Ethics in gynecologic surgical innovation.

J. Marion Sims' efforts in surgically curing vesicovaginal fistula are retold. The controversy surrounding his surgical innovation on black slaves is discussed in the context of the ethical principles of autonomy, beneficence, and justice. The relevance of his story to modern surgical innovation in incontinence surgery is emphasized in a discussion of the Pereyra, Gittes, and paravaginal procedures. A call is made to establish a gynecologic ethic to ensure that patients' rights are respected in all future surgical innovation.