History of Sri Lankan Urology & the Sri Lanka Association of Urological Surgeons (SLAUS)

Urology was established as a speciality in Sri Lanka in 1954 when Dr George Nelson Perera who started his career as a general surgeon and returned to the country after overseas training and appointed as the genitourinary surgeon of the General hospital Colombo (Now the National Hospital of Sri Lanka). He concentrated mainly on open Urological surgeries and endoscopy was reserved mainly as a diagnostic procedure. As experienced by his western counterparts, he also faced a fair degree of resistance from the general surgeons who shared a similar practice and did not like the idea of parting with it. It is legendary that they went to the extent of seeking legal assistance against Dr Perera for including hydrocelectomy in range of his procedures.

In spite of this resistance, his followers Drs LS Attygalle, LM Perera and AM Beligaswatte carried the baton forwards.  They were also general surgeons who were converted into being genitourinary surgeons by spending a period of training at esteemed urological institutions in the UK such as the Institute of Urology, London. After having returned to the country, they occupied urology departments in Colombo & Kandy. During their career transurethral resection surgery was introduced and developed which tremendously helped for speciality to get recognized. Their skills in handling more complicated Urological procedures and certain conceptual changes in the management of urological disease increased the respect towards the speciality. The only drawback was the unbearable work load they had to carry over the next 30 years which automatically led to lack of progress in introduction of rapidly advancing technology in Urology and development of research. The only additional advanced technique introduced during this period was ESWL in 1992.

The third generation of Urologists emerged from 1988 through the newly formed Post Graduate Institute of Medicine (PGIM) of the University of Colombo which introduced more formal and structured supervised programmes similar to those in UK with an exit examination – the MS and now MD (Surgery). Thereafter Urology was taken up as a carrier by training for three years (2 years locally and one year mandatory period in a centre of excellence abroad-usually in the UK).

The first trio to select Urology as a carrier under this new scheme was Drs SAS Goonewardena, Neville D Perera and PGDS Samaraweera who stepped into the boots of their predecessors. Identifying the needs of the country with a population of 20million people and the scarcity of specialists in Urology, more and more post graduate trainees were attracted to take up urology as a career under the mentorship of these trainers and during next one and half decades, these trainers have managed to train over 15 fully fledged consultant urologists who have opened up several urology units outside the two main cities introducing the service of specialty to peripheries of country. While majority of young Urologists returned to country to extend their skills to serve in the public sector, some of them have decided to remain in greener pastures of the west; a few have joined the universities in Sri Lanka and some have joined the private sector.

The development of urological services with introduction of modern minimally invasive skills were rapidly introduced to Sri Lankan practice of Urology centered at the National Hospital of Sri Lanka which included advanced video and urological surgery such as percutaneous renal surgery, ureterorenoscopic procedures, advanced urodynamics and a wide range of reconstructive urological procedures which were rarely considered in the bygone era. By the end of the first decade of the new millennium, laser urological treatment for prostate and stones and advanced urological laparoscopy was introduced and developed at National Hospital of Sri Lanka.

While technical advances were introduced, the most significant in the history of Sri Lankan Urology is the formation of Sri Lanka Association of Urological surgeons (SLAUS) in December 1999 by Drs SAS Goonewardena, Neville D Perera and Anura P Wijewardena. The membership of this specialist association includes full time Urologists and Specialist Registrars in Urology. With an initial membership of 9 it has grown to 59 by today.

Over past decade SLAUS maintain a close collaboration with Urological Association of Asia, British Association of Urological Surgeons, Urological Society of Australia and Newzealand, Singapore Urological Association and Urology Section of Royal Society of Medicine (UK). In association with above organizations SLAUS has organized several academic events which included scientific symposia and workshops. Further SLAUS organizes regular post graduate training programmes, quarterly CME programmes and live/ semi live workshops especially for post graduate trainees and its members.

The first Annual Scientific sessions of SLUAS was held in 2005 and since then SLAUS annual sessions have been held in November/December, every year with participation of international & local faculty. SLAUS has its official publication Sri Lanka Journal of Urology (SLJU) since year 2000 under the editorship of Dr SAS Goonewardena, which has opened a golden path to urological research and publication of Sri Lanka.

Urology is fast evolving in Sri Lanka with increasing number of Urologists, advances in the technology and the reach out to the population of all parts of the island