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The Department of Urology at the New York University Medical Center is one of the oldest in the Western Hemisphere and its history is as formidable as its reputation. In 1658, the Dutch West India Company established a tiny infirmary for the poor on Broad Street, in what was then the town of New Amsterdam. The Old Hospital, as it was called, was the first colonial hospital built in North America.
By the early 18th century, New Amsterdam had become New York — and the population had expanded to over eight-thousand people. Smallpox and other infectious diseases were epidemic, and the city needed a larger facility for poor patients. The Charter of 1731 provided for the construction of a municipal hospital at the site of New York’s present City Hall. Completed in 1736, this new infirmary — known as the Poorhouse or the Almshouse- was meant to be much more ample: in fact, it comprised only a single room, containing six beds. The construction of the Poorhouse cost the city 80 pounds and 50 gallons of rum.
Several decades later in 1787, the physicians working at the Poorhouse opened a medical school on the premises. Then in the 1790s, yellow fever broke out: the small hospital was inundated. In 1795 hospital moved to a moved to a three-story house on Chambers Street in the East Village, and finally in 1811 to an estate just north of Kip’s Bay Farm known as Belle Vue Mansion. After further construction, the Bellevue Hospital opened in 1826 for the "care of the sick and for the clinical instruction of medical students." The medical staff faced a range of cases in the newly independent America, but their chief concern were infectious fevers such as yellow fever, thyphoid and cholera.
In 1841, Bellevue became the teaching hospital for New York Medical Department, today known as the New York University School of Medicine. By the end of the 19th century, the hospital allowed Columbia University College of Physicians and Surgeons and Cornell University Medical College to instruct their students on its wards.
One of the six prominent founders of New York Medical Department was the prominent surgeon, Dr. Valentine Mott. Moreover, the list of the surgical faculty in Mott’s department read like a list of Who’s Who in Surgery: Dr.’s James Rushmore Wood, Stephen Smith and Lewis A. Sayre, considered to be the father of American orthopedic surgery. The young William S. Halsted, who eventually became the first Professor of Surgery at Johns Hopkins Medical College, trained at Bellevue Hospital and was Visiting Surgeon from 1883 to 1887.
A number of surgeons had always directed their practice toward urology, but no surgeon practiced urology exclusively until the twentieth century. Before that, urology clinics had been dedicated mainly to the treatment of venereal diseases and non-surgical problems; the surgical cases, after diagnosis, were referred to the general surgeons.
New York University Medical Center — then Bellevue Hospital- was different. Dr. William Holme Van Buren, grandson of one of NYU School of Medicine’s founders, was a dedicated urologist and he established the first urologic ward in the country. He played a central role in establishing urology as a legitimate surgical subspecialty. A prolific writer, Dr. Van Buren wrote extensively on a wide range of subjects, notable "Medical and Surgical Treatment of Aneurysms" and "A Practical Treatise on the Surgical Diseases of the Genito-Urinary Organs including Syphillis". His areas of specialty were the rectum, bladder and kidney.
Early in his career, he was allowed the singular honor of publically performing a perineal lithotomy, inaugurating Bellevue’s new operative amphitheater on March 2, 1849. But Van Buren is perhaps best remembered for his experiments determining the average length of the male urethra: his curved, nickel-plated steel sounds with conical tips — the Van Buren sound- are still widely used today. In 1851, the New York University Medical College made him the Clinical Professor of Genito-Urinary Diseases. And in 1866, the first Chair of Urology in the country was created for him in Bellevue Hospital’s newly established Department of Diseases of the Genito-Urinary System.
Van Buren’s partner and professor of urology at Bellevue, Edward Lawrence Keyes, Sr., succeeded Van Buren as Chairman of Urology at Bellevue. Keyes, Sr. was the founder and first president of the American Association of Genito-Urinary Surgeons in 1888.
Keyes Sr.’s son, Dr. Edward Loughborough Keyes, Jr., was appointed Chairman of the Urology Service at Bellevue from 1912 to 1932. Holding professorships at Bellevue, New York University and Cornell, Keyes Jr. was internationally recognized as an outstanding urologist and scholar. His book Urology, begun by Van Buren and Keyes’ father, was regarded as the standard urology textbook for years. Following his father, he became president of the American Association of Genito-Urinary Surgeons and vice-president of the New York Academy of Medicine. He was the first urologist in the United States to perform a retrograde pyelography. He served as president, at various times, of the International Urological Society, American Hygiene Association, American Urological Association, Neisserian Society (Honorary) and of many foreign urologic societies.
During the first half of the twentieth century, many outstanding urologists either trained or staffed Bellevue’s urology service: Charles A. Chetwood, R.W. Taylor, Tilden Brown, Joseph McCarthy, Alfred T. Osgood, F. Valentine, David MacKenzie, Byard Clark, Oswald S. Lowsley, George F. Cahill, A.R. Stevens, Benjamin Barringer, Howard Jeck, Meredith Campbell, John W. Draper and Robert S. Hotchkiss.
In 1942, Dr. Meredith Campbell was appointed Chairman of Urology. His classic textbook Campbell’s Urology, based on his urologic experiences at Bellevue, continues to be the authoritative urology textbook today. In 1949, Campbell stepped down as Chairman and Dr. Robert S. Hotchkiss was appointed to that position. Hotchkiss was one of first authorities in the field of male infertility. Bellevue’s urology ward, long arranged in a three division system (Bellevue, Columbia and Cornell Services) was reconceived as a two division unit: the New York University Division (Dr. Hotchkiss, director); and the Cornell Division with (Dr. John W. Draper, director). Columbia P&S continued its affiliation until 1966.
In 1947, New York University planned major expansion that would transform it into The New York University Medical Center. Blueprints allowed for vastly increased resources for education, research and patient care: Tisch University Hospital, the Arnold and Marie Schwartz Health Care Center, New York University Downtown Hospital, Hospital for Joint Diseases and the Howard A. Rusk Institute of Rehabilitation Medicine. The New York Department of Veterans Affairs Medical Center (the Manhattan VA) soon joined the Medical Center in 1955.
New York University took over the entire teaching facilities at Bellevue Hospital by 1966. Accordingly, Hotchkiss’ Bellevue Hospital Chair became a New York University Department of Urology Chair. In 1970, Dr. Hotchkiss stepped down and Dr. Pablo Morales was appointed to his position. Dr. Morales appointed Dr. Salah Al-Askari as Director of Urology at Bellevue. During Dr. Morales’ tenure the Department contributed greatly to the present day understanding of bladder cancer immunotherapy, penile prosthetics, utilization of bowel segments in urinary tract reconstruction and management of neurogenic bladder.
In 1993, Dr. Morales retired and a search committee named Dr. Herbert Lepor as the Martin Spatz Professor and Chairman of Urology. Dr. Lepor’s planning and vision brought further breadth to the Department of Urology. His primary interest has been the management of prostate cancer. Under his supervision, the department received one of the largest NIH grants in the area of prostate cancer. Dr. Lepor’s began a state-of-the-art basic science research team devoted to tackling prostate and bladder bladder from several different angles ranging from dietary influences to gene therapy and stem cell research.
The Department is now a leader in clinical research as well: over 14 clinical trials are in progress, and more are in planning. In April 1999, the Minimally Invasive Urology Unit (MIUU) was opened providing the Department of Urology exclusive use of five operating rooms equipped with the latest laser and endoscopic technology, a lithotriptor and a complete videourodynamic suite. Dr. Lepor also recruited a new faculty in pediatric urology, infertility, laparoscopic/minimially invasive surgery, female urology and neurourology creating a diverse league of physicians and basic scientists and establishing the Department as a frontrunner in urologic care and scientific research.
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