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Richard Turner-Warwick, CBE. A Pioneer of Functional Reconstruction in Urology

Friday 16 Oct 2020 {{NI.ViewCount}} Views {{NI.ViewCount}} Views

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Richard Turner-Warwick. CBE (1925 – 2020) MSc. MCh, DM (Oxon), DSc (Hon), FRCP, FRCS, FRCOG, FACS (Hon), FRACS (Hon).

On Saturday 19th September 2020, Richard Turner Warwick, one of urology’s most famous innovators, passed away at the great age of 95.

Richard Trevor Turner Warwick (RTW) was born on 21st February 1925. His father, William Warwick, was a consultant vascular surgeon at the Middlesex Hospital. His mother, Joan (nee Harris), also a doctor, and specialised in women and children's welfare clinics in the poorer quarter of London’s East End.

In 1942, he started his medical training at Oriel College, Oxford. His future wife Margaret (Moore) was a medical scholar in the year below at Lady Margaret Hall. So, after a third year Final Honours School Degree in Natural Sciences, he stayed on for a fourth research BSc year in neuroanatomy.

He rowed in the first Oxford eight for three years. In 1946 as President of the Oxford University Boat Club, he was instrumental in bringing the Boat Race back from Henley to the Thames tideway, captaining the victorious Oxford crew that year. The challenges involved in competitive rowing had a lasting impact on him; whenever a task required strength and endurance he would just grit his teeth and ‘think of Cambridge’!

He completed his clinical studies at the Middlesex Hospital London. Post-graduation he was fortunate in working with a number of eminent surgeons resulting in an exceptionally broad spectrum of experience. He was one of a very small number of medical ‘polymaths’ to qualify by study and experience in, not just one, but three of the Royal Colleges as FRCS, FRCOG and MRCP

In 1958 he undertook a research fellowship in the USA and visited a number of specialist centres establishing contacts, many of whom became life-long friends. Margaret, by then his wife, was able to join him and together they toured the USA in an ancient bright red Ford V8 convertible.

Following his return to the United Kingdom, he completed his MCh (Master of Surgery) thesis and was appointed the RSO (Resident Surgical Officer) at the Institute of Urology, working with Sir David Innes Williams (the father of paediatric urology). In 1960, he was appointed Consultant Surgeon at the Middlesex Hospital in charge of the thyroid clinic and in 1964 he established the urology department following the retirement of his mentor Sir Eric Riches. His passion was in harnessing every combination of surgical and modern radiological expertise to understand how the bladder worked, in order to optimise the surgical management of incontinence. With other key innovators he developed the then-novel techniques of video-urodynamics and set up a new diagnostic ‘urodynamic clinic’. These early advances in urological practice were critical to restoring urinary continence and so transforming the lives of many thousands patients.

He was one of the founder members of the International Continence Society.

His broad surgical training provided him with the expertise to develop innovative surgical techniques to reconstruct and restore function to the urinary tract and adjacent organs in the abdomen and pelvis. He devised his own surgical instruments manufacturing the prototypes himself in his home workshop.

RTW devoted a significant amount of his personal income to supporting research and visiting surgical fellows, and many of these now hold eminent positions in the field of functional and reconstructive urology worldwide.

As well as his extraordinary surgical talent, a major legacy of RTW was his teaching. He was renowned as a visiting expert ‘coming into town bearing slides’, cinefilms and later videos and often travelled with his own portable generator. Between 1965 and 2005 he undertook over 300 operating surgical teaching visits in America, Australia, New Zealand as well as Europe and the UK.

RTW’s honours and awards were many. He served on the Council of both the Royal College of Surgeons and also the Royal College of Obstetricians and Gynaecologists. He was President of the British Association of Urological Surgeons 1982-1984 and was an instigator of the third part specialist examination in urology. He received honorary fellowship of many academic societies. In 1992 he was made a Commander of the Order of the British Empire, by HM The Queen, for his services to medicine.

In 2002 he published his seminal work with Chris Chapple, “Functional Reconstruction of the Urinary Tract and Gynaenco-urology: an exposition of functional principles and surgical procedures”. Many of the 1600 illustrations were based on his own diagrams. The book and his other writings include his sayings such as “there are no such things as brave surgeons, just brave patients”; “the bladder is an unreliable witness” referring to problems with overreliance on symptoms to make a diagnosis and ‘Any reconstructive procedure is a TITBAPIT – you take it to bits and you put it together again – do not TITB it if you cannot PIT again!’

RTW and his wife, Professor Dame Margaret Turner Warwick, Professor of Medicine at the Royal Brompton Hospital (the first female President of the Royal College of Physicians) married in 1950 and were a devoted couple. Always something of an eccentric, both in dress and other interests, in retirement in Devon Richard continued his reconstructive works on the garden with a 14-ton digger and a tractor! He delighted in fly fishing with Margaret frequently accompanying him to paint one of her fine watercolour landscapes. Margaret sadly predeceased him in 2017. They are survived by two daughters, one a Professor of Medicine and the other a senior art teacher, six grandchildren two of them doctors, and eight great-grandchildren.

Article by Prof Christopher Chapple, Lynne Turner-Stokes and Gillian Bathe

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