The first century of urogynecology and reconstructive pelvic surgery: Where do we do from here?

Abstract

Reviewing the first century of progress in a new subspecialty entitled urogynecology and reconstructive pelvic surgery (URPS) turned out to be a far more daunting and awesome project than I had originally anticipated. The quotation that probably best summarizes the events in this past century is the opening sentence from Charles Dickens' A Tale of Two Cities, which says: 'It was the best of times, it was the worst of times'. It was the best of times because undoubtedly we have made tremendous progress in this burgeoning new field; however, lest we become complacent and, worst of all, rest on our laurels, it was also the worst of times because of the politics of the female pelvis, where we have had urologists, gynecologists and now, more recently, urogynecologists, surgeons and colorectal surgeons, arbitrarily dividing, the female pelvis for political, socioeconomic, financial and turf reasons, the end result of which is that we have done women a tremendous disservice by fractionating health care for pelvic floor disorders. This is one of the challenges which we must meet as we move in to the 21st century if we are to provide women with the type of health care they deserve Correspondence and offprint requests to: