A historical perspective on cystocele repair--from honey to pessaries to anterior colporrhaphy: lessons from the past.
OBJECTIVE
Ancient reports of the treatment of anterior vaginal wall prolapse (cystocele) include the use of honey, astringents and even turning the woman upside down. Various objects were inserted into the vagina to correct this condition. These have since evolved to modern day pessaries. There is limited information on the historical surgical management of cystocele. In this review we provide a historical perspective on the treatment of cystocele.


METHODS
A MEDLINE search was conducted using the words prolapse, cystocele, etiology, anatomy, pathophysiology, classification systems and the modifications in the nonsurgical and surgical techniques involved in cystocele repair.


RESULTS
Development of pelvic surgery finds its roots in the Ebers papyrus (1550 BC) and evolved from Hippocrates (400 BC) who used pessaries with pomegranate to reduce uterine prolapse. Other maneuvers were also used. Vesalius was the first to provide a detailed description of the entire female genital tract. Adolf Retzius defined the boundaries of the prevesical space in 1849. The current concepts regarding the etiology of cystocele were proposed in 1912. Modern pelvic organ surgeons have modified these concepts to popularize new surgical approaches to this ancient clinical problem.


CONCLUSIONS
These contributions provide a sound basis for future surgical developments.
Cooke
Tasha J N D
TJ
University of Miami Miller School of Medicine, Miami, Florida 33136, USA. tashacooke@hotmail.com
Gousse
Angelo E
AE
D052858:Cystocele / Q000266:history* / Q000628:therapy*; D005260:Female; D013509:Gynecologic Surgical Procedures / Q000266:history; D049669:History, 16th Century; D049670:History, 17th Century; D049671:History, 18th Century; D049672:History, 19th Century; D049673:History, 20th Century; D049690:History, Ancient; D049691:History, Medieval; D006722:Honey / Q000266:history*; D006801:Humans; D010570:Pessaries / Q000266:history*; D013520:Urologic Surgical Procedures / Q000266:history