Cystoscopy and Urethroscopy for General Practitioners

Abstract

In 1904 Bransford LewisJ reported the use of his operative cystoscope (Fig. 58), adapted not only to use within the bladder but also in the ureters. The direct-vision air cystoscopes of Luys, § and of CathelinU were submitted in 1904 and 1905, and attracted considerable attention in France. * We cannot agree with Fenwick who decries the necessity for a direct-view instrument, saying that by proper manipulation it is possible to obtain a satisfactory view of the posterior wall through the right-angle view cystoscope.

Two centuries of cystoscopy: the development of imaging, instrumentation and synergistic technologies

“…3). From this position, urine accumulated in the dependent posterior bladder, where it would not interfere with the operative field and could easily be drawn out using the aspirating bulb [9]. Bent hairpins retracted the labia and local pain control was achieved with topical lidocaine, followed by intraurethral cocaine or alypin tablets [8].…”

“…It is credited with being the first truly functional cystoscope [8] and this original design remained essentially constant for almost a century [12]. The instrument consisted of an inner telescope, which contained the lamp and the prism for observation, and an outer sheath, which had an irrigating channel and an operating channel, through which a retractable wire snare could be attached [9]. Nitze’s cystoscope was so popular that in 1910 Christian Jacobaeus used it to perform the first thorascopy and laparoscopy [6].…”

“…While the instrument was simple, by 1865 he was able to both dilate and incise urethral strictures, administer topical agents, and irrigate the bladder [10]. The first successful ureteric catheterization was in 1874, by Grunfeld of Germany [7] in a female patient, by manually dilating the urethra and passing a ureteric catheter [2]; however, the overstretching of the sphincter during this procedure often resulted in severe tears and incontinence [9]. In 1880, Pawlik of Prague described a method of ‘fishing’ for the ureteric orifices with no dilatation of the urethra, by probing the trigone with a metal ureteric catheter until the examiner could feel the catheter catch in the ureter [9].…”

“…The first successful ureteric catheterization was in 1874, by Grunfeld of Germany [7] in a female patient, by manually dilating the urethra and passing a ureteric catheter [2]; however, the overstretching of the sphincter during this procedure often resulted in severe tears and incontinence [9]. In 1880, Pawlik of Prague described a method of ‘fishing’ for the ureteric orifices with no dilatation of the urethra, by probing the trigone with a metal ureteric catheter until the examiner could feel the catheter catch in the ureter [9]. In 1881, Grunfeld visually advanced his vesicle endoscope into the ureter, and in 1883 Newman of Glasgow used an incandescent lamp cystoscope for the same purpose [9].…”

“…In 1880, Pawlik of Prague described a method of ‘fishing’ for the ureteric orifices with no dilatation of the urethra, by probing the trigone with a metal ureteric catheter until the examiner could feel the catheter catch in the ureter [9]. In 1881, Grunfeld visually advanced his vesicle endoscope into the ureter, and in 1883 Newman of Glasgow used an incandescent lamp cystoscope for the same purpose [9]. Later, in 1886, Pawlik catheterized the ureter by placing the patient in the genupectoral position for air insufflation, and cannulating the ureter under direct vision through the endoscope [9,14].…”