History Session - 2010 Meeting, Antalya, Turkey - Voiding Dysfunction Classification; According to the Rhazes's (854-914, Iran) first textbook of urology

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5. Voiding Dysfunction Classification; According to the Rhazes's (854-914, Iran) first textbook of urology

A.M. Kajbafzadeh MD 1, S.M. Tabatabaei 2 MD
1Professor of Pediatric Urology, 2Professor of Psychology,  Pediatric Research Center, Pediatric Center  of Excellence, Tehran University of Medical Sciences, Tehran, Iran

Abu Bakr Muhammad ibn Zakariya al-Razi, known in Latin as Rhazes was born near Tehran, Iran (854AD). Rhazes eventually became the caliph’s personal physician and director of the largest hospital in Baghdad. He is credited with writing 273 manuscripts, most of which are now lost. The clarity of his writings did much to bring Greek medicine, especially Hippocrates and Galen, to the Persian and Arabic world. He wrote more than 24 textbooks in different aspects of medicine, surgery and pharmacology called Al-Hawi.We could find three volumes textbook of urology from these series. His classification on voiding dysfunction was basically the same as the recent classification. He classified voiding dysfunction as follow: Dribbling, defined as constant dribbled micturation.  The etiology was divided in 7 main groups: A. Failure of storage. B. Infection of the kidney or bladder and some diseases of genitourinary tracts presenting with hematuria. C: Pelvic floor, uterine or perineal infection and inflammation. D: Sphincter failure E: Bladder tumor. F: Urinary chemical changes. G: Overstretch of the detrusor muscles due to voluntary holding of micturation. Urgency:  due to bladder or urethral inflammation/ ulcer. Difficulty on urination due to: A: Advance hemorrhoid. B: Anal inflammation or infection. Urinary retention: A- Muscular failure. B: Neurogenic voiding dysfunction due to spinal cord injuries. He noticed that the bladder is constructed from different circular muscles fibers. Nerves dividing from the spinal cord innervate these fibers.
Rhazes’s was a pioneer in the use of bladder catheter and provided many details about the urethral catheterization in the first textbook of genitourinary diseases (1).

1.    Ira M. Rutkow: Islamic and Jewish surgery, In; Surgery an Illustration History Mosby – Year Book, Inc. PP 53-57, 1993