Tribute to Jan van Gool

Published:January 11, 2023DOI:
      With great sadness we announce tha.t our former colleague and friend, Jan van Gool, passed away peacefully, after a short illness, on October 28, 2022, at the age of 83.
      Jan had been an international pioneer in discovering LUTS in children and developing modern urotherapy. Trained as a pediatric nephrologist, he was very interested in pediatric urology, and he brought both specialties together. In that way he had a world-wide reputation as a pediatric nephrologist functioning as a non-operating pediatric urologist.
      His study of medicine at the University of Utrecht was completed in 1967. Following a 2 years in general practice, he served with the Dutch Army Medical corps and then Parttime in an institute for developmentally delayed children. He then trained in pediatrics in Tilburg (1969–71), and in the University (Wilhelmina) Children's Hospital, in Utrecht (1971–73).
      After resigning as a pediatrician in 1973, he worked as a fellow in Pediatrics in Tilburg until 1976, where he deepened his interest in lower urinary tract function and spina bifida treatment, the subject of his PhD thesis in 1986. During his pediatric residency, as early as 1973, he designed and built, together with the Department of Physics, a urodynamic setup for children.
      In 1976 he applied for further training in Pediatric nephrology, and was granted a 7-month stay as a research fellow with the Department of Urology, of the UCFS School of Medicine, San Francisco, California, were he worked in research with Emile Tanagho and Rick Schmidt and received extra nephrology training by Professor Malcolm Holliday.
      In1976 he became a staff member in Pediatric Nephrology in the University Children's Hospital in Utrecht. After the start of Pediatric Urology in 1985, he worked closely with the Urology Department. He trained and influenced many pediatric nephrologists and urologists, and encouraged and motivated his trainees to look deep into details, and to engage in scientific research.
      He loved sharing ideas and working together with others, not only in The Netherlands, but far abroad. He was internationally oriented, and connected with many colleagues, for example by working on the seminal International Reflux study. He fostered the collaboration especially with the Scandinavian colleagues, and developed the care for both non neurogenic and neurogenic lower urinary tract dysfunction. Prior to 1980, biofeedback training for dysfunctional voiding was done exclusively by looking or listening to the EMG reading of the pelvic floor. Jan discovered, together with Marianne Vijverberg, Kjelm Hjalmas and Anna Lena Hellstrom, that the uroflowmetry reading was a better option as a biofeedback signal.
      Spina bifida treatment was boosted by the introduction of oxybutynin in Europe around 1985 and, together with pediatric urology, he developed the policy for starting oxybutynin and CIC in the neonatal period, a policy that, by now, has become the standard treatment worldwide.
      For lower urinary tract dysfunction, he developed and organized a large international multicentered study, the European Bladder Dysfunction Study (EBDS), financed by the European Union, and started in 1994. This was done with the statistical aid of Hildegard Lax and Herbert Hirche from the Institut für Medizinische Informatik, Biometrie und Epidemiologie (IMIBE), Universitätsklinikum Essen, Germany. Jan had worked together with IMIBE earlier on the International Reflux study.
      His international influence is illustrated by the fact that in 1991 he was invited by John Duckett of CHOP (Philadelphia Pennsylvania) for a 6-month visit to help organize better urodynamics for children and to start a cognitive training program for children with LUTS.
      In 1996, together with Kelm Hjalmas and Jens Djurhuus, he co-founded the ICCS.
      As a doctor, colleague and friend, Jan was empathetic, good humored and an unconventional free innovative thinker, not inhibited by any unproven dogma in medical science. He was a tireless worker in the innovation of pediatric health care. He left Utrecht in 1998, at the age of 60 years, but did not retire.
      Between 1999 and 2009 he had an appointment in the Department of Urology, University of Antwerp, Belgium, as a professor in pediatric uro-nephrology, setting up a platform for pediatric urology and pediatric nephrology, and for teaching and clinical research. At that time, he worked closely together with Professor An Bael, among others, on enuresis and bladder volume. From 2009 to 2022, he had a professorship as researcher at the Institute of Medical Informatics, Biometry, and Epidemiology (IMIBE), University Hospital Essen, Essen-Duisburg University, Germany, in close collaboration with Hildegard Lax.
      He remained active scientifically and up to date with 2 recent publications on folic acid use and neuropathies as first author.
      Jan will be remembered and missed as a friend and a colleague with major contributions in the development of pediatric urology and nephrology. He was a giant in the field of bladder dysfunction and spina bifida. He had supporters all over the world as he helped to change the lives of many children far beyond his local sphere of influence. His voice and demeaner will be missed when difference of opinion and debates are on view in the future. We wish all the strength to deal with this loss to his wife Ans, children and grandchildren.
      Sent By Tom de Jong, An Bael and Hildegard Lax.
      Figure thumbnail fx3
      Jan and Kjelm Hjalmas, who he collaborated with extensively.
      Figure thumbnail fx4
      Jan in Boston with his wife Ans and An Bael. 2008.