SGH 160th Anniversary | Xinmin Weekly features a report in Shanghai General Hospital: Urology Center: "Forging the Battleship of Urology"

‍https://mp.weixin.qq.com/s/ISQgnOsDYG1BDtXKrTnsPw

Entering the 13th floor of Building 7 at Shanghai General Hospital, one immediately experiences the convenience of the Urology Clinical Medical Center’s (referred to as the Urology Center) "one-stop" services. This floor houses general outpatient services, expert consultations, VIP clinics, and multidisciplinary team (MDT) consultations. Additionally, tasks such as registration, payment, medication collection, laboratory tests, treatment, and medical record printing can all be completed on the same floor. From the patient rooms on this floor, the stunning skyline of Lujiazui, including its iconic "three-piece suit" landmarks, can be admired through large windows, earning the rooms the nickname "river-view suites."

The predecessor of Shanghai General Hospital treated urethral stricture patients as early as 1865. In 1946, the Urology Department was formally established, becoming one of the earliest independent urology specialties in China. In 2024, the Shanghai Shenkang Hospital Development Center released the "2023 Clinical Specialty Capacity Evaluation of Urology Departments in Shanghai Municipal General Hospitals." In this evaluation, the Urology Center of Shanghai General Hospital ranked first in "medical quality" and "development capacity" and second in overall performance among Shanghai’s municipal general hospitals. The center has also maintained its position as the chair unit of the Shanghai Municipal Hospital Urology Specialty Alliance.

Moreover, the Urology Center is recognized as a national clinical key specialty, an endoscopy training base under the Ministry of Health, a leading discipline in Shanghai medicine, and a municipal key medical specialty. At its inception, the department was divided into four subspecialties: prostate diseases, urological oncology, urolithiasis, and kidney transplantation. Each subspecialty was led by a nationally renowned team. Through the collective efforts of generations of academic leaders and healthcare professionals, the Urology Center of Shanghai General Hospital has evolved into a distinguished and pioneering institution in the field of urology—a revered academic haven for urologists across the country.

Three Generations of Pioneers: Forging the “Comprehensive Urology” Legacy

The phrase "renowned for decades" aptly describes the influence of the Urology Department at Shanghai General Hospital. In 1946, Professor Huang Zheng, who had studied in Germany, established the Urology Department and served as its first director. At a time when urology was still underdeveloped in China, Professor Huang introduced advanced small-incision prostate surgeries. He not only brought cutting-edge techniques to China but also conducted numerous training programs to disseminate these innovations nationwide. His efforts significantly improved prostate surgery techniques in the country and established the Urology Department’s initial reputation.

In the 1970s, Professors Xie Tong and Tang Xiaoda, the second and third department heads respectively, ushered in the department’s second phase of development. Both were esteemed experts in kidney transplantation, with Professor Xie excelling in surgical techniques and Professor Tang specializing in tissue matching. They earned national-level scientific awards for their contributions.

Professor Xie initiated kidney transplantation in 1976 and pioneered dialysis treatment and experimental kidney transplantation research in China. In 1987, he introduced cyclosporine A for clinical use and established a monitoring system for its blood concentration, greatly advancing kidney transplantation and aligning China with international standards. Under his leadership, the department participated in the International Congress of Transplantation for the first time in 1990, promoting global academic exchange. The following year, he founded the Chinese Dialysis and Transplantation Association (CDTA), serving as its chairman for seven consecutive terms. The association has trained numerous professionals across China, significantly accelerating the development of dialysis and kidney transplantation nationwide.

The department’s third development phase was spearheaded by Professor Xia Shujie, who, in the early 2000s, championed minimally invasive surgeries over traditional open surgeries. He divided the department into teams specializing in laparoscopic, ureteroscopic, and percutaneous nephrolithotomy procedures, pioneering the transition to minimally invasive techniques. Shanghai General Hospital was the first hospital in the city to perform percutaneous nephrolithotomy (PCNL) and laparoscopic radical prostatectomy in Eastern China. In 2004, Professor Xia developed the transurethral thulium laser enucleation of the prostate (ThuLEP), which has since been incorporated into international guidelines as a standard technique. For his contributions, he was awarded the National Science and Technology Progress Award (Second Prize). Professor Xia’s leadership also saw the establishment of the Shanghai Jiao Tong University Urology Research Institute in 2005 and the Urology Clinical Medical Center at Shanghai General Hospital in 2012. Over two decades, his team addressed numerous challenges in prostate surgery, cementing the department’s leadership in the field.

Today, the Urology Center comprises seven subspecialties: prostate and urinary control surgery, two divisions of urological oncology, urolithiasis surgery, kidney transplantation, andrology, and pelvic floor and incontinence surgery. It is recognized as a “flagship” in the field of urology.

Helping Patients Live Longer and Better

The history of Shanghai General Hospital’s Urology Department highlights how technological innovation has driven its growth. Professor Han Bangmin, the hospital’s Vice President and current Director of the Urology Center, has performed the highest number of transurethral thulium laser enucleation of the prostate (ThuLEP) procedures globally. In 2014, Professor Han introduced anatomical enucleation techniques using thulium lasers. By 2018, his team further refined these techniques, making transurethral prostate surgeries simpler and safer. In 2019, he led the team that completed Shanghai’s first fourth-generation Da Vinci Xi robotic-assisted radical prostatectomy.

Given the varying conditions of benign prostatic hyperplasia (BPH) patients, including differences in prostate size and shape, the department has prioritized personalized treatment plans. Under Professor Han’s leadership, the department emphasizes comprehensive evaluations before surgery, individualized surgical precision, and targeted postoperative rehabilitation to preserve urinary control. Their efforts have resulted in a 60% early urinary control rate after prostatectomy, far exceeding international averages. In 2020, the department introduced an integrated care model for prostate cancer, establishing a Comprehensive Care Center (CCC) that provides personalized, proactive, and holistic health management for patients.

Innovation is deeply rooted in clinical practice. The department has also made significant strides in treating bladder cancer, one of the most common urological malignancies. Bladder cancer has high recurrence rates, with 5-year recurrence rates ranging from 24% to 84%. The bladder cancer team employs advanced techniques and comprehensive treatments to improve outcomes and control recurrence, adhering to guidelines that recommend immediate and periodic postoperative bladder instillation therapy.

Source: Issue 38, Xinmin Weekly, 2024

Reporter: Ying Chen

Editor: Public Relations and Spiritual Civilization Office, Shishi Cai

Translator: International Cooperation and Exchange Department, Yuhan Wang