Past, Present and Future of Urology in Pakistan

There is very little published literature on urologic diseases prior to 1947 from areas now constituting Pakistan. From inception of the country to 1970s, urology was part of surgery practiced by general surgeons except for two urology units established in 1960s. The real take off of urology began with introduction of transurethral resection of prostate (TURP) in 1980s, ushering the era of endourology; the second era of which began with ureteroscopy along with extracorporeal shockwave lithotripsy (ESWL) in 1987-1989, percutaneous nephrolithotomy in 1992 and introduction of percutaneous nephrostomy in 1997. Renal transplantation was started in 1979 from living-related donors and currently, there are 19 renal transplant centres. At present, there are 11 specialized kidney centers in the country. Urology has undergone marked metamorphosis during the new millennium. It has given rise to many sub-specialties. Over the past few decades, the classical surgical training has shifted towards adaptation of surgical simulation labs. We foresee more specialized urology centers and strengthening of sub-specialty practices in the country.