On the surface, the prospects for Dr Emil A. Tanagho to become a giant in urology appeared slim (Figure). He was born on August 12, 1929, in Tahta, Egypt, into a Coptic family. Fortunately, he was well educated and graduated from the University of Alexandria Medical School in 1952 and stayed on as a lecturer. In 1962, he had the good fortune to be granted a sabbatical year in London, which would prove pivotal in his career. While in London, he worked under the guidance of Sir David Innes Williams and was introduced to scientific research. This would foster a pioneering lifelong career in urological investigation, starting with detailed and groundbreaking anatomical studies, initially related to the ureterovesical junction. During his sabbatical, he was attracted by the fame of John Hutch (who pioneered surgery for vesicoureteral reflux) and visited the University of California, San Francisco (UCSF), where with Drs Hutch and Donald Smith he extended his anatomical studies to the physiology of the ureterovesical junction.

Upon returning to Egypt, he found an unsettled political and social climate under Nasser, particularly for Coptics, that included confiscation of property and travel restrictions. Unable to attend European and American meetings where he had had abstracts accepted, he secretly sought alternatives. Under the guise of a visit to Jerusalem for Easter, he, his wife, and 2 daughters left Egypt in 1966 on a 15-day passport, telling almost no one. From Jerusalem the family traveled to Lebanon, where he worked temporarily at the American University in Beirut. Later in 1966, he was allowed to enter the US with the help of Senator Frank Church, chair of the Senate Foreign Relations Committee, and in 1972, Dr Tanagho became a US citizen. He resumed his research work at UCSF. His studies were innovative in almost every field of urology, from pediatric urology to urodynamics, neural stimulation, tissue engineering, and erectile dysfunction. His work was continuously funded by NIH grants for many years. In 1985, he received the Jacob K Javits Neuroscience Award grant from NIH and received this funding continuously until 1999. Of all his accomplishments, he was particularly proud to have developed the “bladder pacemaker,” which was a culmination of years of work in his laboratory. A now-common procedure known as Interstim, it is the result of work by a unique collaboration of urologists, electrical engineers, industry leaders, and patient advocates, inspired and led by Dr Tanagho.

In 1976, after only 10 years in the US, Dr Tanagho was named the chair of the new Department of Urology at UCSF and the department began a period of impressive growth and development that would make the UCSF Department of Urology one of the best in the world. He had an amazing eye for talent and recruited numerous outstanding surgeons and scientists, including Jack McAninch, Richard Williams, Tom Lue, Barry Kogan, Peter Carroll, and Marshall Stoller, among many others. He encouraged these faculty members to devote energy to their clinical practices and also to lead research in their individual fields; with his encouragement, they all excelled. In addition, he recognized talented individuals overseas, perhaps because of the opportunities he had received, starting with his sabbatical in London. He recruited 120 international fellows from 29 countries, mostly to work in his UCSF laboratory, but many contributed clinically as well. These fellows were remarkably productive, adding greatly to the intellectual environment, and many became leaders in urology in their home countries and internationally.

Dr Tanagho created an environment of open dialogue, and this helped push the boundaries of both clinical and research endeavors. His office door was always open to his mentees for dialogue. He fostered active questioning of whether there was a better way to take care of a clinical problem. He always supported innovative thinking and encouraged those who were confronted with skepticism to stay the course in pursuit of improved treatments. Many who worked with Dr Tanagho helped to redefine the direction of urology. For example, Dr Lue advanced the greatly unappreciated field of erectile dysfunction by exploring the neurophysiology of the penis, and Dr Stoller developed a highly innovative, less-invasive approach to neuromodulation using posterior tibial nerve stimulation. Similarly, Dr McAninch was one of the main forces in creating the previously unrecognized field of reconstructive urology, Dr Carroll popularized to role of active surveillance in the management of prostate cancer, and Dr Kogan fostered the nascent field of fetal urologic development and pioneered the use of laparoscopy in pediatric urology. Dr Tanagho pushed all his trainees and faculty to challenge the status quo.

Dr Tanagho received numerous American and international awards, among them the prestigious Keyes Medal of the American Association of Genitourinary Surgeons. The late Anwar Sadat awarded Dr Tanagho the highest civilian honor for an Egyptian, the Premier Medal of Merit. How ironic and impressive for a Coptic who had fled his native Egypt! In the end, Dr Tanagho would return frequently to Egypt and would often operate in the military hospital in Alexandria on patients with the most challenging problems. When Dr Emil A. Tanagho died peacefully on March 1, 2024, he left behind Mona, his beloved wife of more than 60 years (an accomplished artist in her own right), a large and loving family, and a legacy of brilliant science, clinical excellence, and mentorship to hundreds of urologists around the world.

Figure. Dr Emil A. Tanagho.