James Marion Sims developed a treatment for vesico-vaginal fistulas in Montgomery, Alabama in the 1840s. Vesico-vaginal fistulas were a relatively common condition in which a woman's urine leaked into her vaginal cavity from her bladder, and many regarded the fistulas as untreatable during the early 1800s. After years of efforts to repair the fistulas with myriad tools, techniques, and procedures, Sims developed the speculum and a vaginal examination position later named for him. He also popularized the use of silver metal sutures to treat and cure women who had vesico-vaginal fistulas. Sims's surgical cure for vesico-vaginal fistulas eased both the social stigma and physical discomfort of many affected women. Though current treatments of vesico-vaginal fistulas have evolved since the nineteenth century, some of the basic principles utilized by Sims have been incorporated into present-day surgeries. In particular, Sims stressed the significance of continual bladder drainage after the operation.

A vaginal speculum is a medical device that allows physicians and health providers to better view a woman’s cervix and vagina during pelvic exams. Most specula are made of metal and plastic, and physicians insert a portion of the speculum into the patient’s vagina to separate the vaginal walls. Physicians have used devices to view inside a woman’s vagina for centuries, but physicians did not begin using what is known as a speculum in the twenty-first century until the 1800s. Prior to the invention of the modern speculum, health specialists struggled to find a way to view the cervix and vaginal walls. Because of that, health specialists could not accurately diagnose medical problems that were occurring in those tissues. Therefore, the speculum has enabled healthcare professionals to provide women with better gynecological diagnoses and care.