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Objectives  Radical cystectomy is a complex surgery for bladder cancer which has undergone progressive changes for a century. The originators of the procedure required pioneering innovation and their biographies place the challenges of radical cystectomy in proper perspective  Methods  English and German textbooks and secondary sources  Results  Bernard Bardenheuer (1839-1913) and Karl Pawlik (1849-1914) performed the world’s first two cystectomies for bladder cancer, overcoming challenges of contemporary anesthesia, vascular control, and renal drainage.  Conclusions  The originators of radical cystectomy illustrate that true advances in surgery require bold innovation and forward thinking but also that the limitations of contemporary technology must be overcome.

The First Two Total Cystectomies – A brief history of failed-successes