Edward McGuire's influence in the field of stress urinary incontinence and bladder storage symptoms.
OBJECTIVE
Dr. Edward McGuire's academic career spans four decades. His impact in our field of female urology and urodynamics is reflected by the many residents and fellows he has trained that are now academic leaders in our subspecialty. For this festschrift, my goals are to: (1) review the history of the surgical approaches to alleviate stress urinary incontinence (SUI) (2) discuss recent research in SUI and bladder storage symptoms and the influence of Dr. McGuire in these areas and (3) propose a paradigm shift in the understanding of the function of the bladder urothelium from providing barrier function to providing afferent input that affects bladder storage function.


METHODS
A literature review of the publications related to SUI and bladder storage symptoms was performed. Using Thompson Reuters ISI Web of Knowledge, the two most cited papers by Dr. McGuire are discussed.


RESULTS
Dr. McGuire's two most cited publications are related to valsalva leak point pressure (VLPP) and the utility of the American Urologic Association Symptom Index (AUASI). These two instruments, one objective and one subjective, address two canonical areas in our subspecialty: 1. role of urethral function in continence and 2. pathophysiology of lower urinary tract symptoms. These two areas continue today to be fertile areas for research and creativity. Recent investigations have proposed that bladder urothelium may play a role in bladder afferent function; thus mediating bladder storage.


CONCLUSIONS
Dr. McGuire helped establish the scientific foundation for our subspecialty. His influence remains pertinent today as it ever has.
Chai
Toby C
TC
Division of Urology, Department of Surgery, University of Maryland School of Medicine, Baltimore, Maryland, USA. tchai@smail.umaryland.edu
D000344:Afferent Pathways / Q000503:physiopathology; D000818:Animals; D035843:Biomedical Research / Q000266:history; D005260:Female; D049673:History, 20th Century; D049674:History, 21st Century; D006801:Humans; D016896:Treatment Outcome; D001743:Urinary Bladder / Q000294:innervation; D014550:Urinary Incontinence, Stress / Q000150:complications / Q000266:history* / Q000503:physiopathology / Q000601:surgery; D014563:Urodynamics; D013520:Urologic Surgical Procedures / Q000266:history; D014572:Urology / Q000266:history*; D019459:Urothelium