World Federation of Societies for Paediatric Urology

Progress Medels

Progress Medal 2012 is awarded to
Prof. Stephen A. Koff

Formerly, Chief, Section of Pediatric Urology
Nationwide Children's Hospital &
Professor of Surgery, Department of Urology
The Ohio State University College of Medicine
Ohio, USA

In the world in general and in medicine specifically, there is often a "herd" mentality of thought and action. It is much easier to follow the pack than to tell the pack that it may be going in the wrong direction and to point out a new pathway that may be better. Steve Koff, however, is different than most in that he has never been content to simply follow whatever thought process is in vogue at any given time. This singular quality struck me most and I could think of no one more deserving of the 2012 Pediatric Urology Progress Medal of the World Federation of Societies for Paediatric Urology, than him.


Steve Koff has co-authored 150 publications in peer-reviewed journals, written 50 book chapters and co-edited a definitive textbook on pediatric urology. On the wall in his office is a classic saying by Louis Pasteur: "In the fields of observation, chance favors only the prepared mind." This concept lies at the heart of his academic life. It is important to emphasize that he considers medicine to be a "field of observation," that an academic, thinking pediatric urologist is more than a technician and that to advance the art, one must always observe and analyze. Steve Koff has always stressed the fact that even as surgeons, we must not only consider anatomy, but also function, as functional abnormalities may be more important than those anatomical.

Who has not heard of the Koff formula for expected bladder capacity? These days we commonly use terms such as "voiding dysfunction" and "dysfunctional elimination" but Steve Koff was one of the pioneers who first described these conditions. More than 30 years ago he wrote an article describing the relationships between urinary tract infections and reflux with uninhibited bladder contractions and sphincteric dysfunction that was published in The Journal of Urology®. He was one of the first to describe the relationship among voiding dysfunction, constipation and complications of reflux, and even coined the term "dysfunctional elimination syndrome." If we all now recognize the need to take a detailed history of bowel function in a patient with urinary issues, we can thank Dr. Koff as he demonstrated the importance of doing so!

Concepts that we all presently take for granted came out of his observations of his patients. An incredibly important observation was the fact that the bladder is not the problem in most boys with "valve bladder" and something as simple as leaving a catheter indwelling overnight could reverse upper tract changes and potentially the need for major reconstructive surgery. However, his most controversial work dealt with hydronephrosis, and his articles on nonoperative management of prenatally detected hydronephrosis more than any other caused quite a stir in the pediatric urology world, which led to many heated debates in the literature as well as at national and international meetings.

Steve Koff received his undergraduate and medical school education at Duke University. He began a medical internship and residency at the New York Hospital and always had been planning on a career in nephrology. However, it soon became clear to him that his heart was in surgery and he secured a urology residency in Ann Arbor under Dr. Jack Lapides.

In 1982 he moved to Columbus where he has been the chief of pediatric urology at the Children's Hospital affiliated with the Ohio State University for the last 25 years as well as the current chief surgical officer in charge of surgical operations.

He has a simple technique for education which is, he never answers a question. Rather he asks a question in response that forces a trainee to answer his or her own original question. His interest in education prompted him to establish a dedicated pediatric urology fellowship program.

There is a dictum 'a doctor never retires' and Steve Koff epitomizes it. However, I know he is spending more time with his family- his children, Cory, Ashley and Jon as well as his grandchildren. His wife Bunny has always been supportive of him and he is responding in kind as she becomes more established in the art world.

As I think about Steve Koff's career, what strikes me is that what may be more important than all the academic accolades he has received are the relationships and friendships he has developed throughout the years within international fora like the World Federation of Societies for Paediatric Urology.

In closing, I am honored to be writing this tribute and I am thankful for all Steve Koff has done in refining the field of pediatric urology and for me as an individual.

A Tribute by:

Dr. Venkata R. Jayanthi

Chief, Section of Paediatric Urology
Nationwide Children's Hospital
Clinical Assistant Professor of Surgery
Department of Urology
The Ohio State University College of Medicine
Ohio, USA