The field of urology plays a crucial role in maintaining and improving the health of millions of individuals worldwide. We look back with astonishment at how the AUA created a cadre of urologists from its initial membership of 8 to a present number of more than 15,000 considering its multiple categories. Ramon Guiteras and his neologism, urology, launched the AUA in 1902 and from its first annual convention, held in Saratoga Springs, New York, blended curious and innovative clinicians with emerging science and technology.¹ The AUA was intended by Guiteras and its founders as an inclusive organization of urologists. It quickly became national and then international, linking many regions, nations, and peoples. The organization and field of urology grew in synchrony with friendships, collaborations, and new ideas, skills, and technologies, coming together at the annual conventions with inevitable socialization of the members.

The lessons of history and science show that reality tends to fall short of idealism, and the inclusivity intended by Guiteras and his early band of brother-urologists remains a work in progress. This lesson is seen through what we might call the retrospectroscope, a term invoked by John R. Herman in his book, Urology, a View Through the Retrospectroscope (1973).² The AUA was more inclusive internationally than it was within its own American borders. For example, early on women urologists were not included in the profession. It was not until 1962 that the first female urologist, Elisabeth P. Pickett, who trained at Sloan-Kettering Memorial Hospital, received certification by the American Board of Urology (ABU). It would take 13 years before the second female surgeon, Mary L. Gannon, was certified by the ABU. In 1975, she became the first woman to become a member of the AUA.

Figure. The Gold Cystoscope won by R. Frank Jones and his golfing foursome at the AUA National Convention in 1973. Used with permission from David A. Bloom and Tupper Stevens.

Fast forward to today and while the urology workforce has made some progress, it has yet to reflect the demographics of the communities we serve. Data from 2022 indicate that the field comprises only 11.6% women and 2.2% Blacks/African Americans. Latinos and Native Americans are also unrepresented. Looking through the retrospectroscope, we appreciate where we have been, where we are now, and most importantly, what we must do to get closer to the ideal.

Recognition and acknowledgment of outstanding contributions to this dynamic and ever-evolving field have become prominent features of AUA annual meetings. One such prestigious honor is the AUA Gold Cystoscope Award, named after the cystoscope, the defining tool of urology, and its diagnostic and therapeutic procedures. At the 1936 convention, held in Boston with George G. Smith as president, a gift from endoscopy manufacturer ACMI (American Cystoscope Manufacturers, Inc.) for the best golf foursome in the traditional AUA competition launched the first Gold Cystoscope Award, won by Walter Hatch of Duluth and his group of four.³

The year 1936 was additionally significant for urology as that was when R. Frank Jones obtained his certification by the ABU, then in its second cohort of diplomats. Jones, the first Black ABU diplomat, practiced in the Washington, DC, and Baltimore areas. He applied for AUA sectional membership in 1937 as well as in later years, but was unsuccessful due to local barriers to inclusion.⁴ Jones would go on to have an extraordinary and distinguished career, commemorated with today’s R. Frank Jones Urological Society.⁵ He ultimately became an AUA member in 1965 (28 years after his first attempt), after the AUA created a member-at-large route for admission, thus avoiding the previous requirement for sectional membership to precede national membership. As it turned out, Jones also was an excellent golfer, and in 1973 he and his foursome won the Gold Cystoscope “Golf” Award at the New York City AUA meeting (Figure).

The Gold Cystoscope award transitioned in 1977 from the “golfing” honor to an annual “academic and professional” honor to recognize a urologist distinguished by outstanding professional contributions within 10 years of completing residency training. The first award went to Donald Skinner, then at the University of California, Los Angeles. Ironically, Skinner was also an exceptional golfer and participant in the AUA golfing contests, though never won the sporting version of the trophy. Many other institutions and individuals would share the academic Gold Cystoscope over the ensuing 47 years. In time, the award would go to 3 University of Michigan Urology faculty: Edward McGuire (1982, when he was still at Yale), William Roberts (2014, trained at Johns Hopkins under Patrick Walsh, himself a Gold Cystoscope award winner in 1978), and this year it goes to Simpa S. Salami (2024, trained at Hofstra Northwell Health under Louis Kavoussi, Gold Cystoscope award winner in 1999). Dr Salami is deeply honored and humbled by the AUA’s selection. Since 1977, 3 women have won the award, namely, Margaret S. Pearle (UT Southwestern, 2003), Stacy Loeb (NYU, 2021), and Angela M. Smith (UNC, 2022). The Gold Cystoscope Award holds immense significance not only for the recipients but for the entire urological community. Although 1 person is named in this award, the Gold Cystoscope is a recognition of the collective efforts of teams of people including collaborators, mentors (Dr Salami is mentored by Ganesh S. Palapattu and Todd M. Morgan, amongst others), and enabling environments that support continuous innovation in research and patient care.

By showing us our past as people and organizations, the metaphoric retrospectroscope of historical investigation helps diagnose mismatches between our best aspirations and realities to help create a better society. The AUA Gold Cystoscope Award offers an instructive case study, and we are grateful to those who launched, deployed, and sustained it, in its 2 iterations, for nearly 90 years. Looking to the future, we are confident that the Gold Cystoscope Award will continue to inspire urologists to strive for excellence, contribute to the ongoing evolution of urology, and foster advancements that enhance the lives of all people.

Acknowledgments

Appreciation to the William P. Didusch Center for Urologic History at the American Urological Association and Museum and Archives manager, Tupper Stevens, MLS.