Stone surgery has ancient roots
Urinary stones troubled ancient civilisations too: Hippocrates described bladder-stone symptoms, and the earliest recorded details of perineal lithotomy are attributed to Cornelius Celsus.
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Tefekli A, Cezayirli F. ScientificWorldJournal. 2013;2013:423964Nephrostomy had an accidental start
In 1955, Willard Goodwin was attempting a renal arteriogram when his needle entered a hydronephrotic collecting system. He imaged it and left a drainage tube—an early nephrostomy born from an unexpected turn.
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The Modern History and Evolution of Percutaneous Nephrolithotomy. J Endourol. 2014Dogs sniffed for prostate cancer
In a double-blind pilot study, two trained dogs assessed urine for Gleason 9 prostate cancer. Sensitivity was 71%, with specificity of 70–76%. The experiment explored feasibility rather than establishing a routine screening test.
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Guest C et al. PLoS One. 2021;16:e0245530Ureteroscopy predates modern lasers
Young reported ureteroscopy in 1929. The idea of looking into the ureter therefore predates the modern laser systems now associated with endoscopic stone treatment.
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Tefekli A, Cezayirli F. ScientificWorldJournal. 2013;2013:423964Tiny mammals don't make big streams
Very small mammals often release urine as droplets rather than a continuous stream. The physics study behind this finding identified viscosity and surface-tension effects as important obstacles at their tiny scale.
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Yang PJ et al. Proc Natl Acad Sci USA. 2014;111:11932–11937The surprisingly similar toilet timer
A study of mammalian urination found that animals weighing over 3 kg emptied their bladders in roughly similar times: 21 ± 13 seconds. This was a comparative finding, not a diagnostic time limit for humans.
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Yang PJ et al. Proc Natl Acad Sci USA. 2014;111:11932–11937Urinary viruses can target bacteria
Urinary microbiome research has found bacteriophages—viruses that infect bacteria. Many detected phage sequences differ markedly from previously described ones, revealing a largely unexplored viral world in urine.
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Ackerman AL, Chai TC. Curr Bladder Dysfunct Rep. 2019;14:331–341A transplant pioneer began with burns
Joseph Murray's work with skin grafts in injured soldiers helped spark his interest in graft rejection. The plastic surgeon later performed the successful 1954 kidney transplant between identical twins and received a Nobel Prize in 1990.
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Joseph Murray: Pioneering Plastic Surgeon and Father of the First Organ Transplant. 2021Enlargement can obstruct urine flow
The prostate surrounds the first part of the urethra below the bladder. Benign enlargement can squeeze this channel and cause voiding symptoms, including weak flow, difficulty starting and incomplete emptying.
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healthdirect benign prostate hypertrophyA shock-wave turning point
A history of stone treatment identifies 1980 as the arrival of the first extracorporeal shock-wave machine—a major shift towards treating stones without cutting directly into the urinary tract.
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Tefekli A, Cezayirli F. ScientificWorldJournal. 2013;2013:423964Above the pubis, back in 1561
The first recorded suprapubic lithotomy was performed by Pierre Franco in 1561. Surgeons were approaching bladder stones above the pubis centuries before modern endoscopic stone treatment.
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Tefekli A, Cezayirli F. ScientificWorldJournal. 2013;2013:423964Your bladder has microbial company
The bladder is not necessarily sterile. Modern studies have detected resident microbial communities in urine, including in people without urinary symptoms. Finding microbes is not, by itself, the same as diagnosing infection.
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Ackerman AL, Chai TC. Curr Bladder Dysfunct Rep. 2019;14:331–341A kidney model took a thrill ride
The 2018 Ig Nobel medicine prize recognised Marc Mitchell and David Wartinger for investigating roller-coaster rides as a way to encourage kidney stone passage. Their cited study used a functional model of the kidney's collecting system.
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Improbable Research: 2018 Ig Nobel Prize winnersYou're all caught up
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