FR02-01 THE GREAT CIVILIZATIONS OF ANTIQUITY DEMONSTRATE A SURPRISING AMOUNT OF UROLOGICAL KNOWLEDGE

Abstract

INTRODUCTION AND OBJECTIVE: Evidence exists for Urological procedures and diseases for 5780 years. The objective of this study was to review the extent and breadth of Urologic disease and intervention during various periods of antiquity. METHODS: A comprehensive literature search of Pubmed, Ovid, Google Scholar and the Internet was undertaken RESULTS: The first reference to a Urological surgical procedure is circumcision in the Old Testament, indicating that this has been performed for over 5780 years. Additional reference to this is next in hieroglyphic reliefs from 3400 BC. Homer (1102 BC) in the Odyssey claims that Egyptian men are the most skilled of any in medicine and mentions the genitourinary organs. Kidneys were thought to be sacred and left in situ for embalming. This allowed for the study of mummies revealing renal abscesses, vesicovaginal fistulae, and stone disease dating back for 3200 BC. In 1550 BC, the Ebers Papyrus makes mention of Priapism, long before there is any suggestion of Priapus, the Greek God (400 BC). Urinary retention was treated with assorted catheters. Spinal cord injury was associated with incontinence. There is also mention of gonorrhea, schistosomiasis, enlarged prostate, stricture, bladder stones and hydroceles. Different descriptions of circumcision exist. Susruta, treated strictures, infections and stone disease, in India around 1000 BC as well as being responsible for the Susruta Samhita, the earliest text for the systematic teaching of surgery. He also demonstrated an understanding of the medical management of this disease, STDs and urinary tract infections. He performed sequential urethral dilatations. Urinary calculous disease was first mentioned by Hippocrates 460 BC, and later treated via the perineum by Ammonias (283 BC) and Celsus, however this approach was similar to that described nearly 400 years earlier by Susruta. Hippocrates also wrote about analyzing urine to interpret body function and incontinence. Excellent documentation for the use of the catheter and its potential complications for fistulae, kidney inflammation and bladder paralysis exists in 360 CE from Oribasius a Byzantinian. CONCLUSIONS: There is evidence that all great ancient powers identified and attempted to treat Urological disease. The extent of the understanding and attempts to render treatment is rather surprising and common to these civilizations. Each attempted to build upon and not just copy earlier civilizations findings. The literature strongly supports the recognition of the urinary tract and efforts to treat various entities during these times. Source of Funding: none