Montgomery was a large slave-trading centre. In the early years of his medical practice, Sims lived in Mount Meigs, a small town near Montgomery, Alabama. Childbirth-related VVFs are now exceedingly rare in the developed world – but remain a significant problem in some poor countries. A Sims IVF Clinic was established in Dublin in 1997, and there are several others in Ireland now. Today, Sims’s name is well known to medical students and doctors the Sims speculum, an instrument designed by him, is frequently used in gynaecological procedures. At the time, there was a statue of Sims in Central Park, New York. In my chapter on VVFs, I commented on Sims’s surgical achievements – but went no further. By the time of his death in 1883, he was the most famous surgeon in the world his obituary in the New York Times said he was the “Father of Gynaecology”. In 1852, Sims published the results of operations he performed on women with VVFs, detailing how he cured them. Because of their position and the degree of tissue destruction, VVFs were, for a long time, incurable. In the past, the majority of VVFs occurred because of genital tract trauma associated with prolonged labour. Thirty years ago, when I was training in gynaecology surgery in the United States of America, I published a chapter in a medical textbook about vesicovaginal fistulas (VVFs) in which I referred to the pioneering surgery of Dr James Marion Sims.Ī VVF is a pathological connection between the vagina and bladder that results in continuous urinary incontinence through the vagina.

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