The historical development of urology in Aue

The establishment of independent urological clinics around the world mostly began only after the Second World War. Understandably, this process followed the models established by pioneers in the fields of urology and surgery: Félix Guyon (Loukas 2007), Maximilian Nitze (Nitze 1879), Peter Freyer (Freyer 1901, 1919) and James Israel (Israel 1925), to name but a few.

Compared with the present day, clinical practice in the 1950s and 60s was therefore characterised largely by open surgical procedures, without  - interventional endourology and endoscopy of the upper urinary tract   - percutaneous stone treatment and ESWL  - sonography and computer tomography   - chemotherapy   - regular radical prostatectomy, cystectomy and urine derivation   - urodynamics and   - urological laparoscopy.A particular aspect of this period, however, was undoubtedly the concerted effort to find a form of kidney replacement therapy. Although the first kidney transplant on a human was successfully conducted as early as 1954 (on identical twins), the clinical breakthrough only took place 30 years later when the first suitable immunosuppressant, cyclosporine, was introduced in the early 1980s.Preliminary work on haemodialysis, on the other hand, had already been done by Thomas Graham (Graham 1861), John Jacob Abel (Abel 1913) and Georg Haas (Haas 1925); in 1924 the latter succeeded in performing the first human “blood purification” at the Medizinische Klinik in Giessen, for which he used hirudin as an anticoagulant (Enke 2007). Encouraged by further successes by Willem Kolff (Kolff 1945; the world’s first clinically successful dialysis) and Nils Alwall (Alwall 1946; first use of ultrafiltration), Curt Moeller (Moeller 1955) performed the first clinically effective dialysis in Germany on March 8th, 1950 at the Marien-Krankenhaus in Hamburg (www.curtmoeller.de). The improved models he developed in the 1950s (Moeller II and III) – which were introduced in a total of 14 (mostly West) German hospitals up to 1960 (Rafal 2002) – were the starting point for independent development in Aue, in the then-GDR, for which two historical dates are significant: firstly, the foundation of the Aue Urological Clinic on 1 August 1961, and secondly, the construction of the Berlin Wall a few days later on 13 August 1961 – with the resulting isolation, both politically and in terms of medical research.The decisive factor in the establishment and development of the Aue Urology Clinic into a well-known urology and nephrology centre of supra-regional importance was, however, the founder of the clinic:

 


                                                    Professor Wolfgang Kaden
(1927-2014, CV).


He is regarded not only as the father of the “Artificial kidneys” Aue I and II (Kaden 1965/ 1970), which he developed in association with the Scheibner company in Bernsbach, the head of the research laboratory of the Chirurgische Klinik Halle, Dr. Manfred Richter, and the Chemnitz engineer Günter Fechner, but also as an important driving force and a luminous figure in East German and Saxon urology.

Literatur

Abel J,  Rowntree L, Turner B
On the removal of diffusible substances from the circulating blood by means of dialysis
Trans. Ass. Am. Phys. 288,1913

Alwall N, Norvitt L
On the artificial kidney: technical and methological problems
Acta Med Scand. 1948 Sep 15; 131(3): 237-50

Enke U
Georg Haas - Pionier der Hämodialyse,
Dtsch Ärztebl 2007; 104(33): A-2252/ B-1993 / C-1925

Freyer P
Suprapublic prostatectomy.
Report of 4 cases.
BMJ 11, 125; 1901

Freyer P
Total Enucleation of the Prostate: a further series of 550 cases of the operation
BMJ 1919 Feb 1; (3031): 121-120.2

Graham T
Liquid Diffusion Applied to Analysis
Philosophical Transactions of the Royal Society 151, 1861, S. 183-224

Haas G
Über Versuche der Blutauswaschung am Lebenden mit Hilfe der Dialyse,
Archiv für Experimentelle Pathologie und Pharmakologie 116, Heft 3/4, 1926, S. 158-172

Haas G
Über die Künstliche Niere
Deutsche Medizinische Wochenschrift., 77. Jhg. Nr.52,1952, S.1641

Israel J, Israel W
Chirurgie der Niere und des Harnleiters
Thieme Leipzig (1925)

Kaden W, Fechner G
Künstliche Niere Aue nach Dr. Kaden und Dr. Richter
Medizintechnische Versorgung 2, 34 (1965) pdf

Kaden W
Das neue Dialysenzentrum Aue Medizintechnische Versorgung 7, 163 (1970) pdf

Kolff W and Berk H
The Artificial Kidney: a dialyser with great area.
Acta Medica Scandinavica, Vol. 117, Fasc.2 (1944)
 
Loukas M, Linganna S, Jordan R.
Jean Casimir Felix Guyon -- urogolist and anatomist.
Clin Anat. 2007 Jan;20 (1): 1-2.

Moeller C.
Zum Thema ,,Künstliche Niere"
Deutsche Medizinische Wochenschrift, Jhg. 80, Nr. 43, 1955, S. 1578-1579

Moeller C.
http://www.curtmoeller.de/4.html

Nitze M
Eine neue Beobachtungs- und Behandlungsmethode für Harnröhre, Harnblase und Rectum.
Wiener Medizinische Wochenschrift 1879 (29), 24

Rafal A
Entwicklung und Einsatz der Dialyse - Ein Vergleich zwischen der BRD und Polen
Inauguraldissertation, Justus-Liebig-Universität Gießen, Gießen 2002.