Operative management of primary hyperparathyroidism began in 1925 when Felix Mendl performed the first successful parathyroidectomy for a patient with Von Recklinghousen Disease. This landmark operation initiated the practice of parathyroidectomy for patients with primary hyperparathyroidism and osteitis fibrosa cystica between 1925 and 1932. In 1932, Dr. Fuller Albright noted that 80% of patients treated with parathyroidectomy for primary hyperparathyroidism and osteitis fibrosa cystica also had either nephrolithiasis or nephrocalcinosis. This observation widened the criteria for operative intervention to include patients with hyperparathyroidism and nephrolithiasis and less severe bone disease. Thus, over the subsequent 30 years, the major indication for parathyroidectomy became renal stones without overt bone disease.