History of the VFN Urological Clinic and the 1st Faculty of Medicine of the University of Prague in Prague

Establishment of a clinic in Karlov

The building of the urology clinic in Karlovy Vary Doctor II first came up with the idea of ​​separating a separate urology clinic from surgery. surgical clinic VFN prof. MD Miloš Klika around 1945. Although he was already a highly respected expert at that time, his request was rejected. Professor Klika lost his titles and position due to the ruling party after 1948, but he did not resent urology and left behind a lot of quality work and book materials. his dream came true only after 30 long years.

The building of the urology clinic in Karlovy Vary

The Urology Clinic of the Faculty of General Medicine of Charles University and Faculty Hospital 2 with the Faculty Polyclinic (FLV UK and FN2 with FP) - now the Urology Clinic of the 1st Faculty of Medicine and the General University Hospital in Prague (hereinafter 1st Faculty of Medicine UK and VFN in Prague) was established in 17 .October 1975 . The clinic building was officially opened a year later on September 22, 1976, with the participation of national artists and a contemporary political delegation. At the time of the opening, it had 96 beds and 30 doctors worked there. Its founder and first chairman (in the years 1975-1987) was prof. MD Eduard Hradec, PhD. , who also played a significant role in shaping the modern form of urology, its teaching and specialization.

Construction of the clinic building

Professor Hradec collaborated with the director of the Regional Project Institute Ing. architect Vratislav Růžička, who became the author of the construction project. The project was financed by the the city of Prague (186 million crowns) and the equipment of the clinic (for another 20 million crowns) participated in the participation of important companies focused on medical technology, such as the Czech Chirana, and among the foreign ones, the most Siemens. The construction itself was in charge of a Romanian construction company, and it is interesting that the costs associated with the construction were also financed in the form of coking Ostrava coal. The construction itself took just over 3 years (from 1973), which was unusually fast for its time. The building has 7 floors, 1 underground (used as a technical floor - control center of not very effective air conditioning) and 6 above ground. At the time of opening, the clinic had 96 beds (including the children's ward), a 4-bed dialysis center, a 6-bed intensive care unit connected to its own operating tract and a separate ambulatory tract on the ground floor. The operating tract on the 2nd floor included 3 separate operating rooms for open operations and 3 specialized rooms for transurethral procedures, endoscopy and shock wave lithotripsy (LERV device Lihostar from Siemens). The workplace also housed complement workplaces (radiology workplace, nuclear medicine workplace, biochemical, microbiological and histopathology laboratory). From the beginning, the clinic was one of the first workplaces in Europe where they dealt with a completely new issue - the use of urodynamic measurements in their own laboratory.

Among the first employees of the clinic were recruited doctors and nurses from the ranks of experienced personnel II. FLV and FN2 surgical clinics with FP. Their indisputable qualities, in addition to the results of their own work, are also evidenced by their international successes not only in the field of urology, but also in the field of complementary complementary workplaces, e.g. in cytology.

The heads of the clinic

The founder and first director of the clinic in 1975-1987 was Prof. MD Eduard Hradec, PhD. Professor Hradec (born 1918 - 2005) was the author of many important teaching materials and publications (the most cited work is the publication on bladder replacements). He was also a member of many professional societies and significantly influenced the shape of the concept of modern urology and the system of its study in Czechoslovakia. He studied and lectured at many important European and American workplaces. Among other things, he was the first urologist in the Czech Republic to introduce standard radical prostatectomy as the method of choice in the treatment of prostate cancer.

In the years 1987 - 1990, doc. MD Ladislav Jarolím, CSc. (born 1949). In 1993, after a visit to Los Angeles, he developed, together with Czech anatomists of the 1st LF UK, the idea of ​​orthotopic replacement of the bladder in women, for which he received an award from the Ministry of Health. He significantly developed the technique of radical prostatectomy and is considered one of the greatest experts in Europe on the issue of genital reconstruction of transsexual persons. He is a member of many professional societies and editors. For his publications, he received many awards from the Czech Urological Society of the Czech Medical Society of Jan Evangelista Purkyně (hereafter ČUS ČLS JEP). He left the clinic - like some other colleagues - to the urology clinic of the 2nd Faculty of Medicine in Motola.

Doc . MD Miroslav Hanuš, CSc. (born 1940 - 2015). Like his mentor prof. Hradec was a member of many prestigious foreign associations, including the American Academy of Sciences, founded the Society of Ambulatory Urologists and was a member and later president of the Czech Urological Society ČLS JEP. He mainly focused on endoscopy and the issue of bladder and prostate tumors. He presented the results of his work abroad (including in the USA, Australia, Japan) and almost all over Europe. He was a priority until 1992, when he became the director of the first private Urocenter in the Czech Republic, which was soon involved in domestic and international diagnostic and pharmacological studies. For his lifelong contribution, he was awarded Honorary Membership of the ČUS ČLS JEP and the Eduard Hradec Award.

Another head of the clinic (in the years 1992 - 1995) was doc. MD Radko Petřík, CSc.(b. 1927), who was also able to enjoy working with prof. Hradec, because after 1960 he became his closest collaborator. Perhaps due to this, he was one of the main pillars of the clinic from the beginning of its opening in 1975. In the difficult post-recession period, he was able to stabilize the situation at the clinic, establish a creative regime and restore international cooperation. At the clinic together with his successor prof. Dvořáček founded the Lucie Foundation and became its first chairman. He was thus able to hand over a prosperous clinic to his successor. Docent Petřík became the first multi-term president of the Czech Urological Society ČLS JEP (1990-1993) and in 2007 he was awarded the honorary medal of JE Purkyně, in 2012 he received from the hands of the president of ČLS JEP Honorary membership of ČLS JEP and in 2010 he was awarded the Prize Eduard Hradec for lifetime achievement.

In 1995, he took over the clinic from Prof. Petřík's colleague Prof. MD Jan Dvořáček, DrSc. (born 1943). He held the position of head in 1995-2009. Also Prof. Dvořáček worked at the clinic under the guidance of prof. Castle. After the establishment of the clinic, he was appointed to the position of general practitioner for pediatric urology, where he headed a separate children's department. Together with other doctors, he is considered the creator of modern pediatric urology in our country. Thanks to his contribution, a leading children's urology department was created at the clinic. During the presidency of prof. The Dvořáčka clinic was renovated, new devices (Dornier for LERV ), X-rays for endourological operations were installed, and overall facilities for doctors and patients were improved. He was the first in the Czech Republic to perform appendicovesicostomy and gastrocystoplasty. As a big supporter of laparoscopy advocated the creation of one of the first urological laparoscopy centers in the Czech Republic. He is the author of a number of professional works and textbooks, which have become the basis for the study of modern urology. Professor Dvořáček received numerous medals (including a medal from the hands of the President of the Czech Republic for merits in the field of science and healthcare, 1st degree), honors, honorary memberships in many domestic and international urological societies. He was the president of important international urological symposia in the Czech Republic, the head of the IPVZ department, the chairman of the scientific council of the Ministry of Health of the Czech Republic and then the chairman of the AC of the Ministry of Health of the Czech Republic for the field of urology (2005-2010). In 2017, he was awarded the Vladimír Zvara award as the highest award of the Slovak Urological Society for his lifelong contribution to the field of urology.

In 2009, Prof. MD Tomáš Hanuš, DrSc. (born 1951). At the beginning of his career, Professor Hanuš also received an offer from Prof. Hradec to work at the newly opened clinic. He began to devote himself to the newly developing fields of urology - the investigation and treatment of functional disorders of the urinary tract and urodynamics. He thus became a pioneer and pioneer of Czech urodynamics and has many firsts in this regard. His extraordinary experience in the field of functional disorders led him to the International Continence Society - ICS . In 1994, he chaired the Scientific Committee of the ICS Congress, which he co-organised. In the same year, he organized the first EBU ( European Board of Urology ) In Service Test in the Czech Republic . In 1998, he organized the first ESU laparoscopic course(European School of Urology)in the Czech Republic ending with the first Czech laparoscopic nephrectomy for a tumor. He gradually became a respected national and international expert, thanks to whom Czech urology enjoyed important foreign visits. Thanks to his personality and pro-European feeling, Czech urology quickly joined the flow of world urology. For many years (1993-2008) he led and represented the ČUS ČLS JEP as chairman. As chairman of the Czech Association of Urologists, he always tried to improve the position and possibilities of Czech urologists within Europe. From the position of EBU delegate for the Czech Republic, he always promoted European requirements in the urological education of Czech doctors. The EBU written and oral tests are now recognized in our certification exams. He is or was a member of many important national and international institutions (EBU, ESU committee member, Georgian Urological Society, ICC working group). He was the president of the ČUS Annual Conference and the 6th Central European EAU Conference. His position in the committee is significant EAU Guidelines Office and support for the participation of Czech urologists in the creation of European recommended procedures. He completed a number of foreign study stays at urological clinics and today he is invited as an " invited speaker " at congresses abroad. He is also the author or co-author of 9 monographs, 36 comprehensive chapters in monographs, 112 original scientific-research or comprehensive articles in our country and abroad with many citations. As the vice-dean of the 1st Faculty of Medicine of the UK, he coordinates the teaching of urology, is the chairman of the exam committee for urology, chairs the pedagogical committee of the faculty, and manages doctoral studies. Since 2009, he has been heading the department of urology at the IPVZ. He repeatedly won the ČUS award for the best publication, he is the holder of the honorary medal of the 1st Faculty of Arts of the UK. In 2011, he was awarded the Gold Medal of Merit Slovak Medical Society . Prof. Hanuš, from the position of chairman of ČUS, has always supported above-standard relations with the Slovak Urological Society. In 2013, he received the " Aesculap Academy Award " in the doctors category and the Gold Medal of the Association of Czech Doctors in Prague for his lifelong contribution to health education. He received the " Award of Distinction the European Association of Urology " honorary plaque for ten years of activity in the Guidelines Office of the EAU .

Profile and development of the clinic

The clinic provides comprehensive diagnostic and treatment care in the entire range of urology (teams for oncourology, functional urology and urodynamics, pediatric urology, andrology, urinary tract reconstructive surgery, comprehensive treatment of urolithiasis, endourology, adrenal surgery, plastic reconstruction of the lower urinary tract and laparoscopy ) , with with the exception of kidney transplantation , which is performed at IKEM in Prague. The clinic has been performing laparoscopic surgeries for 25 years.

The authors of the clinic published dozens of works with IF ( impact factor ), in 2014 the most extensive grant of the clinic (on oncomarkers) was defended as " excellent ". A new concept of the children's department was implemented - the centralization of children's urology on the 4th floor, including an increase in the capacity of beds, the school, the construction of new facilities for nurses and treating doctors of various fields. The ambulances, halls (including equipment), rooms for ward nurses and doctors were modernized. New rooms for endoscopy, sonography, complementary workplaces and for technical and administrative staff were created or modernized. The clinic is very closely involved in the undergraduate and postgraduate teaching of medical students and doctors. Thanks to the support from the 1st Faculty of Arts of the University of Warsaw, the parts used for teaching were also modernized.

After the last reorganization, the clinic has 73 beds (50 for adults, 11 for children, 8 ICU beds for adults and 4 ICU beds for children). The operating tract includes 3 operating theaters for open/laparoscopic operations, 1 for transurethral endoscopy, 1 for upper urinary tract endoscopic operations equipped with an X-ray device and 1 for LERV . The outpatient section is divided into acute and chronic cases - counseling. The separate RDG part is a detached workplace of the 1st Faculty of Medicine of the UK. The building also has an auditorium, a study room, a library, a laparoscopy classroom, a teaching ambulance for medics, a pharmacy and a sterilization office.

Medical care

Annually ( data valid as of 2017 ), about 2,500 patients (including about 700 children) are hospitalized at the clinic. About 2,800 operations are performed annually (over 1,400 of which are laparoscopic/endoscopic), and about 180 patients undergo LERV annually. About 600 children from all over the Czech Republic undergo surgery at the clinic annually. Almost 33,000 patients are treated on an outpatient basis at the clinic, of which 3,800 are under 18 years of age.

Close cooperation with oncologists is evident in medical care, and in the case of extensive oncological procedures, also interdisciplinary cooperation with cardiologists, gynecologists and surgeons; andrological care for the assisted reproduction center of the gynecology-obstetrics clinic near Apolinář; cooperation with the clinic of pediatric and adolescent medicine. Joint consultations with oncologists have been ongoing since the opening of the clinic. Traditional winter symposia are also devoted to oncology topics. As the leading representatives of the clinic are often respected members of important multinational urological societies, the clinic occasionally organizes international conferences, regular symposia and educational events. The clinic also holds numerous national firsts in the introduction of new diagnostic and operative procedures, e.g. the introduction of:

pack up

Year	Diagnostic, operative procedures
1977	urodynamic examination methods
1980	microsurgical reconstructive surgery in pediatric urology
1982	puncture nephrostomy
1984	hanging operation for female incontinence according to Stamey-Perreira
1985	percutaneous extraction of urinary stones
1986	hypospadias surgery with a tubulated foreskin flap; retropubic radical prostatectomy
1987	bladder replacement with a detubulated low-pressure ileocecal segment (Mainz pouch I); LERV (even as the first post-Soviet bloc country)
1988	replacement of the bladder with a detubulated low-pressure ileal segment
1990	bladder augmentation with a detubulated low-pressure ileal segment
1992	hypospadias preputial onlay plasty; sigma-rectum pouch (Mainz pouch II); transsexual plastic surgery; implantation of an artificial urinary sphincter AMS800
1993	augmentation of the bladder by the stomach; hanging operations for female incontinence according to Raze
1994	preputial onlay-inlay plasty of hypospadias; autoaugmentation gastrocystoplasty
1995	use of buccal mucosa in urethral reconstruction; laparoscopic nephrectomy in a child
1999	laparoscopic lymphatics-sparing varicocelectomy; laparoscopic adrenalectomy
2000	laparoscopic nephrectomy for a tumor in an adult
2001	laparoscopic pyeloplasty in a child
2002	laparoscopic resection of a kidney tumor; laparoscopic radical prostatectomy
2004	laparoscopic heminephrectomy in a child; TVT plastic surgery in female stress incontinence
2005	TOT plastic surgery in female stress incontinence
2006	ARGUS suburethral tape for male incontinence
2007	laparoscopic uretero-pyeloanastomosis and other...

Education at the clinic

The clinic provides undergraduate education for medical students in Czech and English. In total, about 400 students go through the clinic per year, participating in a 2-week block internship. In the first week, there are lectures supplemented by case studies, teaching of urological sonography and practice of bladder catheterization on a phantom. The next week, the practical part takes place, when students have the opportunity to visit ambulances, consulting rooms and operating rooms.

The clinic is accredited for the entire educational program for the field of urology. Thus, he participates in specialized education . In addition to residents, doctors from some workplaces with Type I accreditation and doctors from related specialties (surgery, gynecology) are also trained here. The clinic met the demanding conditions for awarding a certificate from the European Board of Urology on the accreditation of the European urology educational program taking into account the high quality of the workplace. The clinic is home to the IPVZ department (head Prof. Tomáš Hanuš, MUDr., DrSc.). Until 2012, all certifications in urology took place here. The clinic has long had its representatives in the accreditation commission of the Ministry of Health of the Czech Republic for urology.

The clinic has accreditation for additional fields , namely for the newly established field of oncourology, and for the long term also for teaching pediatric urology. Postgraduate education takes place within the disciplinary board of experimental surgery of the 1st Faculty of Medicine, UK. The clinic also serves as a base for practical teaching of female students of the Higher Medical School .