title: Extraction of a bladder stone in a child as described by the renaissance physician Cristóbal Méndez.
abstract: BACKGROUND
  in his Libro del exercicio y de sus provechos (Book of exercise and profits), the Spanish Renaissance physician Christopher Mendez (1500-1553) describes extracting a bulk stone from the bladder of a child younger than 5 years in the land of colonial Mexico. This is the first description of a surgical procedure in America.
  
  
  METHODS
  Biographical data were collected on Christopher Mendez. The electronic facsimile of the Book of exercise and profits was read. The historical aspects of perineal lithotomy and etiology of bladder stones were analyzed.
  
  
  RESULTS
  In chapter seven of the third treatise (page 120), Mendez speaks about the removal of a bladder stone in a boy named «Villaseñor». It uses the word «open» to describe the procedure, corresponding to a lithotomy more than a necropsy. It attributes the etiology of excess movements after ingestion and suggests a possible hereditary etiology.
  
  
  CONCLUSIONS
  Perineal lithotomy was a common practice in ancient times for children due to the high incidence of bladder stones. The technique was very invasive and was improved over the centuries.
  
  
  CONCLUSIONS
  The surgery described by Mendez for the child called Villaseñor most likely corresponds to a perineal lithotomy. A congenital cause could play a role in its etiology.
authors.affiliation: Servicio de Urología, Fundacio Puigvert, Barcelona, España. Electronic address: fsanchez@fundacio-puigvert.es.
authors.forename: F M
authors.initials: FM
authors.lastname: Sánchez-Martín
authors.affiliation: Unidad de Pediatría, CAP Plana Lledó, ICS, Mollet, Barcelona, España.
authors.forename: A M
authors.initials: AM
authors.lastname: Hostalot
authors.affiliation: Servicio de Urología, Fundacio Puigvert, Barcelona, España.
authors.forename: J M
authors.initials: JM
authors.lastname: Santillana
authors.affiliation: Servicio de Urología, Fundacio Puigvert, Barcelona, España.
authors.forename: O
authors.initials: O
authors.lastname: Angerri
authors.affiliation: Servicio de Urología, Fundacio Puigvert, Barcelona, España.
authors.forename: F
authors.initials: F
authors.lastname: Millán
authors.affiliation: Servicio de Urología, Fundacio Puigvert, Barcelona, España.
authors.forename: H
authors.initials: H
authors.lastname: Villavicencio
mesh_terms: D002648:Child; D049669:History, 16th Century; D006801:Humans; D013030:Spain; D001744:Urinary Bladder Calculi / Q000266:history* / Q000601:surgery; D014572:Urology / Q000266:history*
keywords: Bladder stone; Historia de la urología; History of urology; Lithotomy; Litiasis vesical; Litotomía; Urology; Urología