After circumcision the first operations done on man were for bladder stone. Done by charlatans the operation often resulted in loss of life and caused the early lithotomists to maintain a peripatetic existence, vanishing from the town the night after surgery was performed. About two centuries ago stones became a common disease amongst kings: surgeons took over from the charlatans and commenced blind skilful mechanical lithotripsy where a curved instrument was introduced per urethram, its jaws opened to engage the stone which was then crushed by a mechanical (screw driven) closure of the jaws. Now-a-days urinary bladder lithotripsy is done under vision and aided by ultrasound drilling, or electrohydraulic shock wave produced by a direct contact probe. Renal stones can be safely operated on or removed percutaneously
