedish or English) for many years. But from the 20th congress in Lund in 1995, the official language of the scientific meetings has been changed to English to get more international interest in the SAU meetings.
There was a strong opposition to the change of the language, as many members found that the common ability to understand the other Scandinavian languages was a major reason for the close relation between the countries. ;
The President at the time, Jens T. Andersen, was a strong advocate of the change, and prevailed over the leader of the opposition, the former President Sten Sander.

At the 23rd NUF-Congress in Helsinki on August 22-24th, 2001, there were 500 participants and Professor Mirja Ruutu was the president, Martti Ala-Opas the Secretary General.

The next and 24th Congress of Scandinavian Association of Urology, will be held June 11-13th 2003 in Bergen, Norway.

In addition to the biennial congresses there have been numerous Symposia and Course on various themes.
To be specially mentioned :
The Copenhagen Symposium on Endoscopic Urology held regularly at Herlev Hospital is a Danish Organised, International clinical course, which is recommended for every younger urologist in the Nordic countries.
Finnish Urological Club:The dirty lobster club was a club for invited urologists.grounded by prof. Olof Alfthan It was held in February in Helsinki Central Hospital. The members were mainly Swedish and Finnish, but also some from the other Nordic countries. There were lectures during the day and in the evening there were the tests for the new member candidates. It was great fun to follow how the main actors Per Åge Höisaeter, Olf Alfthan and Mirja Ruutu acted as the tentators. The Club lived on from 1972 to 1992.

THE CHAIRMEN AND GENERAL SECRETARIES OF SAU:

Prof. Gustav Giertz was the spiritual father of the organisation. He was amaster in table speeches and he spoke about the independency of urology and an own speciality of urology separated from surgery. He underlined also the high moral and ethics standards for urologists. Under his reign admission to the association was limited. Every country had a fixed quota of how many members it could have.

Olof Alfthan opened the association for all members of the national associations. P.O. Hedlund, in 1977 , founded the different cooperation groups, for prostatic cancer, bladder cancer, urologic infections etc.
The best achievement was probably the start of our information media: NUF-Bulletinen. The merit belongs to the secretary general Jan Rusk.

THE PUBLICATIONS.

The precious diamond of SAU is our scientific Journal :

Scandinavian Journal of Urology and Nephrology.
The first number appeared in 1967. The first editor was Gustav Giertz with Åke Fritjofsson as associate editor.
The Journal has now reached its 36th edition and the Editor in Chief is Jan Adolfsson, with Stefan H. Jacobson from Stockholm as associate editor and Rolf Lundgren, Helsingborg as the managing editor.

NUF-Bulletinen.
The Bulletin has been published since 1976 with two publications per Year. Jan Rusk as secretary general of (SAU) was the initiator of the NUF-Bulletinen. From a modest typed fotocopy the Bulletin is appearing nowadays as a multicoloured magasin.
The Editors after Jan Rusk have been:

Closing words

There was scepticism for the future at the time of the foundation of the Scandinavian Association of Urology in 1956 but the Association is living still strong and at the gatherings have more and more participants. The fear that the change of the language from Swedish to English would cause any harm has been groundless. The feeling of Scandinavians to belong together has been the most important power to activate the society. Also the growing interest of the collaborating pharmaceutical and equipment industry has helped the congress organisations. We warmly and cordially welcome also foreign urologists to our next congress in Bergen Norway.