The history of urology (the branch of medicine that focuses on diseases of the urinary system and the reproductive organs) in Sri Lanka is only 70 years old. The first genito-urinary surgeon in Sri Lanka was Dr. G.N. Perera and he established the first Urology Unit at the General Hospital, Colombo in 1954. However, compared to other surgical specialties, urology had grown in leaps and bounds, most likely due to the high academic and organisational skills of Sri Lankan urological surgeons. Dr. B. Balagobi is the best example for a urological surgeon with such exceptional qualities. As an undergraduate and a postgraduate trainee, he won all possible prizes and medals including the prestigious Vice Chancellor’s Prize of the University of Colombo. He was a recipient of the esteemed accolade as one of the 10 Outstanding Young Persons of the Year in 2010. Dr. Balagobi is the first Sri Lankan urological surgeon to obtain the coveted Fellowship of the Royal Colleges of Surgeons (FRCS) (Urol) qualification from the RCS of the United Kingdom.
For the good fortune of those in Northern Sri Lanka, Dr. Balagobi joined the academic staff of the Faculty of Medicine, University of Jaffna. His latest academic work is the book titled ‘Urology Essential – A Clinical Guide’ (ISBN: 978-624-6164-79-9. Published by Kumaran Book House, Chennai, India). It is mainly intended for medical undergraduates. But, it is suitable for postgraduates in surgery as well as for the paramedical staff who wish to learn basics in urology. The founder of the first Mission Medical School for Western or allopathic medicine in Ceylon in 1847 in Manipay, Dr. Samuel Green had translated many Western medical books into Tamil in the 1850s for the benefit of his students. He would have been thrilled to see a Sri Lankan surgeon and a Senior Lecturer in Surgery from the Jaffna Medical Faculty writing a book in English for the benefit of his students 164 years later.
‘Urology Essential’ contains 337 pages of B5 size. It is printed in high quality paper for heavy use. There are a large number of colourful diagrams and pictures which makes the reading interesting and easy. The summarised tables make it more reader friendly. The book is priced at Rs. 2,800 and I wonder whether the publishers can produce a low-priced edition using less costly paper for the benefit of the undergraduates. The book has 25 chapters and the most attractive section for the undergraduates would be the two annexures which have possible structured essay questions and objective structured clinical examination questions and answers. In addition, every chapter ends with several questions on that topic which allows self assessment by the reader. I wish that there was such a book when we were medical undergraduates, as if so, many more would have got distinctions in surgery.
Starting with the anatomy and physiology of the urinary tract, the book covers common popular topics like prostatic (relating to the prostate which is an organ near the penis that produces a liquid that carries sperm) diseases, urolithiasis (kidney stones), haematuria (blood in the urine), urological malignancies, urinary infections and goes to include less discussed topics like urinary incontinence, neurogenic bladder (urinary bladder problems due to disease or injury of the central nervous system or peripheral nerves involved in the control of urination), subfertility and transplant-related urology.
As a fierce believer in the latest research evidence, Dr. Balagobi has ensured that the contents in the book are up to date and evidence-based with accepted protocols and guidelines. In practice, it may be necessary to modify these protocols for this country’s health system, yet, educating undergraduates on these aspects will produce a homogenous set of young doctors who would avoid harmful interventions.
In the preface, Dr. Balagobi indicates that his main aim of writing this book was to bridge the gap between the theoretical knowledge and practical application. After reading the book, I must say that he has achieved that objective perfectly. I sincerely hope that all medical schools in this country would adopt this as the official recommended reference book for their undergraduate curricula. I am sure that this book will have a demand internationally, especially in the South Asian region, if advertised properly.
The work done by Dr. Balagobi in Jaffna reminds me of a quotation by the world-renowned Ceylonese surgeon, writer and anthropologist, Dr. R.L. Spittel in 1944 – “It is not for us to go through the travail of slow development, always bringing up the rear of scientific progress. It is for us to rather, by having as exemplars great modern institutions, to try to achieve, not by slavish imitation but by selective adaptability, the position they have attained”.
(The reviewer is a urological surgeon and the Emeritus Editor of the Ceylon Medical Journal)
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The views and opinions expressed in this article are those of the author, and do not necessarily reflect those of this publication