History of Reconstructive Urology

The histories of urethral surgery, pelvic-floor reconstruction, prosthetic urology and urinary diversion span more than three millennia. Much of the progress came from surgeons who were also anatomists and instrument designers.

The histories are told separately because they developed on different timescales and in different patient populations. Urethral surgery is the oldest, running from Sushruta's reed catheters (about 600 BCE) through Johanson's staged urethroplasty (1953) and the work of Turner-Warwick to buccal mucosa graft urethroplasty. Prolapse surgery and urogynecology grew out of the obstetric fistula epidemic of the 19th century, from Sims's operations in Montgomery, Alabama to the McCall culdoplasty and modern apical suspension. Prosthetics and erectile dysfunction treatment is the youngest, beginning with Bogoras's rib-cartilage penile reconstruction in 1936 and continuing through the three-piece inflatable penile prosthesis of Scott, Bradley and Timm (1973) and the introduction of sildenafil in 1998. Urinary diversion runs from Simon's ureterosigmoidostomy for bladder exstrophy (1852) through Bricker's ileal conduit (1950) to detubularized continent reservoirs and orthotopic neobladders. Each history follows the surgeons and patients involved and the eponyms still used in practice.

• History of Urethral SurgeryThree millennia of urethral stricture surgery, hypospadias repair and urethral reconstruction, from reed catheters to robotics.
• History of Prolapse Surgery & UrogynecologyHow pelvic floor reconstruction evolved from pessaries to mesh, and how the URPS subspecialty formed.
• History of Prosthetics & ED TreatmentThe origins of penile prostheses, vacuum erection devices and oral ED drugs, from splints to inflatable implants.
• History of Urinary DiversionFrom Simon's ureterosigmoidostomy (1852) through the ileal conduit, continent reservoirs and orthotopic neobladders to robotic intracorporeal reconstruction.