What is privilege in urology?
Answer: it is sitting at the feet of a famous, much admired senior colleague and absorbing his or her wisdom and hanging onto every word. Some of us had such a privilege in the late 1960s when we attended the ward rounds and radiological sessions at Great Ormond Street Hospital and at the Shaftesbury Hospital, led by Sir David Innes Williams. The standard studies then were intravenous urograms and micturating cystograms, often showing gross dilatation of the urinary tracts in boys with posterior urethral valves. In the absence of vesico-ureteric reflux, the burning question was whether or not the ureter was obstructed and if so, whether any form of surgery was applicable. What a challenge!
For me it was a light-bulb moment and it set me off on a career-long challenge to define and investigate urinary obstruction and to provide adequate evidence for whether or not any form of reconstructive surgery might be helpful. Are we any clearer now than we were then? I like to think so.
Who else can remember those halcyon days I wonder?