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Development of pediatric urology in Romania

dr ionescu

Sebastian Ionescu

MD PhD Associate Professor

Emergency Clinical Hospital for Children "MS Curie"

Bucharest, Romania

The beginnings of pediatric surgery in Romania started with the year 1886, in Bucharest, when the first children’s hospital – “Grigore Alexandrescu” - was built by an English architect, according to the same plans used, at that time, for the Children’s Hospital in London and Saint Petersburg.

Observing children with urological congenital malformations and seeing the implications it had on the development of child’s personality, integration within the family and social life, and on the other hand, knowing the limited possibilities available to reconstruct the anatomy and function of these abnormalies, a group of Romanian pediatric surgeons decided that this chapter in children’s pathology deserves a special attention. The determinant contributions came from the medical education provided by Prof. Alexandru Pesamosca, Prof. Coban Nicanor, Prof. Titel Vereanu, Prof. Mircea Socolescu, those who have been very close to this surgical subspecialty.

Proper management in reconstructing these complex lesions implies cooperation between different medical specialties – perinatology, obstetrics, genetics, pediatrics, radiology, endocrinology – with everyone playing its special and essential role. All those who are involved must communicate with each other in order to define their level of knowledge, share expectances, use a common terminology and follow the same criteria to evaluate the results.

It was after the country’s political changes in 1990, that we became aware that we had no proper surgical technology available in order to provide viable and up-todate solutions for the pediatric urologic pathology. Knowing the existing restrains in communication between certain medical specialties it became more obvious the selflimitations we had to overpass, because as it is well known closed systems are dying but open systems progress.

In these circumstances, we drawn an initiative plan to open the interest in pediatric urology for the medical graduates, have direct contact with the EU medical community, have open access to scientific literature and improve our surgical skills and knowledge during exchange programs in EU and USA hospitals – such as at Columbus Children’s Hospital under coordination of Professor Stephen Koff or at St. Luc Hospital, in Bruxelles with Professor Francois-Xavier Wese.

This was followed by significant scientific meetings such as:

- The first international pediatric urology conference in Romania in October 1998 entitled “Surgical Vs Endoscopic Treatment In Pediatric Urology: Indications, Techniques, Advantages” brought us the experience of I. Oesch, J. Thorup, Tom PVM de Jong, C. Rance, S. Perovic, Rienj M. Nijman, Hans G. Dietz, P. Alessandrini, M. Ardelean

- The National Congress of Pediatric Surgery - Urology Section with the support of Romanian Medical Academy in May 2004 at Poiana Brasov with the participation of distinguished urologists like T. Manzoni-Italy, S. Tekgul-Turkey, J. Dilhon-United Kingdom, Tom de Jong- The Nederlands, C. Buyukuna-Turkey, Andrew Pinter – EUPSA president, T. Boemers-Koeln, E. McGahren-USA, M. Robert-France, Al. Haller-U.S.A., when Philip Ransley - United Kingdom, accepted to become Honorary Member of Romanian Academy.

- Updates In Surgical Treatment In Congenital Urogenital Malformations – April 2005 - Updates In Pediatric Urology

– Cloacal Extrophy, Neurogenic Bladder, Bladder Extrophy, Treatment Of VUP, Live Demonstrations in May 2006 with participation of T. Boemers, D. K. Gupta and M. Ardelean

- Multidisciplinary Approach For Congenital Malformations at Sinaia in 2006

- Minimaly Invasive Techniques In Pediatric Urology – Live Demonstrations; First Laparoscopic Approach For PUJ Obstruction (A. Najmaldin) Bucharest, 2006

- Minimaly Invasive Techniques Course In Pediatric Urology October 2010, Brasov

- First Clean Intermittent Catheterization Course by LoFric catheters in Romania

Being at the beginning of this long development process we must continue with determination and consistency to actively initiate and sustain the next steps towards bringing pediatric urology in Romania at international standards. Development plans for infrastructure improvement and efficient administrative management need to be continued by all those directly or indirectly involved.

Our most reliable partners from the very beginning have been our ESPU colleagues and we are confident that such collaborations will bring a positive outcome.