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Year : 2000  |  Volume : 16  |  Issue : 2  |  Page : 140-148

Urology on the internet - introduction and update

Departments of Urology and Pediatric Surgery; All India Institute of Medical Sciences, New Delhi, India

Correspondence Address:
A K Hemal
Department of Urology, All India Institute of Medical Sciences, New Delhi - 110 029
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Source of Support: None, Conflict of Interest: None

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The Internet, which has truly united the developed and developing nations, is an extensive network of inter-linked computers storing immense bytes of information, which can be accessed by anyone transcending all geographi­cal barriers and this has become the ultimate frontier to access information. The Urology and Andrology informa­tion on Internet is exponentially growing. The urologist need not know the intricacies of the hardware and soft­ware but can start right away navigating through this web. We reviewed methods available to take advantage of this network to provide a glimpse to busy urologists to accrue the benefits easily and efficiently rather than to be lost in the information-ocean by surfing individually. By getting connected to Internet, an urologist of any part of the world gains enormous information by interacting with other urologists of the rest of the world. This could be of use to gain knowledge and to offer the best and the most modern treatment to the patient. Internet has revolutionised the scientific publication by virtue of its faster and accurate transmission of manuscripts. We can send manuscripts by this channel and also access journals obviating the lag period inherent in snail mail. The on-line journals have virtually brought the library to the desktop.

Keywords: Internet; Urology; Electronic Publishing

How to cite this article:
Anand I, Srinivas M, Hemal A K. Urology on the internet - introduction and update. Indian J Urol 2000;16:140-8

How to cite this URL:
Anand I, Srinivas M, Hemal A K. Urology on the internet - introduction and update. Indian J Urol [serial online] 2000 [cited 2023 Feb 3];16:140-8. Available from:

   Introduction Top

Over the last decade or so, the Internet has evolved into the ideal medium for sharing information. Recent advance­ments in computer hardware, software and high bandwidth transmission media have made it a cheap and convenient communications solution for data of all kinds. Health pro­fessionals and institutions are among the most active us­ers of the Internet. Medical information on the Internet is growing rapidly. [1],[2] The urologist stands to gain much by participating in this forum. There are innumerable re­sources on the Internet related to Urology and the associ­ated disciplines of Andrology and Reproductive Medi­cine. [3],[4] Thanks to the Internet, concepts such as telemedi­cine which were once considered futuristic are finally be­ing put into practice. Electronic publishing and transfer of manuscripts on the Internet have ushered in a new para­digm for scientific journals and literature. [5] It is therefore imperative that the urologist be aware of the Internet and its scope.

This article is intended for busy urologists to help them reap the benefits of the Internet without surfing too much for locating the resources.

The Internet - Concept and History

The Internet is a vast web of interconnected computer networks that are in geographically diverse locations. Computers can exchange information only if there is con­sensus about the set of rules that governs data transfer. Any such definition of rules is known as a "Protocol" in computer jargon. Irrespective of the native hardware and software, all computers on the Internet communicate us­ing data communications protocols known as Transmis­sion Control Protocol/Internetworking Protocol (TCP/IP). This suite of protocols evolved from work on an experi­mental network called ARPANET set up by the Advanced Research Projects Agency of the United States Depart­ment of Defence in 1969. Each resource on the Internet is identified by a unique address known as a Uniform Re­source Locator (URL). For instance, the web site of the American Urological Association can be found at http:// Everybody on the Internet uses the same URL to access a resource irrespective of his or her geo­graphical location relative to the computer hosting that resource.

Getting Connected to the Internet

Institutions which need to be continuously online and serve their own content should procure a high bandwidth leased line from the local Internet Service Provider (ISP). For personal use, commercial ISPs offer dial up TCP/IP accounts to individual subscribers. In this arrangement, the user connects to the ISP through a modem and a regular telephone line. Dial-up connections have a maximum data transfer rate of 56 kilobits per second (kbps). Higher band­width solutions for individual use are ISDN (Integrated Systems Digital Network), cable modems and Asymmet­ric Digital Subscriber Lines (ADSL). Very Small Aperture Terminal (VSAT) and direct satellite links are used in re­mote locations. Hardware and software requirements are hard to specify since a number of processors and operat­ing systems are available. For individual use, a computer with a Pentium processor, 16 MB of RAM, I GB of hard disk capacity, colour monitor, 16 bit sound card and 56 kbps modem is adequate. Operating systems such as Win­dows 9x have built-in support for dial-up networking and the TCP/IP protocols. Popular Web Browsers and E-mail Clients are available for free download on the Internet.

Internet Services

Internet services may be classified under the following headings:


An e-mail account is a secure password-protected elec­tronic mail box that has a unique address, usually in the following format:

user [email protected] name. type of code (e.g., [email protected] ) or user [email protected] name. top level domain (e.g., [email protected] )

Anybody on the Internet can send e-mail to another user just by knowing his or her e-mail address. The addressee can read the e-mail after being authenticated by the com­puter hosting the mailbox, using a password. E-mail may contain text or file "attachments" containing any data (e.g..sound, video, formatted documents, and executable files).

Most ISPs provide an e-mail account along with the subscription for Internet access. Alternatively, one may sign up for an account with any of the numerous free e­mail services available on the Internet that are accessible through the World Wide Web. The following site has an exhaustive list of such services: .

Depending on the e-mail service provider, mail may be used online by using a web browser or downloaded to the user's computer using e-mail clients which employ protocols such as Post Office Protocol (POP) or Internet Message Access Protocol (IMAP).

Mailing Lists

Mailing lists facilitate discussions on specific topics by forwarding mail received at a particular location to all the e-mail addresses on that list. This makes it easier to com­municate information to several interested people without having to know each of their e-mail addresses. It is possi­ble to subscribe to mailing lists, which carry on discus­sions about a variety of topics. Such user groups allow rapid and reliable communication of developments among professionals in a field such as Andrology. [6] The follow­ing site allows users to search for mailing lists and news groups related to a particular topic: [Table 1] enlists the mailing lists related to Urology.

New Groups

This is similar to the concept of mailing lists but mes­sages are not mailed directly to subscribers. Instead, in­terested users may log on to a Network News Server and read or post messages on a particular topic in its appropri­ate category.

The World Wide Web

The World Wide Web (WWW) refers to documents available on the Internet which are written in a page for matting language called Hyper Text Mark-up Language (HTML). The paradigm of a web is used because it is pos­sible to place "links" on one HTML document which point to other Web pages (another name for HTML documents) and resources on the Internet by providing their URL. For instance, an HTML document on Urology can provide a link to another site that has a more elaborate discussion on surgery of the prostate. The user viewing the Urology page only has to click on the link (which is usually repre­sented underlined and in a different colour to differentiate it from the rest of the text) to access the page on prostate surgery. Links can also be provided to e-mail addresses, news groups, pictures, data files, and audio/video re­sources. In this way a rich network or "web" of related Internet resources is available to the user.

Browsers are programs used to interpret these HTML documents and render them in a readable format. Two of the most commonly used browsers are Microsoft Internet Explorer and Netscape Communicator. Technology known as the Common Gateway Interface (CGI) allows users to interact dynamically with a website by using forms writ­ten in HTML. This ability makes Web pages the ideal in­terface for accessing large indexed information resources such as libraries, archives of data (e.g., clinical case stu­dies, past news group discussions, etc.) and indeed any resource which needs to be searched methodically such as the MEDLINE (a massive index of articles which have appeared in international medical and surgical journals). Urology dedicated sites are listed in [Table 2]. Information resources related to Urology and Andrology are listed in [Table 3],[Table 4],[Table 5],[Table 6],[Table 7] respectively.

Most academic institutions, hospitals and associations host their own "home page" on the Internet. An institu­tion's home page is an HTML document or group of linked documents that usually offer information about its organi­zation and resources. For instance the home page of a uni­versity might contain information about its courses with applications which can be filled and submitted when still on-line. In addition it could include information about the faculty and contain links to the home pages of the indi­vidual departments. Popular Urology associations, Urol­ogy departments, Andrology associations and departments are listed in [Table 4],[Table 5],[Table 8],[Table 9] respectively.

Although the medical information available on the web has proliferated at a remarkable rate, the quality of the information is often variable' and one should exercise dis­cretion before placing faith in it.

File Transfer Protocol & TELNET

File Transfer Protocol (FTP) is a TCP/IP protocol which can be used to transfer files between computers on the Internet. TELNET is another protocol which allows users to issue commands to a remotely situated computer over the Internet. Both protocols are extensively used by insti­tutions such as libraries to offer public access to electroni­cally stored texts.

FTP offers a secure and error-free method of transfer­ring large volumes of medical data such as radiological images, clinical case reports and also journal articles.


Internet has reduced the communication gap to virtually nil by filling the gap between the office of the authors on one hand and the Editorial office on the other. Today manuscripts can be instantaneously delivered to the con­cerned editors and from there the manuscripts can be passed on to the concerned reviewers by e-mail as an at­tachment. This would save the precious paper and reduce the delay inherent in the post which is aptly described as snail mail. Many journals are on-line and offer access to the abstract and index and some are even available free on line. Sites of Urology and Andrology journals are noted in [Table 6],[Table 10] respectively.

Intersex disorders are having wider surgical, ethical and legal complexities and are handled by Paediatric Urolo­gists. This area needs better interaction between the ex­perts from the various parts of the world and the popular sites are listed in [Table 11].

Newer Types of Resources

Java: Java is a semi-interpreted platform independent programming language which is widely used on the Internet. Unlike CGI programs which execute on the server (the computer hosting the web page), Java programs are downloaded by the browser along with the HTML page and executed on the local machine.

Streaming Audio/Video: Recent improvements in the processing capacity of computers have permitted the im­plementation of rigorous algorithms for compressing and decompressing sound and full motion video. Coupled with the increases in bandwidth, this has led to the ability to receive audio and video in real time over the Internet. This has major implications for telemedicine and video-con­ferencing. Many events are relayed live on the Internet using this technology.

VRML: Virtual Reality Markup Language (VRML) documents allow the representation of functional three dimensional structures using a plain text file which can be transmitted over the Internet. A VRML browser can be used to render the object and explore it interactively. Ana­tomical structures may also be modelled to aid the expla­nation of surgical techniques for instance.

Emerging Applications

The potential of the Internet is still largely untapped in medical applications. Medical Informatics has gained the status of an independent discipline only recently and aca­demic research in this field has already gained impetus. There are a number of telemedicine (teleradiology, tele­pathology, home telecare and teleconferencing) projects being implemented and evaluated. [8] It is estimated that 25% of the usage of health care technology in the next 5 years will be to access medical records via the Internet. [9] Studies have shown that patient images and records can be trans­mitted via the Internet cheaply and conveniently without compromising diagnostic accuracy. [10] Virtual Hospitals are available on the Internet which simulate real patients and facilitate distance education. [11]


The Internet is growing at an amazing pace, not only in size but also technologically. There is no doubt that the Internet will dominate the use of information technology in health care in the years to come. The large number of online resources and discussions related to Urology is evidence of the active role being played by urologists world-wide in adopting this technology. Besides being the handiest source of educational resources and scientific updates on the subject, the Internet is also the perfect plat­form to forge friendship between urologists across politi­cal and geographic boundaries. It will become the best choice for fast and error-free manuscript transmission. [12]­

Some of the most interesting and informative discus­sions on health-related topics take place on Internet. As more and more hospitals, educational and research insti­tutions get connected to Internet, a very healthy collabo­ration is emerging.

   References Top

1.Glowniak JV. Medical resources on the Internet. Ann Intern Med 1995; 123: 123-131.  Back to cited text no. 1  [PUBMED]  [FULLTEXT]
2.Hubbs PR. Rindfleisch TC, Godin P et al. Medical information on the Internet. JAMA 1998; 280: 1363.  Back to cited text no. 2    
3.Vale JA, Thompson AC. Information technology, the Internet and the urologist. Br J Urol 1997: 80 (Suppl 3): 8-1I.  Back to cited text no. 3    
4.Sjogren D. Urology sites on the Internet and search tips for Internet browsers. AORN J 1999; 69: 270-271.  Back to cited text no. 4  [PUBMED]  
5.Smith J, Smith R. Preparing the BMJ for the electronic revolution. Br Med J 1996; 312: 1626.  Back to cited text no. 5    
6.Meacham RB, Niederberger CS. Use of a moderated international Internet information exchange in the study of male reproduction. Urology 1996; 48: 3-6.  Back to cited text no. 6  [PUBMED]  [FULLTEXT]
7.Sacchetti P, Zvara P, Plante MK. The Internet and patient education - resources and their reliability: focus on a select urologic topic. Urology 1999; 53: 1117-1120.  Back to cited text no. 7  [PUBMED]  [FULLTEXT]
8.Takeda H. Minato K, Takahasi T et al. High quality image oriented telemedicine with multimedia technology. Int J Med Inf 1999: 55: 23-31.  Back to cited text no. 8    
9.Cesnik B. The future of health informatics. Int J Med Inf 1999: 55: 83-85.  Back to cited text no. 9    
10.Kuo RL, Aslan P, Dinlenc CZ et al. Secure transmission of urologic images and records over the Internet. J Endourol 1999: 13: 141-146.  Back to cited text no. 10    
11.Galvin JR, D'Alessandro MP, Erkoen WE et al. The virtual hospi­tal: A new paradigm for lifelong learning in radiology. Radio­graphics 1994; 14: 875-882.  Back to cited text no. 11    
12.Kassirer JP, Angell M. The Internet and the Journal. N Engl J Med 1995: 332: 1709-1710.  Back to cited text no. 12    


  [Table 1], [Table 2], [Table 3], [Table 4], [Table 5], [Table 6], [Table 7], [Table 8], [Table 9], [Table 10], [Table 11]


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