Early twentieth century surgical urology: the 1909-1939 experience of Henry Wade

This historical review uses the experience of Henry Wade (1876-1955) to examine the state of surgical urology in the early decades of the twentieth century. For 50 years, Wade was a central figure in the life of the Royal College of Surgeons of Edinburgh. His work epitomises Scottish surgery in the years between 1909 and 1939. Wade adopted every available technique to arrive at the precise diagnosis of urinary tract disease. An exact clinical history and examination were followed by the testing of the urine, the analysis of the blood, radiography and cystoscopy. During his time, urological surgery was revolutionised by the advent of excretion pyelography. Soon afterwards, blood transfusion and the first antibacterial agents began to transform prognosis. Nevertheless, the urological scene was still dominated by the hazards of prostatectomy, the high frequency of renal tuberculosis, and the challenges of bladder and renal cancer. The virtual impossibility of eradicating malignant prostatic tumours, much less common in a population where the mean expectation of life for males was 20 to 30 years less than now, relegated this insidious disorder to a small place in his practice. In 30 years of active consultant life, Wade brought to surgical urology the skills, integrity, knowledge and determination that had already led him to prominence in the fields of cancer research and in orthopaedic and military surgery.