# Ahmed Shafik (Surgeon)

Ahmed Shafik (10 May, 1933 – October 31, 2007) was an Egyptian surgeon and prolific researcher, best known for his groundbreaking work in colorectal and pelvic floor surgery, as well as his contributions to sexual health research. Shafik's dedication to advancing surgical techniques and understanding human physiology made him a prominent figure in the medical field.

## Early life and education

Shafik was born on May 10, 1933, in Menoufia, Egypt. He graduated with honors from Cairo University's Faculty of Medicine in 1957, receiving his MD in 1962. Following his initial medical training, Shafik joined Cairo University's Faculty of Medicine, where he held various academic and clinical positions, culminating in his appointment as Professor and Chairman of the Department of Surgery and Experimental Research in 1990. His dedication to both surgical practice and experimental research positioned him as a pioneering figure in Egypt and internationally.

## Contributions to surgery

Shafik was instrumental in advancing colorectal and pelvic floor surgery, with his innovations in these areas leaving a lasting legacy. In 1964, he introduced the cutaneous uretero-ureterostomy urinary diversion (Shafik I), a procedure for reconstructing the urinary system in patients with compromised bladder function. Later, in 1967, he performed the first bladder transplant, pioneering a significant milestone in urology and setting the stage for further developments in organ transplantation.
Following his work on urinary diversion, Shafik developed the perineal ileo-urethral neo-bladder (Shafik II), an advanced reconstructive technique that preserved bladder function for individuals with severe pelvic trauma or bladder cancer. His articles discussing these procedures and findings are published under the names "Shafik I" in The Journal of Urology and "Shafik II" in the British Journal of Urology (BJUI) and other medical literature, marking his distinct contributions in medical records.
In 1991, Shafik identified pudendal canal syndrome, a painful condition resulting from compression of the pudendal nerve. Recognizing the syndrome's clinical implications, he introduced surgical decompression as a treatment, significantly advancing approaches to chronic pelvic pain management and establishing a foundation for further research into pelvic nerve disorders.
Shafik's research extended beyond traditional surgical topics; he became known for his innovative studies on how external factors affect physiology and behavior. In 2016, he was awarded the Ig Nobel Prize for his unique study on the effects of different textiles (polyester, cotton, and wool trousers) on the sexual activity of rats. His research demonstrated that polyester-induced static electricity could negatively impact reproductive health, providing insights into how fabric types might influence human physiology as well. In addition to this animal study, he conducted further research examining the contraceptive efficacy of polyester in inducing azoospermia (a reduction in sperm count) in men, findings that were published in Contraception and European Urology.
Shafik identified and documented over 80 anatomical reflexes, many of which pertain to sexual physiology. Notably, he studied the vaginocavernosus reflex, which highlights a synergistic relationship between male and female anatomy during sexual activity. These discoveries underscored his ability to bridge clinical insights with foundational physiological research, sparking discussions within the scientific community despite limited replication efforts.
Throughout his career, Shafik authored over 1,000 peer-reviewed articles and reviews, covering a wide array of topics in anatomy, physiology, and experimental surgery. His commitment to experimental and clinical studies laid the groundwork for a deeper understanding of colorectal and urinary tract diseases, as well as the impact of external factors on physiological health.

### "Triple-loop" theory of the external anal sphincter

Shafik's "triple-loop" theory of the external anal sphincter has significantly influenced our understanding of anorectal anatomy. In his 1975 study, Shafik described the external anal sphincter as comprising three loops: the top, intermediate, and base loops, each with distinct anatomical features and functions.
Subsequent research has utilized advanced imaging techniques to validate and expand upon Shafik's findings. A 2008 analysis confirmed the triple-loop configuration of the external anal sphincter using coronal and coronally reconstructed imaging modalities. Further studies have also explored the functional implications of the triple-loop system. For instance, research into the role of the levator ani muscle during defecation has provided additional insights into the complex interactions within the pelvic floor musculature, building on Shafik's foundational work..
Shafik's triple-loop configuration of the external anal sphincter remains a cornerstone of modern pelvic floor research. Advanced imaging technologies have not only corroborated his findings but have also enhanced the understanding of anorectal mechanics, influencing surgical approaches in colorectal procedures.

### Research philosophy

Shafik self-funded his research, allowing him the freedom to pursue unconventional and groundbreaking studies without reliance on external funding or corporate sponsorship. This independence enabled him to explore topics with no immediate practical application but significant contributions to scientific understanding, exemplifying a 19th-century approach to science for its own sake.

## Awards and recognition

Shafik received numerous accolades throughout his career. In 1977, he was awarded the Egyptian State Prize for Science and Art, First Class, for his exceptional contributions to medical research and surgical innovation. He was also honored with honorary fellowships from institutions such as the Italian Academy of Coloproctology and the Société Nationale Française de Coloproctologie. His influence extended internationally, notably as a founding member and President Elect of the International Society of University Colon and Rectal Surgeons (ISUCRS) from 2004 to 2006.

## Death

Shafik died on November 1, 2007, at the Georges Pompidou European Hospital in Paris, France, at the age of 74, due to cardiac arrest. Prior to his death, he experienced a heart attack while in Egypt’s North Coast region. Delays and inadequacies in medical care during this time contributed to the deterioration of his condition.

## Legacy

Shafik's extensive research portfolio includes over 1,000 peer-reviewed papers covering topics from pelvic floor reflexes to innovative surgical techniques. His work has significantly advanced the understanding of anorectal physiology and pelvic floor disorders.
Shafik’s groundbreaking techniques in colorectal and pelvic floor surgery remain a cornerstone in contemporary medical practice, frequently referenced and adapted by modern surgeons. His relentless pursuit of both theoretical and practical advancements has left an enduring legacy, elevating Egyptian and global medicine alike. Shafik's work continues to inspire a new generation of surgeons and researchers, encouraging a holistic approach to patient care and the exploration of uncharted scientific territories.
With a scientific philosophy reminiscent of 19th-century polymaths, Shafik pursued knowledge for its own sake, unbound by conventional limits. His fearless engagement with taboo subjects, such as sexology in conservative societies, positioned him as a pioneering figure in his field. While some in the international scientific community questioned his findings due to limited replication, others praised his boldness and the breadth of his inquiries.