A safer alternative to the 'High Operation' for treating bladder stones in women: the experience of Thomas Molyneux (1661-1733)
BAUS ePoster online library. Murtagh K. Jun 25, 2019; 259561; P6-7
Kevin Murtagh
Kevin Murtagh
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Through early modern history, many techniques were developed to deal with bladder stones with the transperineal approach thought the most effective. The suprapubic approach, or 'High Operation', was mostly avoided due to its high morbidity and mortality.

The High Operation's dangers lead many to explore alternatives for bladder stone removal. Thomas Molyneux(1661-1733), Dubliner, esteemed academic, politician, co-founder of the Dublin Philosophical Society and Royal Society fellow was one such advocate of an alternative approach in females. He appreciated that while females are less frequently affected than their male equivalents, their shorter urethras make dilatation and stone extraction an option. Molyneux's experiences in dealing with bladder stones were published in the Philosophical Transactions of 1698. This, the journal of the Royal Society was am important organ to voice the latest scientific and medical opinions of the time. Here he proposed that 'extraction of the stone, by gradual dilatation of the urethra, without any manner of section, as the most safe and easy way, for freeing those of the female sex from the stone in the bladder'. He details his own encounters with the procedure from first reading about it in Traite Complet des Operations de Chirurgie (published by Monsieur de la Vauguion in Paris in 1696), to ultimately the removal of stones of 'extraordinary bigness' from the bladders of young girls and women in Dublin.

We look at this theory of urethral stone extraction, as described by Molyneux the C17th Gentleman Scientist, where it originated and how it influenced future techniques.
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