Urological surgery deals with surgical pathology of the kidneys, ureters, bladder, seminal vesicles, vas deferens, testicles, scrotum, urethra, and female urology. Key areas include urological oncology like prostate, bladder, kidney, and testicular cancers. Surgeries are performed openly as well as laparoscopically and robotically. Endourology techniques include treating stones, endoscopic surgery, and reconstruction. Urology training in Ireland involves initial surgical training followed by urology residencies and specialization, with the goal of developing more units and increasing Ireland's low number of urologists per population.

1. Urological SurgeryUrological Surgery
David Galvin MDDavid Galvin MD
Specialist Registrar In UrologySpecialist Registrar In Urology

2. Urological SurgeryUrological Surgery
 ““Most fascinating area in Surgery”Most fascinating area in Surgery”
 Deals with all Surgical PathologyDeals with all Surgical Pathology
involving:involving:
 KidneysKidneys
 UretersUreters
 BladderBladder
 Seminal Vesicles and VasSeminal Vesicles and Vas
 Testicles and ScrotumTesticles and Scrotum
 UrethraUrethra
 Female UrologyFemale Urology

3. Urological OncologyUrological Oncology
 Prostate Cancer: Commonest male cancerProstate Cancer: Commonest male cancer
 Bladder Cancer: 4th commonest male cancerBladder Cancer: 4th commonest male cancer
 Kidney Cancer: 8th commonest cancer. Most lethal.Kidney Cancer: 8th commonest cancer. Most lethal.
 Testicular Cancer: Commonest cancer <40Testicular Cancer: Commonest cancer <40
 Ageing populationAgeing population

4. Urological OncologyUrological Oncology
 Partial or Radical NephrectomyPartial or Radical Nephrectomy
 Open / Laparoscopic / RoboticOpen / Laparoscopic / Robotic
 Radical ProstatectomyRadical Prostatectomy
 Open / Laparoscopic / RoboticOpen / Laparoscopic / Robotic
 Radical CystectomyRadical Cystectomy
 Open / Laparoscopic / RoboticOpen / Laparoscopic / Robotic
 Penectomy - Bilateral Groin Dissection - RPLNDPenectomy - Bilateral Groin Dissection - RPLND

5. EndoUrologyEndoUrology
 StoneStone
 PercutaneousPercutaneous
NephrolithotomyNephrolithotomy
 Flexible UreteroscopyFlexible Ureteroscopy
 Rigid UreteroscopyRigid Ureteroscopy
 Dormia BasketDormia Basket
 Laser FragmentationLaser Fragmentation
 ESWLESWL
 CystolithopaxyCystolithopaxy
 Endoscopic SurgeryEndoscopic Surgery
 CystoscopyCystoscopy
 TURPTURP
 UrethrotomyUrethrotomy
 TURBTTURBT
 OtherOther
 ReconstructionReconstruction
 Female UrologyFemale Urology
 ED SurgeryED Surgery
 TransplantationTransplantation

6. Manpower NationallyManpower Nationally
 2323 Urology ConsultantsUrology Consultants (7 outside Dublin)(7 outside Dublin)
 Also 5 Private Urologists (increasing)Also 5 Private Urologists (increasing)
 99 Specialist RegistrarsSpecialist Registrars Positions (8 filled July 06)Positions (8 filled July 06)
 Dublin (7), Galway (1), Limerick (1)Dublin (7), Galway (1), Limerick (1)
 1212 Non-SpR RegistrarNon-SpR Registrar PositionsPositions
 5 will be Urology Residents5 will be Urology Residents
 Urology Research RegistrarsUrology Research Registrars
 Conway (2), Trinity (2) - Cork, Beaumont etcConway (2), Trinity (2) - Cork, Beaumont etc

7. Future Manpower NeedsFuture Manpower Needs
 Lowest Urologists in Europe (1:180,000)Lowest Urologists in Europe (1:180,000)
 Maintain Dublin CentresMaintain Dublin Centres
 MMH / SJH to expand over timeMMH / SJH to expand over time
 Develop 4 man units in Cork, Limerick,Develop 4 man units in Cork, Limerick,
GalwayGalway
 Huge Expansion RequiredHuge Expansion Required
 Enhance present unitsEnhance present units
 Single appointments working in triosSingle appointments working in trios
 Natural increase in private sectorNatural increase in private sector

8. Urology Training: UKUrology Training: UK
Intern
Foundation Year 1 (FY1)
Foundation Year 2 (FY2)
Foundation Year 3 (FY3)
Foundation Year 4 (FY4)
Foundation Year 5 (FY5)
Urology Fellowship 1
Urology Fellowship 2
FRCS (Urol)
Consultant Urologist
Consultant Urological
Surgeon

9. Urology Training: IrelandUrology Training: Ireland
Intern
Basic Surgical Training (MRCS)
Urology Residency 1
Urology Residency 2
Urology Residency 3
Urology Residency 4
Urology Specialist Registrar
5 Year Scheme
Consultant Urological
Surgeon

10. Why I did Urology …Why I did Urology …
 I wanted to do SurgeryI wanted to do Surgery
 I enjoyed Endoscopic UrologyI enjoyed Endoscopic Urology
 It is largely (75%) Elective basedIt is largely (75%) Elective based
 On call is frequent but generally lightOn call is frequent but generally light
 Call is from home throughout the countryCall is from home throughout the country
 Enjoy family life with my wife andEnjoy family life with my wife and
childrenchildren
 Well structured Training postsWell structured Training posts
 Very ‘International’ - Regular ConferencesVery ‘International’ - Regular Conferences

11. How to get into UrologyHow to get into Urology
1.1. Talk to UrologistsTalk to Urologists
2.2. Request a Urology rotation while a BSTRequest a Urology rotation while a BST
3.3. Do some Urology based audit while BSTDo some Urology based audit while BST
4.4. Get Registrar ExperienceGet Registrar Experience
• Cork - Galway - Limerick best betsCork - Galway - Limerick best bets
1.1. Apply for new Residency programmeApply for new Residency programme
2.2. Do Urology Research (MCh, MD)Do Urology Research (MCh, MD)
3.3. Attend teaching / ISU meetingAttend teaching / ISU meeting

12. Present and FuturePresent and Future
 Training undergoing changeTraining undergoing change
 Future is bright - huge expansion long overdueFuture is bright - huge expansion long overdue
in an ageing populationin an ageing population
 Very competitive SubspecialtyVery competitive Subspecialty
 Training is well structuredTraining is well structured
 Getting ‘in the door’ is now much easierGetting ‘in the door’ is now much easier

13. ContactsContacts
Urological Trainees of Ireland (UTI) website:Urological Trainees of Ireland (UTI) website:
www.homepage.mac.com/www.homepage.mac.com/davidgalvindavidgalvin
European Society of Residents in Urology:European Society of Residents in Urology:
www.esru.netwww.esru.net (Ireland webpage)(Ireland webpage)
Me: davidgalvin@mac.comMe: davidgalvin@mac.com