, Volume 2, Issue 3, pp 177-185

History of urolithiasis

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The history of urolithiasis dates back to the dawn of civilization. The symptoms, signs, and treatment of kidney and bladder stones are chronicled in most extant ancient medical texts, and cutting for stones in the bladder is one of the oldest elective surgical procedures recorded. Physicians performed perineal lithotomy until the Middle Ages, when prejudice against surgical procedures relegated them to barber surgeons, lithotomists, and the clergy. The anatomical studies of the Renaissance led to the emergence of surgeon anatomists and a gradual integration of surgery and lithotomy into the medical profession. A part from instrumental refinements, surgical progress had to wait for the advent of anesthesia and aseptic techniques in the 19th century when suprapubic lithotomy became possible. Surgery for kidney and ureteral stones was not possible until the discovery of the X-ray. This was also the age when chemical analysis of stones began to provide a rational basis for the medical management of urolithiasis.