HISTORY OF UROLOGY TRAINING PROGRAM

HISTORY OF BOSTON UNIVERSITY MEDICAL CENTER
UROLOGY TRAINING PROGRAM

The history of the current Boston University Medical Center Urology Training Program dates back to 1973, when three hospitals merged into a single amalgamated program under the auspices of Boston University. Under the directorship of Dr. Carl Olsson, the training programs at the Boston Veterans Administration Medical Center, Boston City Hospital and Massachusetts Memorial Hospital became a single Boston University Medical Center program.

In the late 1940’s, Dr. Samuel Vose was Chairman of Urology, and director of the residency program at Massachusetts Memorial Hospital, which would later become University Hospital. Urologists on the Boston University faculty included Drs. Richard Chute, Grant Dixey, George Austen, Jr., and David B. Stearns, who would succeed Dr. Vose when he retired in the mid-1950’s. In 1959, Dr. George Austen, Jr. who had been Head of the Section of Urology at Boston City Hospital, replaced Dr. Stearns as Chief of Urology at Boston University Medical Center Hospital. He then combined the Boston City Hospital program with the Boston University Medical Center Hospital into a single program. In 1953, the Boston Veterans Administration Medical Center in Jamaica Plain was constructed and Richard Chute, M.D. was named its first Chief of Urology. A residency-training program was begun which was initially associated with Massachusetts General Hospital. That association ended in 1971.

When Dr. Olsson combined the Boston Veterans Administration Medical Center program with the University Hospital and Boston City Hospital program, it ushered in the modern era of Boston University Urology. Dr. George Austen, Jr. moved to the Boston VA Medical Center, in Jamaica Plain, where he continued to train residents and provide valued expertise. Dr. Robert J. Krane assumed the position of Chief of Urology at Boston City Hospital, as Dr. Olsson became Professor and Chairman of Urology at Boston University Medical Center. Shortly after the combined program was established, an ongoing association with Pediatric Urology, at Boston Children’s Hospital, under the direction of Dr. Alan Retik was established, providing Boston University residents with 6 months of invaluable pediatric urologic experience, which continues today.

In the early 1970’s, Dr. Olsson was noted as a pioneer in ex-vivo renal surgery and autotransplantation. He was recognized as a renowned uro-oncologic surgeon and reconstructive urologist. Drs. Krane and Olsson collaborated on a number of innovative investigations including a pioneering publication in 1973 concerning the alpha-adrenergic control of the bladder region. This seminal article would open the door for the use of alpha-adrenergic agonists and antagonists in the treatment of neurogenic bladder dysfunction, stress incontinence and later, benign prostatic hyperplasia. In 1974, based on the investigations of Drs. Olsson, Krane and Siroky, the first clinical urodynamics laboratory in New England was opened at University Hospital. Dr. Mike Siroky joined the faculty in 1976. The BU Urology program placed an emphasis on innovative investigation, and as a result, in 1979, the New England Male Reproductive Center was established at University Hospital. This was the first multidisciplinary center for the treatment of male infertility and erectile dysfunction in the northeast. It was initially co-directed by Dr. Krane and Dr. Ralph deVere White, who was added to the BU faculty, in 1977, from Duke University, adding expertise in Uro-oncology as well as male infertility.

In 1980, Drs. Olsson and deVere White left Boston University. Dr. Olsson was succeeded, as Chairman, by Dr. Robert J. Krane, who chaired the Department of Urology from 1980 – 1999. In the early 1980’s, Drs. Krane and Siroky, were joined on the faculty by Dr. Irwin Goldstein, who completed a National Kidney Foundation fellowship in neurourology and erectile dysfunction and Dr. Richard K. Babayan, who was the first of eight Boston University urologists to be named an American Urological Association research scholar. His joint research project at BU and MIT, investigating hyperthermia and GU malignancies was supported by a Whitaker Health Sciences Fund grant. Dr. Gennaro Carpinito, who was the second BU recipient of an AUA research scholarship, studying immunotherapy for genito-urinary malignancies, joined the Urology faculty in 1984, and was eventually appointed Chief of Urology at Boston City Hospital in 1987, succeeding Dr. Goldstein.

The Department of Urology had continuous NIH research funding from 198 to 2005. Numerous advances in the basic sciences and clinical applications resulted from research within the department. In the area of erectile dysfunction, such advances as dynamic infusion cavernosometry and cavernosography, the use of polypharmacology for intracavernosal injection therapy, and the advent of microvascular bypass surgery for penile arterial insufficiency, were developed by Drs. Krane and Goldstein within the department. Basic science research efforts in erectile dysfunction and smooth muscle physiology were conducted under the direction of research professors Inigo Saenz de Tejada and Abdul Traish, PhD.

In the area of urodynamics, Dr .Siroky’s research contributed several diagnostic tests, including evoked potential studies, sacral latency time, genitocerebral evoked potential studies as well as the clinically relevant flow rate nomogram, which won the Past President’s Prize at the 1976 New England section, AUA annual meeting. Ongoing basic research into smooth muscle physiology and bladder function has been conducted by Dr. Siroky and research professor Kazem Azadzoi. MD, both at Boston University and at the Boston Veterans Administration research laboratories. Dr. Siroky was Chief of Urology at the US Public Health Service Hospital from 1976 – 1981. He succeeded Dr. George Austen as Chief of Urology at the Boston Veterans Administration Hospital in 1983.

Dr.Robert Oates joined the department in 1988 to bring further expertise in the area of male infertility and provided microscopic reconstructive surgery, sperm aspiration and electro-ejaculative techniques for infertile males. In conjunction with the Department of Human Genetics his research efforts have contributed to the etiology of various forms of vasal agenesis and its relationship with cystic fibrosis. Working with Dr. David Page at the Whitehead Institute (MIT), Dr. Oates has contributed to the understanding of Y chromosomal structure and the mapping of genes important to the process of sperm production.

Pioneering work in the field of Endourology has been developed within the department. Dr. Babayan was amongst the first urologists to adapt flexible endoscopy for both the upper and lower urinary tract, and helped promote the concept of video-endoscopy in the early 1980’s. The first percutaneous stone extraction at Boston University was performed in 1980, and the department was the first to report percutaneous removal of a staghorn calculus performed under local anesthesia. Other minimally invasive technologies have been investigated in the multi-disciplinary minimal access surgery lab.

In the field of uro-oncology, advances in tumor immunology have resulted from research efforts. Dr. Carpinito helped develop autolymphocyte therapy for metastatic renal cell carcinoma. He has also worked on early detection of bladder cancer using nuclear matrix protein analysis. Members of the department were among the first to use intravesical BCG for the treatment of superficial bladder cancer in the early 1980’s. Dr. Carpinito has gone on to be named Chief of Adult Urology at New England Medical Center in 2003.

In 1996, Boston City Hospital and University Hospital merged into a single institution known as Boston Medical Center. Dr Krane stepped down as Chairman of Urology in 1999. Richard K. Babayan, MD was appointed Chief of Urology at Boston Medical Center in 2000. Dr. Babayan served as President of the New England Section, American Urological Association from 1999-2000 and hosted the annual meeting of the Section, in Quebec City, in September, 2000.
Dr. Babayan has been involved bringing rotobic surgery to BMC with the use of the daVinci robot to perform radical prostatectomies and UPJ repairs.

Dr. Irwin Goldstein extended the horizons of erectile dysfunction with studies into the pathophysiology of erection. He hosted and chaired the 6th Biennial International Conference on Corpus Cavernosum Revascularization, of the International Society for Impotence Research in Boston in 1988, and was President and host for the Society for the Study of Impotence annual meeting in 1999. He has pioneered investigation into female sexual disorders. In 2002, the Sexual Medicine Institute at Boston University School of Medicine was established with both research and clinical components. Boston University School of Medicine was the first medical school to formally establish a curriculum in Sexual Medicine. In 2002, Dr. Goldstein was named Editor of the International Journal of Impotence Research. Dr. Goldstein left BUSM in May, 2005 to pursue his goals for Sexual Medicine elsewhere.

In July, 2002, the Department of Urology and the newly formed Sexual Medicine Institute prepared to move into newly renovated clinical space. Dr. Ricardo Munarriz, having completed an AFUD and American Urological Association Research Fellowship in Sexual Medicine joined the Department as an Assistant Professor of Urology to further his interests in Sexual Medicine Dr. Munarriz currently oversees the Center for Sexual Medicine at BMC>

Dr. Tracey Wilson, was added to the full time faculty in 2002 after having completed fellowship training in Female Urology, Pelvic Floor Disorders. In 2004, Dr. Wilson moved to the north shore community of Andover to pursue her career in private practice.

Dr. David Wang joined the faculty in July, 2003 having completed a Fellowship in Endourology and Laparoscopic Surgery at the University of Iowa. He rounds out the department by pursuing his interests in minimally invasive urologic surgery and has been actively involved in our latest acquisition of a daVinci robot.

Louis S. Liou, MD, Ph.D. also joined the faculty in July 2003 after completing a Fellowship in Renal Reconstruction and Research Pathology at the Cleveland Clinic. He carried out his clinical and research interests in Uro-Oncology and Genomics and Proteomics. Dr. Liou in June, 2007 accepted a position at the Cambridge Health Alliance.

Dr. Linda Ng joined the faculty in August, 2005 following a fellowship training at the University of Michigan in pelvic floor reconstruction and female urology.

Dr. Jeremy Wiygul  joined the faculty in August, 2007 after completing his urologic training at Duke University Medical Center. Dr. Wiygul played an important role in patient continuity care overseeing the general urology patient population.  Dr Wiygul left in 2009 to pursue a fellowship in pediatric urology.

Dr Mark Katz, a Boston University School of Medicine graduate, joined our faculty in 2009.   Dr Katz completed his urologic residency at Columbia University in 2007.  He then went on to the University of Chicago to complete a Uro-oncology/Minimally Invasive Surgery Fellowship.  His practice focuses on urologic malignancies with an emphasis on minimally invasive approaches.

Aleksander Chudnovsky, MD   joined our faculty in 2010.  He is also a BUSM graduate and completed his urologic residency at SUNY Buffalo in 2006.  He then pursued an Adnrology Fellowship at the University of  Illinois finishing in 2007.   He maintained an active practice at UMASS Medical Center before joining our department.   In 2011 he went on  to join the faculty at St. Elizabeth’s Medical Center. 

The residency program at Boston University has produced a number of graduates who have gone onto fellowship training and academic urology careers. In the 1970’s the residency program was a straight 3 year clinical program following 2 years of general surgery, training 3 residents per year. In the early 1980’s, the program increased to 4 years of Urology, training 2 residents per year. Training included a 6 month basic science rotation. Since 1973, nearly 2/3 of all BU residents have entered post-graduate fellowship training. A total of 8 AUA (AFUD) scholars have conducted their research within the Department of Urology at Boston University Medical Center. Currently the program has completed a transition to a 5 year, post medical school training program, requiring only 1 year of general surgical instruction prior to 4 years of urology training.

AUA (AFUD) SCHOLARS AT BUSM

1980 – 1982 Richard K. Babayan, MD –
Hyperthermia and GU malignancies

1982 – 1984 Gennaro Carpinito, MD –
Immunotherapy of GU tumors

1985 – 1987 Harin Padna-Nathan, MD – Erectile dysfunction

1990 – 1992 Allen Seftel, MD – Erectile dysfunction

1993 – 1995 Ajay Nehra, MD – Erectile dysfunction

1998 – 2000 Jennifer Berman, MD – Female sexual dysfunction

1999 – 2001 Iain MacCauley, MD – Sexual dysfunction

2000 – 2002 Ricardo Munarriz, MD – Sexual dysfunction

AUA AWARDS

GOLD CYSTOSCOPE (awarded for outstanding contributions to Urology by an individual who is less than 10 years out of residency training)

1980 – Carl A. Olsson, MD
1982 – Robert J. Krane, MD

AUA DISTINQUISHED SERVICE AWARD

2011 – Richard K. Babayan, MD

AUA Essay Contest (Clinical Research)

1970 – Carl A. Olsson, MD
1973 – Robert J. Krane, MD
1980 – Mike B. Siroky, MD
1981 – Irwin Goldstein, MD
1988 – Irwin Goldstein, MD

AUA Research Essay Contest

1988 – Fred Levine MD (BU fellow)
& Irwin Goldstein, MD

AUA Walter Kerr Essay Contest (Cost Containment in Urology)

1978 – Richard K. Babayan, MD & Bernard Katzman, MD

New England Section, AUA – Past President’s Prize

1976 – Mike B. Siroky, MD

Paul Zimskind Award (excellence in NeuroUrology)

1984 – Mike B. Siroky, MD

Jack Lapides Award (Urodynamics & NeuroUrology research)

1985 – Irwin Goldstein, MD
1988 – Mike B. Siroky, MD

International Society for Impotence Research Essay Contest (Basic Science)

1990 – Kazem Azadzoi, MD, Irwin Goldstein, MD & Mike B. Siroky, MD
1996 – Mike B. Siroky, MD

American Society of Clinical Oncology – Merit Award

1994 – Mike B. Siroky, MD
1999 – Mike B. Siroky, MD

Textbooks Authored by BU Faculty

1979: Clinical NeuroUrology – Robert J. Krane
& Mike B. Siroky
1986: Male Sexual Dysfunction – Robert J. Krane,
Mike B. Siroky, Irwin Goldstein
1990: Potent Male – Irwin Goldstein
1990: Manual of Urology – Robert J. Krane & Mike B. Siroky
1991: Clinical NeuroUrology, 2nd Ed. – Robert J. Krane
& Mike B. Siroky
1994: The Prostate – Robert J. Krane, Mike B. Siroky,
John Fitzpatrick
1994: Clinical Urology – Robert J. Krane,
Mike B. Siroky & John Fitzpatrick
1995: The Bladder – John M. Fitzpatrick & Robert J. Krane
1999: Manual of Urologic Diagnosis and Therapy 2nd Ed–
Mike B Siroky,
Robert Edelstein, Robert J. Krane
2000: Operative Urology – Robert J. Krane,
Mike B.Siroky, John M. Fitzpatrick
2000: Atlas of Urologic Surgery – Robert J. Krane,
Mike B. Siroky, John Fitzpatrick
2004 Handbook of Urology 3rd Ed–
Mike B Siroky,
Robert D. Oates,Richard K. Babayan

Primary teaching affiliate
of BU School of Medicine