LEGENDS

Arturo Mendoza-Valdés, MD Assistant Professor of Urology
Instituto Nacional de Ciencias Médicas y Nutrición “Salvador Zubirán” Urologist at Hospital Medica Sur
Mexico City, Mexico

When I was invited by the editorial board of The Canadian Journal of Urology International to write an autobiography I was doubtful about accepting since I didn’t really think I deserved such honor. Nevertheless I asked my wife, Amelie Olaiz for her opinion and with her objectiveness and always present support throughout all my professional life and her love, she wisely asked me whether accepting and writing this autobiography would be of any benefit to someone else besides myself. Then I thought that maybe this article could somehow be inspirational for young urologists, especially from Mexico and Latin America, so I started to work.

I was born on February 2nd, 1953 in Mexico City, Mexico. My father, Sergio A. Mendoza-Rossolillo was also a urologist. Undoubtedly he was my main influence in life to become a physician and then urologist. Unfortunately he passed away before I finished my specialty but I was lucky enough to assist him in some urological surgeries. With him I learned the open transvesical prostatectomy that was seldom done during my residency due to the increasing use of TURP. I graduated from medical school at the Universidad Nacional Autónoma de México (UNAM) in Mexico City. I did my internship in a suburban town, Irapuato, Guanajuato where I had my first experiences in clinical research and paper publishing due to two excellent mentors and teachers, Dr. José Ramón Nogueira (gastroenterologist) and José Luis Moragrega (cardiologist). As a result from this research experience in 1980 I got a scholarship from the International Society and Federation of Cardiology for a 2 week statistics and epidemiology course in Kaunas, Lithuania, in that time what used to be the USSR.

Since I wanted to do my residency in urology in the USA I wrote to several sites but Ruben F. Gittes from the Peter Bent Brigham hospital in Boston, Massachusetts answered me that if I could do urology with Dr. Fernando Gabilondo who just went back to Mexico City to start a urology residency program, there was no reason for me to look for any place in the USA. Immediately I looked for Dr. Gabilondo who founded the residency in Urology at the Instituto Nacional de Ciencias Medicas y Nutrición “Salvador Zubiran” (INCMNSZ) in Mexico City in 1979. Then after 2 years residency in internal medicine, 3 years of general surgery and 3 years of urology at INCMNSZ I finally became a urologist. Dr. Gabilondo was not only the chief of the urology program but turned to be my lifetime mentor, teacher, example and friend. Dr. Jorge Elías Dib who started the urology department in that hospital and supported the creation of the urology residency program by Dr. Gabilondo, was my other mentor. I learned from Dr. Elías Dib, besides surgical techniques and other skills in urology the importance of always sharing everything I learned with the younger urologists and counseling them in all ways possible not only as urologists but also as human beings and physicians. His teachings became a mantra in my life. After finishing my residency I have continued collaborating as professor in the urology residency program of the INCMNSZ until today.

In 1987 I started working at the National Cancer Institute (INCAN) in Mexico where later on I became chief of the department of urology. In that time the open radical retropubic nerve sparing prostatectomy was popularized by Patrick Walsh so I started doing it at the INCAN and promoted it in Mexico. Also in that time the continent bladder substitutions with different segments of the bowel after radical cystoprostatectomies started to be used all over the world so I tried the Meinz pouch and other techniques and ended up performing the Miami pouch (pouch made with the ceccum and the stoma made with the tubularized ileum) with intermittent catheterization through the stoma placed in the umbilicus. I learned to do it from the videos at the AUA meetings, and I also invited Dr. Darwich Bejany from Miami to operate with me a couple of cases in order to improve my technique. I taught this technique to many colleagues all over the country. Later I started doing the orthotopic neo bladders, both in men and women and also promoted them in my country and in some Confederación Americana de Urología (CAU) meetings. When the use of PSA was started for prostate cancer detection, I did the first validation study in Mexico at the INCAN. We also started doing US guided transrectal biopsies. I started the first urologic oncology fellowship program in Mexico. In that time we did the first multicentric (4 other hospitals in Mexico City) Mexican BCG maintenance protocol for non-muscle invasive bladder cancer. While working at the INCAN I participated in several International research protocols regarding BPH, bladder and prostate cancer (adjuvant bicalutamide in localized prostate cancer, intermittent androgenic blockade in advanced prostate cancer, etc.).

In Mexico, as well as in most Latin American countries and in some European countries, most urologists practice private medicine besides the institutional government practice. In 1987 I started working at Hospital Médica Sur where together with Dr. Gabilondo, Dr. Guillermo Feria, and others, we started the first ESWL stone clinic in Mexico and Latin America with a Siemens Lithostar lithotripter. This clinic works until today, although now ESWL is seldom used, but at that time there were days when we had up to 10 cases a day. We published our experience with ureteral calculi, stones in horseshoe kidneys, staghorn stones and ESWL in children, ureteral stones treatment without double-J catheters. Some urologists from other hospitals from Mexico and Latin America came to our hospital to learn ESWL. In 1989 I organized a world meeting on ESWL in Cancun. At Hospital Medica Sur I also participated in several research projects regarding erectile dysfunction, urinary infections, BPH, advanced prostate cancer, and metastatic castrate resistant prostate cancer (mCRPC).

In 1987 I became member of the Sociedad Mexicana de Urología (SMU). In 1989 Dr. Jorge Elías Dib, President of the SMU asked me to organize the first poster sessions ever in our association in the City of Morelia. In 1992 I became Secretary of the SMU with Dr. José Antonio Medina. That year I also organized the first International Symposium of Urological Cancer in Mexico City with the participation of Dr. E. David Crawford, David Swanson, Michael Jewett and others. In 1994 once again I became Secretary of the SMU with Dr. Francisco Calderón-Ferro and I was in charge of the scientific program of the Annual meeting that took place in Cuernavaca. That year I also organized the second International Symposium on Urologic Cancer in Ixtapa, Zihuatanejo, Guerrero. In 1998 I became President of the SMU. That year the SMU had its annual meeting jointly with the CAU in Cancun where I was in charge of the scientific program that included many outstanding personalities from the CAU, the EAU, and the AUA. During my presidency, Dr. Mariano Sotomayor was the Secretary of the SMU. Since then he became one of my best friends and followed my steps becoming President of the SMU (2013-2015) and President of the Mexican Board of Urology (2021-2023). That same year in July, together with Dr. Aarón Torres, Dr. Gabilondo, Dr. Elías Dib, and many other urologists I founded the Mexican Urologic Oncology Association which has since then has had its subsequent International Symposiums in Urologic Oncology and its annual meeting every July in Acapulco until today with the participation of cancer urologists from Mexico, USA, Canada, Europe, Brazil, Colombia, Argentina, and Venezuela. The purpose of this Association has been to improve and enhance the education in the area of oncology of Mexican urologists specially residents from all over the country, and to get together all urologists interested in urologic oncology to share and discuss their experiences in this area of urology. In this meeting the newest and more controversial issues in urological oncology are presented and discussed and the topics are rounded up in interactive clinical cases discussion. In the last three years a special section on robotic surgery has been introduced. In this meeting many Mexican residents have had the opportunity to get in touch with some of the visiting professors and later on become fellows in their oncology fellowship programs. As past President of the SMU I have always continued supporting our association. The last President, Dr. Alfredo Medina-Ocampo, as well as the current President, Dr. Melchor Castro-Marin asked me to collaborate with them in their board of directors in charge of the International relationships.

In 1991 I attended for the first time the 2nd International Prostate Cancer Update organized by Dr. E David Crawford in Beaver Creek, Colorado. The format, quality and organization of this meeting inspired me for the organization of the International Symposiums on Urological Oncology that I have organized since 1992, as well as the annual Meeting of the Mexican Urologic Oncology Association. Out of the 30 meetings of the IPCU I have attended almost 20 of them and as faculty member about 16 times. Dr. Crawford challenged me with different topics such as finding out the epidemiology of prostate cancer in Latin America when Internet did not exist, as we know it today. He has been an inspiration to me and an example that I have followed all these years.

My first participation in the AUA was attending a South Central Section meeting in 1985 when I was a resident. In
1986 in the Annual Meeting of the SCS-AUA I won the first place in the resident’s essay contest with the paper “
Non-invasive Method for Renal Mass Determination: its Application for Calculating Glomerular Filtration Per Gram
of Renal Mass.” That same year I presented my first poster accepted at the AUA annual meeting in New York City. I
was delegate for Mexico in the SCS-AUA (1998-2003), and then in 2003 I became the third Mexican President. Other
participations in the AUA have been member of the editorial committee of The Journal of Urology (2001-2005), member of the Clinical Practice Guidelines (2010-2103), member of the Urologic Diagnostic and Therapeutic Imaging Committee
(2010 to 2016). In May 2018 I received from the President of the AUA, Dr. Brantley Thrasher, the President’s Citation
for years of service to the Mexican Urological Association and to the SCS-AUA, and in 2019 I became Honorary
Member of the AUA due to my contributions in the tightening of the relationships between the AUA and Mexico.

I started attending the Societe International D’Urologie (SIU) meetings in 1989 and became delegate for Mexico for several years, and then I was Member of the Scientific Program Committee from 2000 to 2013. My job there was mainly to include Latin American urologists in the program. Once again I have been elected as delegate of Mexico at the SIU (2019-2021) and elected delegated for all the international delegates in the board of directors of the SIU (2019-2020). Along all these years I participated in the SIU meetings presenting lectures, panel discussions, chairing plenary sessions, podium or poster sessions.

In 1989 I became member of the CAU and have attended most of its meetings presenting, papers, posters, lectures, participating in panels or chairing sessions. For a couple of years I was in charge of the research office, and the publications office. I was in charge of the scientific program of the joint CAU-SMU meeting in Cancun, Mexico in
1998. I presented the CAU lecture in the EAU meetings two times and at the SIU meetings three times.

In 2004 Dr. Laurie Klotz founded the World Urologic Oncology Federation (WUOF). The Mexican Urologic Oncology Association was one of the founder associations. I have been member of the steering committee of WUOF since its foundation until today, participating in almost all of its annual meetings either with lectures or chairing sessions. Besides participating in the scientific program, my job has been to include Latin American urologists, and to promote education in urologic oncology in other countries.

I started attending the EAU meetings in 1992. That year I invited Dr. Frans Debruyne who was the General Secretary of the EAU, to participate in the annual meeting of the SMU since I was responsible for the scientific program. Since then the relationships between the SMU and the EAU have become increasingly closer. As a result Dr. Debruyne as well as the subsequent General Secretaries of the EAU, Dr. Per-Anders Abrahmson and Chistopher Chapple have supported Mexican Urology with the sponsorship of different speakers and sometimes themselves, both to the SMU and the Mexican Urologic Oncology Association. Since then I have attended most of the EAU annual meetings presented lectures in 2000, 2002, 2008, and 2013, I also participated as faculty member in the European Urology Winter Forum (EAU sponsored meeting) in Davos in 2000, 2002, 2004, 2006, 2007, 2008, 2010 (as faculty member in 6 of them). In February 2012 due to my work getting the EAU and Mexico closer I became honorary member of the EAU being that the first time a Mexican or Latin American urologist to obtain such honor.

After all these years I feel that the best way to thank my mentors has been continuing what I learned from them, constantly improving and updating what I learned. I take pride in sharing my experience and knowledge (teaching) with as many urologists as possible, mainly residents and young urologists, enhancing urological education mostly in the area of oncology, not only in my country but in all countries with whom I have had contact with. As I look back on my long career in the field that I am so passionate about, I am proud to have contributed to the growth of urology and urologic oncology in Mexico and Latin America.

Arturo Mendoza-Valdés, MD Assistant Professor of Urology
Instituto Nacional de Ciencias Médicas y Nutrición “Salvador Zubirán” Urologist at Hospital Medica Sur
Mexico City, Mexico

© The Canadian Journal of Urology™; 27(4); August 2020

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