When was kidney stones discovered

However, some patients will have specific metabolic abnormalities or hormonal abnormalities that predispose them to stone formation. If such an abnormality is suspected, special test will be performed and chronic medication may be prescribed. For most cases however, the key to stone prevention is simply increasing water intake. The vast majority of stones are calcium stones, either calcium oxalate or calcium phosphate. If a stone can be seen on a plain x-ray, it is a calcium stone.

These stones cannot be dissolved, and must either pass or be treated. These stones can form spontaneously, but can also be a result of high blood uric acid levels, a condition that can also cause a disease called gout. What is unique about uric acid stones is that they can, if not coated with calcium, be dissolved by raising the pH of the urine. One of the first things an Urologist will want to determine is whether a uric acid stone is suspected or not when a stone is present as this may affect how that stone will be managed.

Stones are discovered in one of three ways. A patient may undergo a radiologic exam for an unrelated reason when a stone is found incidentally. A stone can be found as a result of a workup of hematuria, or blood in the urine, or a stone can be found when it decides to pass. Stone passage presents itself in many ways. Although the old adage is that stone passage is very painful, often likened to childbirth, this is not always true.

Rather, many stones are very small and hardly noticed other than perhaps having what is felt to be an upset stomach or irritative urinary symptoms as the stone approaches the bladder.

In some patients there is no pain at all, with perhaps the only sign that a stone is passing being the presence of blood in the urine. It is important to understand that pain occurs with a stone only when it is obstructing the flow of urine from the kidney to the bladder via a tube called the ureter.

If a stone is small enough, it can slowly pass down the ureter without causing much obstruction and thus not much pain. It is for this reason that stones in the kidney itself are largely asymptomatic, a fact that surprises most patients.

When a stone is uncovered, the most important detail that must be known to advise the patient as to what to do is the size of the stone. His approach was to make an incision below the scrotum directly into the bladder, find the stone, and extract it. He had his brother help him in the surgery by holding the scrotum aside. It is from them that he likely learned the technique.

Modern stone surgery was developed in the last half century. In , the first percutaneous stone surgery was performed by Fernstrom and Johansson. ESWL shockwave lithotripsy was developed out of early research on the effect of shockwaves on aircraft parts by the German company Dornier. This was further developed for the treatment of stones in the first human procedure occurring in The Dornier HM-3 which stood for human model-3 required the use of a water bath and an elaborate overhead gurney to position patients.

Ureteroscopy, or the placement of a lens into the ureter was first described in by Hugh Hampton Young but the first ureteroscopic stone surgery did not occur until Hi there, I want to subscribe for this webpage to get hottest updates, so where can i do it please help. An intriguing discussion is worth comment. I think that you ought to publish more about this subject matter, it might not be a taboo subject but typically people do not talk about these topics.

To the next! Many thanks!! Have your Doctor refer you to a Urologist — In the mean time start drinking 64 ounces of water per day. The operation was carried out through a perineal incision down to, then through, the bladder neck to reach the stone and extract it.

Comparing the descriptions of the operative technique as carried out during ancient Indian and Greek civilizations, the description given by Albucasis in his book Al-Tasreef clearly shows how Albucasis remarkably improved the technique of this operation and reduced its risk [ 8 ].

Furthermore, in the ancient and Greco-Roman texts before Albucasis, there is no such emphasis on avoiding the midline perineal incision. That innovation in the technique of perineal cystolithotomy, introduced by Albucasis, was of considerable practical anatomical significance.

Albucasis was also the first to use forceps to extract a bladder stone. Before him, extraction of the stone was by an instrument similar to a small spoon that goes around the stone and scoops it out. He is also considered as the first to use a tool to confirm the presence of the stone before proceeding with the perineal cystolithotomy operation. He also introduced the 2-stage bladder stone operation in complicated cases.

During the medieval period in Europe — there was little activity in the management of stone disease [ 10 , 11 ]. In this era lithotomists were essentially commercial travelers moving from town to town looking for business and cutting all who came their way [ 7 ]. Often uneducated and occasionally dishonest, some were great showmen.

The procedure was generally performed in the public without anaesthesia and generally lasted a few minutes [ 7 ]. However, lithotomists were held responsible for their bad results and fined accordingly. In the 14th century, Chauliac — , considered as the father of French surgery, wrote the Chirugia Magma, combining surgical influences of the Arabs, the Greeks, and his experiences [ 12 ].

He wrote much about stone disease but never performed lithotomy, which was a dangerous operation at that time. Although some separation of surgery from the practice of medicine had begun to develop in early medieval times, this was accentuated in by the Fourth Lateran Council, a papal edict which forbade physicians most of whom were clergy from performing surgical procedures, as contact with blood or body fluids was viewed as contaminating to men [ 10 ]. As a result, the practice of surgery was relegated to craft status with training by apprenticeship through guilds.

Physicians followed a university-directed program of education, which involved knowledge of the classics and writings of ancient medical authors such as those by Galen, which allowed no independent thought or inquiry. Competition among physicians and surgeons, including the lowest group of surgical practitioners, the barbers, continued until Henry VIII signed a charter in uniting barbers and surgeons in London.

This Guild of Barbers and Surgeons, forerunner of the Royal College of Surgeons, established a regulatory agency for training and certification of surgical practice, which set the stage for legitimizing surgery as a profession [ 10 ]. With Renaissance — , there was a rapid increase in intellectual creativity in many fields.

During this period, new procedures could be tried on criminals. As a result, Colot removed stones from a criminal suprapubicly in Thereafter, the Colot family in France held some kind of a monopoly of lithotomy over 2 centuries [ 1 , 13 ]. They were members of the College of Surgery and had high reputation. However, the first major scientific improvement since Celsus and Albucasis was done by Farncisco de Romanis in [ 1 ].

They also wrote comprehensive prescriptions to aid stone passage and dissolution in their texts. He also wrote long and detailed prescriptions to stone patients in his book. The first recorded removal of a calculus by suprapubic lithotomy was also carried out during Renaissance by Pierre Franco in [ 13 ]. Although his patient recovered well, Franco advised others not to follow his example because of the extreme hazards of this approach.

The first account of an operation performed on the kidney was also around this time during Renaissance. Cardan of Milan opened a lumbar abscess in and discovered 18 stones [ 1 ]. However, there was no further mention of this procedure for many years. Thereafter, this method was further perfected and popularized by Ferre Jacques, who performed more than operations. William Cheselden and John Douglas were the first to realize that distended bladder mowed upwards and therefore an extraperitoneal approach was possible.

However, these two famous friends accused each other of plagiarism, which lasted for many years [ 1 , 7 ]. Hermann Boerhaave — was one of the most important figures in 18th-century medicine [ 18 ]. During the early 18th century the surgical approaches for lithotomy to treat lithiasis had very high risks of complications.

In the face of the very common and dangerous complications, the doctors and surgeons actively sought all possible solutions short of surgery and left lithotomy as the last alternative.

His recommendations included an increase in liquid intake, a hot bath in order to induce vasodilation, and exercise. Using these methods, Boerhaave felt that stone removal should be achieved, perhaps reflecting both the status of surgery in the early 18th century and an appreciation of the risks of the surgical procedures available.

Although the issue of informed consent has become the concern of medical researchers since the beginning of the 20th century and recently became almost the main issue of medical treatment, we see the medicolegal infrastructure of informed consent concept in the law court archives of the Ottoman Empire during the 16th and 17th centuries [ 19 ]. In these informed consents, patients or parents signed that they understood the complications of lithotomy and that they would not complain and bring the case to suit in case of any complication.

The history of urinary stones is becoming more appealing with the famous persons harboring the disease. Michelangelo, who is thought to have a high-functioning autism, that explains his single-minded work routine, unusual lifestyle, limited interests, poor social and communication skills, and issues of life control, also suffered from urinary stones [ 20 ].

Depression and various medical conditions, including gout, renal colic, and urinary stones, did not stop his obsessive working habits. His terminal illness with symptoms of fluid overload suggests that he may have sustained obstructive nephropathy.

That this may account for his interest in kidney function is evident in his poetry and drawings. Most impressive in this regard is the mantle of the Creator in his painting of the Separation of Land and Water in the Sistine Ceiling, which is in the shape of a bisected right kidney. His use of the renal outline in a scene representing the separation of solids Land from liquid Water suggests that Michelangelo was likely familiar with the anatomy and function of the kidney as it was understood at that time [ 20 ].

Napoleon Bonaparte and Emperor Napoleon III were suffering from bladder stones and had severe symptoms, probably affecting their decisions and judgments [ 13 ]. Today, historians discuss what might have happened in the Russian campaign in if Napoleon Bonaparte had not had a bladder stone. Similarly, the whole European history might have changed if Napoleon III was treated with modern surgical techniques during the Franco-Prussian War of [ 13 ].

In , Bigelow developed a stronger and harder lithotrite, which was introduced into the bladder with the help of anaesthesia [ 22 ].

He filled the bladder, crushed the stones, and evacuated the fragments. Besides the developments in cystoscopic lithotrite, alternative surgical procedures for stone removal were being attempted.

Gustav Simon performed the first planned nephrectomy for a fistula in [ 23 ]. In , Ingalls from Boston carried out the first nephrotomy. The first pyelotomy was performed by Heinecke in , and the first nephrolithotomy was carried out in by Le Dentu [ 1 , 24 ]. Czerny is credited with being the first to suture a nephrotomy incision in [ 25 ]. Kummel and Bardenheuer carried out the first partial nephrectomies for stone disease in [ 25 ].

Max Brodel described the avascular area of the kidney in [ 26 ]. Lower revived interest in pyelolithotomy by suggesting that it may be a safer and easier method for removing renal stones than nephrolithotomy in [ 25 ].

Another important advance in open renal stone surgery was intrasinusally extended pyelolithotomy , pioneered by Gil-Vernet in [ 27 ]. Fitzpatrick et al. On the other hand, Smith and Boyce from USA introduced and popularized anatrophic nephrolithotomy for the treatment of staghorn stones in [ 29 ]. This technique has further gained popularity, became treatment of choice for large staghorn stones in experienced hands, and is even applied during laparoscopic approaches [ 30 ].