[The clinic Heilanstalt Weidenplan in Halle (Saale), origin of the German urology. Otto Kneise's founding of the first independent urology department in Germany]. / Die Klinik "Heilanstalt Weidenplan" in Halle (Saale), eine Pionierstätte der Deutschen Urologie. Otto Kneises Weg zur ersten selbständigen Urologie in Deutschland.

The routine use of cystoscope initiated the development of the modern urology. Otto Kneise (1875-1953) extended the targets of cystoscopy by including examinations of the male bladder and prostate. He achieved the goal that "cystoscopy is part of general work in urology and not a pure gynecological act". He, thus, founded the specialty gynecological urology in the field urology, which prevented it from becoming an independent field. Under the leadership of Otto Kneise, the first independent urology department in Germany was created in the hospital Heilanstalt Weidenplan.

Exciting times: towards a totally minimally invasive paediatric urology service.

Following on from the first paediatric laparoscopic nephrectomy in 1992, the growth of minimally invasive ablative and reconstructive procedures in paediatric urology has been dramatic. This article reviews the literature related to laparoscopic dismembered pyeloplasty, optimising posterior urethral valve ablation and intravesical laparoscopic ureteric reimplantation.

[Gaining insight--visualization of the invisible in urology: on the history of the technique and evidence in urological endoscopy]. / Einblicke nehmen--die Sichtbarmachung des Unsichtbaren in der Urologie: Zur Geschichte der Technik und Evidenz in der urologischen Endoskopie.

The tactile inspection of the bladder had a long tradition in urology. Examination results and their interpretation depended heavily on the individual tactile skills of the urologist. Because this examination method (if correctly applied) proved the artistic skills and experience of a doctor, urologists did not see any need to replace tactile examinations with a competing method.Nevertheless, urology as well as many other medical disciplines was receptive to techniques aiming at the visualization of pathology. Visualizations served the purposes of science-oriented medicine to be objective and to document examination results. However, it needed the development of specific technologies to create objective images. One major problem in urology was the question of how to light body cavities. After extracorporeal light sources had proven to be ineffective, attempts were made at bringing light sources into the interior of the body. It needed heated tungsten filaments and later mignon bulbs at the tip of endoscopes to illuminate the bladder to such an extent that images from the interior of the bladder could be produced. The paper examines the status of these images as self-evident and objective. It is argued that the images produced were not self-evident. It is shown how combinations of texts and images were needed to develop an endoscopic viewing technique in order to read endoscopic images properly and to recognize those aspects of endoscopic documentations which were necessary for correct interpretations of the images.

The light bulb, cystoscopy, and Thomas Alva Edison.

BACKGROUND AND PURPOSE: Thomas Alva Edison was an icon of American achievement who literally invented the 20th century. Although best known as the inventor of the electric light bulb, the phonograph, and motion pictures, he also left a lasting legacy via peripheral developmental applications, such as endoscopes. METHODS: A review of published urologic writings about incandescent cystoscopes was cross-referenced to writings about or from Edison. Important events that allowed transference of technology from the Edison laboratory to clinical practice were emphasized. RESULTS: Edison was born in 1847 while Lincoln was serving in Congress; he died in 1931 when Hoover struggled with the Great Depression. Edison's life spanned the formative period of America that Henry Adams called the "coming of age." Edison received a Sprengel vacuum device in late 1879, and as usual, he was able to tweak the machine to better performance. For 5 days in October, 16 to 21, he improved the vacuum from 1/100,000 to 1/1,000,000 atm, and his first incandescent bulb burned softly. On December 21, 1879, he leaked the story to N.Y. Herald journalist Marshall Fox, and the world was notified of the light bulb. Special Christmas light visits started in Menlo Park just 4 days later. Edison patented the screw cap for easy changes, and the first bulbs sold for 40 cents (cost $1.40). 100,000 bulbs sold in 1882, 4 million by 1892, and 45 million in 1903. Immediately, competitors and specialty manufacturers entered the market. Dr. Henry Koch and Charles Preston in Rochester, N.Y., developed a smaller, low amperage bulb that could be fitted to medical devices. CONCLUSIONS: No discussion of electricity and modern applications would be complete without some discussion of Thomas Alva Edison and his sentinel contributions. The first church, post office, and ship were illuminated in 1892. The first hotel, theater, and electric sign were in 1893. The rapidity of dispersal and secondary applications of Edison's inventions is typified by the rise of cystoscopes. Nitze used a modified Edison bulb in his second and third generation scopes by 1887-1888 within 8 years of discovery.

Where next for the endoscope?

The concept of examining the body's interior and its organs dates back to ancient times. The roots of modern endoscopy lie in early nineteenth century Europe, and the intervening centuries have seen a steady evolution of devices and techniques. Nowadays, a wide variety of urinary tract disorders are successfully managed in a minimally invasive manner thanks to the endoscope and related technologies. Distal-sensor, 'digital', endoscopes have the potential to revolutionize the field, and change the way in which we use and think about endoscopy. Virtual endoscopy, capsule endoscopy, and a range of other techniques derived from physics and molecular biology all promise great improvements in visualization of the urinary tract and other urologic structures. Ultimately, the continued improvement of these minimally invasive technologies will enhance the quality of care that we can offer our patients.

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

The cystoscope used today is the product of centuries of development. The desire to view the cavities of the body was first described several centuries ago. The earliest true prototype was Bozinni's 1805 urethral viewing tube, on which many others were based. These primitive instruments were challenging to use for the operator, uncomfortable for the patient, and dangerous for both. Patient positioning was based on the method of bladder distension and the goal of the operation, rather than comfort. Images visualized by early models were inverted and backwards, and required the operator to be skilled in correcting this image. Reflected candlelight was used for illumination, and objects appeared small and distant. With the advent of lenses, prisms and the incandescent light, cystoscopy advanced to Nitze's prototype, a forerunner of the current cystoscope. Once the image quality was improved, instrumentation through the cystoscope was introduced, broadening the scope of urology, from the management of venereal disease to a premier surgical speciality. Finally, the invention of fibre optics and digital imaging provided the cystoscope used by urologists worldwide, giving unparalleled image quality, allowing for educational opportunities and a quality of patient care unimaginable to the early pioneers. An understanding of this past brings not only an appreciation of the technology currently available, but also a glimpse into what the cystoscope has the potential to become. From this past, it is clear that today's cystoscope is merely a forerunner of that which the future will bring.

[Introduction of cold light to endoscopy]. / Die Einführung des Kaltlichts in die Endoskopie.

It is the aim of the paper to describe how, 40 years ago, optic glass fibers were developed, and what has been K. Storz's contribution to the new technology. In 1951 the term "Cold Light" was used the first time for illumination of a French type film- and photoendoscope. In 1957 the gastroenterologist B. Hirschowitz at Ann Arbor, U.S.A. succeeded making glass fibers of high light-guiding properties. In 1961 the Cystoscope Makers Inc (ACMI) at New York using these fibers brought the first flexible gastroscope on the market, still equipped with a conventional electric lamp. But in 1960, the year before, the physicist's of ACMI, J. H. Hett and L. Curtiss built the first cold light endoscope using glass fibers for both light and images conduction. In the following years ACMI equipped all of his endoscopes with this new type of illumination. Not before 1963 did K. Storz and the other German manufacturers produce their first cold light cystoscopes. Not possessing the know-how of glass fiber manufacturing, they had to get their fibers from abroad. K. Storz transmitted the term "cold light", which before had been the label of his French-type endoscopes, to the new glass fiber illumination. He constructed an excellent light source for fiber illumination without having light cables of his own fabrication. That is why his name is intimately connected with cold light illumination. But, nevertheless, the invention of the new glass fiber illumination must be credited to B. Hirschowitz and the physicists of ACMI in the U.S.A.

Inicio y desarrollo de la ureterorrenoscopia / Birth and development of ureterorenoscopy

Se describe en este trabajo la historia del desarrollo de la ureterrenoscopia rígida que comenzó en 1979 y hoy en día es una realidad en la mayoría de los servicios urológicos del mundo. Desde el primer Ureterorrenoscopio con un calibre extraordinariamente amplio y sin ningún sistema de dilatación, ni tampoco ningún sistema operativo, fue desarrollándose la actual técnica en donde desde la bomba de hidratación hidráulica hasta la fragmentación con láser ha permitido convertir a la ureterorrenoscopia en un procedimiento habitual para la resolución de litiasis, extracción de cuerpos extraños intraureterales ó renales, resolución de estenosis, diagnóstico de hematurias unilateralesy tratamiento endourológica de tumores uroteliales muy seleccionados

In this paper we describe the history of the development of rigid ureterorenoscopy. It started in 1979 and today is a reality in most urological departments of the world. From the first ureterorenoscope with a extraordinarily large caliber and no dilation or operative systems, the current technique have developed, so that from hydraulic water pump to laser fragmentation have enabled to make ureterorenoscopy a common procedure for the resolution of urinary stones, extraction of foreign bodies in the ureter or kidney, treatment of stenosis, diagnosis of unilateral hematuria and endourological treatment of selected urothelial tumors

Hans Christian Jacobaeus: Inventor of human laparoscopy and thoracoscopy.

Hans Christian Jacobaeus performed the first clinical laparoscopic surgery in Stockholm. This pioneering procedure was based on the animal experiments of Georg Kelling (1866-1945), a German physician from Dresden, who performed the first laparoscopic intervention in 1901 using a Nitz cystoscope in a dog. In 1910, Jacobaeus published his initial experiences with laparoscopic surgery in the Münchner Medizinischen Wochenschrift under the title "The Possibilities for Performing Cystoscopy in Examinations of Serous Cavities." He used this technique for diagnostic purposes in undefined abdominal complaints and functional impairment. Jacobaeus was the first who pointed out the possibility of injuring organs, especially the intestines, by inserting the trocar. In 1910, Jacobaeus recognized the immense diagnostic and therapeutic possibilities of laparoscopic surgery, as well as its difficulties and limits. He also was the first to realize the need for initial endoscopic training in animals and corpses. He promoted the development of special laparoscopic instruments to optimize and simplify the procedure.

[A look inside the bladder--the human behind it]. / Ein Blick in die Blase-der Mensch dahinter.

To study the inside of humans is an old wish of mankind. Cystoscopy and its development are known to-initiates. In the following we do not stress this examination, but focus on those people behind it who shared in paving the way for improvement with their fantasy and energy without neglecting to report on the human and very human aspects.

Julius Bruck (1840-1902) and his influence on the endoscopy of today.

A hundred years ago, on 20 April 1902, Breslaus most famous dentist of the time died. Julius Bruck was not only the most famous dentist and fighter for dentists' education in Germany in his time, but also one of the most successful inventors. In 1866, he produced light by using an exposed electrically heated platinum loop, which at that time was the most powerful light source known. He conceived of the possibility of placing the source of light in the distal end of an instrument and invented a double glass tube with a water-cooling compartment. This water cooled apparatus (diaphanoscope) was inserted into the rectum or vagina, to transilluminate the bladder. The key to further advances was born with the introduction of an internal electric light source. In 1877, the potential of Bruck's theoretical advance was realised in combination with other advances which virtually established the form of the clinically useful cystoscope as it is used today. The remarkable man responsible for this synthesis was Maximilian Nitze.