3 minute read
Eponyms and Dutch urological innovations in perspective
Dr. Pieter Dik Retired paediatric urologist Utrecht (NL)
An eponym is a person, place, or thing named after (or believed to be named after) someone or something. Discoveries and innovations are often named after the discoverer or an influential person. Examples of these include Alzheimer’s disease and the Apgar score.
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All urologists know famous names such as Bricker and Millin, which are indeed typical examples of eponymes. Bricker and Millon did not invent nor describe uretero-ileal stoma and retropubic prostatectomy, respectively. How come their names are associated with these procedures? Who were the urological surgeons who pioneered these procedures many years before?
The Dutch urologist, Dr. Willem J. van Stockum (1860-1913) started to do prostatectomy operations in the early years of the 20th century. On November 3, 1908 he performed the first “Prostatectomia Suprapubica Extravesicalis” and published this method in the Zentralblatt für Chirurgie journal in January 1909.
Dr. Willem J. van Stockum The Irish urologist Dr. Terence Millin (1903-1980) performed a similar operation, the “Retropubic Prostatectomy” and published this “new extravesical technique” as a report on 20 cases in The Lancet, Dec.1;2(6380):693-6,1945. He was aware that this operation was performed some decades before and correctly referred in his paper to the case reports of van Stockum.
Dr. Terence Millin
The Dutch urological surgeon Dr. Hendrikus J. Zaaijer (1876-1932) was working in the University Hospital of Leiden when he performed the first uretero-ilealcutaneo-stomy in 1911 on a patient with total incontinence because of a vesico-vaginal fistula. Unfortunately, she died 11 days later due to extensive malignancy of the cervix. The second case was a patient with carcinoma of the bladder. This patient died six days postoperatively from peritonitis.
Dr. Eugene M. Bricker employed urinary diversion by an uretero-ileal stoma method in hundreds of patients since 1950. Bricker was probably not aware of the two aforementioned patient cases of Zaaijer. This may be explained by the fact that Zaaijer did not publish his cases in literature. Nonetheless, Zaaijer was quite famous in the Netherlands because of his surgical innovations. In 1908, he was also the first to perform a successful long-term autotransplant of the kidney in a dog. This dog lived another eight years. It may have been possible that Zaaijer’s stoma operation was discussed during European congresses.
Later, Dr L. Seiffert from Neunkirchen made a conduit with the use of jejunum. He performed this operation on two patients. The first patient survived for three years, while the second one died of renal failure. In 1950, Dr. Heinz Haffner from the St. Louis City Hospital in the United States created an ileal conduit when he was “unable to use coecum as a reservoir and was forced to use an isolated segment of the ileum alone” during an operation. Perhaps he was inspired by Zaaijer or Seiffert? One will never know for sure. Why was the eponym for the retropubic prostatectomy operation “Millin” instead of “van Stockum”? It is because Millin popularised this operation and published many cases.
In the case of the uretero-ileal cutaneo-stoma operation, the eponym became “Bricker” and the name Zaaijer is totally unknown to most urologists. This is mainly because Zaaijer did not publish his first two cases, probably because he was disappointed about the complications and outcome which is an outstanding example of “publish or perish”.
I must confess, I am not a true advocate for the use of eponyms. It seems odd to me that a name of a person should live on as a kind of trademark or glorification. On the other hand, it is easier to refer to and discuss about scheduled operations e.g “Mr. Johnson will undergo a Bricker” is shorter than “Mr. Johnson will undergo a uretero-ileal-cutaneostomy”.
However, my personal concern against the use of eponyms is that my family name would be unsuitable for an eponym.
Dr. Hendrikus J. Zaaijer
Dr. Eugene M. Bricker
Saturday, 2 July 11.00 - 13.30 EAU History office Grey Area, Room G107
Urologist asks for medical instrument that was invented by Dr Dik
