The history of the Institute is closely entwined with that of St Peter's Hospitals...


Hospital for Stone, 42 Marylebone St Hospital for Stone, 42 Marylebone Rd

The Hospital for Stone, as it was first called, opened on 42 Great Marylebone Street in 1860. The other specialist hospitals in London - The Eye Hospital at Moorfields, St Mark's Hospital, the Orthopaedic Hospital, The Cancer Hospital and the Hospital for Sick Children - had opened over the previous 50 years. 42 Great Marylebone Street was a former family home and so proved too small for its purpose and in 1863 the hospital moved to Berner's Street and became St Peter's Hospital for Stone. We do not know for sure why it became St Peter's Stone but presumably this follows from the biblical allusion "You are Peter and on this rock I will build my church - Peter being the Greek word for rock or stone". The crossed keys that is the logo of St Peter's is of course the logo of St Peter. When it became the logo of the hospital is not clear.

The Berner's Street address had also been a domestic home beforehand and although it was somewhat bigger it too proved to be too small. Eventually a new purpose-built site was developed in Henrietta Street and this was opened in 1882. This is the building familiar to most urologists who were associated with St Peter's Hospital in its heyday.

Initially the two main causes for hospital admission were for the treatment of stones in the bladder and for the treatment of urethral strictures. In reality not much has changed except for the site of the stones and the nature of the treatments. Throughout the early part of the 20th century urological disease became more clearly defined and St Peter's became more involved with them.

St Paul's Hospital, 24 Endell St St Paul's Hospital, 24 Endell St

St Paul's was founded in 1897 and was initially a hospital for skin disease as well as genitourinary disease. This too has had a chequered geographical history, moving to 24 Endell Street in 1920 where it remained until the move to the Middlesex Hospital in 1992. Both hospitals moved temporarily to safer locations during the first and second world wars and by the end of the second world war it was clear that the National Health Service was coming and at that time St Peter's and St Paul's were brought together under a single Board as one of the 12 specialist postgraduate teaching hospitals in London. There were further developments on the two original hospital sites and, in addition, St Philips was added to the group in 1952, and in 1969 the Shaftesbury became the fourth and final member of St Peter's Hospitals group. This gave the combined group about 160 beds - 40 adult urological beds at St Peter's, 50 beds at St Paul's including the acute and chronic renal failure unit, 26 pure nephrology beds at St Philip's and 40 beds (20 of which were shared with the National Heart Hospital) at the Shaftesbury including all of the beds for paediatric urology.

It was the development of renal transplantation that brought nephrology to the group and hence the development at St Paul's and St Philip's during the 1960's.

Henrietta St 10 Henrietta St

It had always been part of the practice of St Peter's to give clinical assistants the opportunity of learning surgical urology and although the surgeons at St Paul's were initially reluctant to get involved, this informal teaching structure developed throughout the end of the 19th and the first half of the 20th century. Between the two World Wars didactic teaching was added to the apprenticeship-style training of clinical assistants and with the development of the Postgraduate Medical Federation in the 1950's and 1960's a formal process of teaching developed in nursing as well as in urology. Eventually, with the amalgamation of the four hospitals, the Institute of Urology and Nephrology was developed and this came into being in name in 1947 although it wasn't until 1951 that it was given two floors in 10 Henrietta Street where it remained until 1970. In 1970 the teaching facility of the Institute moved to the Shaftesbury Hospital and the laboratory facility to St Paul's Hospital. There they remained until the Institute moved to the Middlesex Hospital site in 1992.

By 1970 the structure and organisation of the Institute of Urology had stabilised and after many years of change it was able to flourish during the ensuing 20 year period of stability. By the 1970's the scope and scale of what was possible in urology and nephrology had expanded to an enormous degree and these were the heyday of St Peter's and of the Institute and indeed, in a sense, of British urology. Teaching was flourishing, research was developing, there were strong links with other London teaching hospitals through joint appointment at a time when there were very few outside London and there were a number of very eminent urologists at the height of their career developing the Institute of British urology in a number of different ways.

Middlesex Hospital Middlesex Hospital

Nonetheless within a decade or so and certainly, by the beginning of the 1980's, it was clear that further change was on the way. The St Peter's Group and the Institute of Urology were to be relocated to be part of an undergraduate teaching hospital. Various options were examined and eventually it was agreed to move to the Middlesex site and this took place in 1992. The hospital was originally to be called St Peter's Hospital at the Middlesex Hospital but this was a cumbersome name and so we became St Peter's Urology, now within UCLH. Likewise, the relocation of the Institute was originally an independent and largely autonomous research unit until the disestablishment of the Institute's in UCL caught up with urology in 2006 and our Institute was disestablished and merged with the other Surgical and Interventional Sciences.

University College London Hospital University College London Hospital

And so here we are in 2009. St Peter's Urology is the largest by far of the surgical specialties at UCLH and with the highest percentage by far of tertiary referrals. There is still a thriving academic nucleus based on a small but vibrant nucleus of clinical academics.

It is clearly disappointing to have gone from an independent and autonomous group of hospitals with its own academic institute to being subsumed within a huge organisation like UCL and UCLH. But the world has moved on and this has happened to all the other specialist institutions and I think we can still be proud of our importance to UCLH and to UCL which is, after all, one of the best universities in the world. Our clinical and academic output keeps the name of the Institute and St Peter's at an international level in a number of sub specialist areas due to the activity and achievements of a number of world class individuals. So in a sense nothing has changed and we are keeping the dream alive.

Tony Mundy

Thu, 1st Jun, 2023