Cystoscopy

Phillip Bozzini, a German army surgeon, invented the first instrument to visualize the inside of a human body in 1806. He named this device the Lichtleiter. A candle and angled mirrors within the device would enable a surgeon to see inside a body cavity. The device was originally intended to view the pharynx, but it was quickly adapted to view inside the penis and urethra. This was the catalyst for further experimentation and innovation of endoscopic instruments. Maximilian Carl-Friedrich Nitze and Joseph Leiter developed the first true working cystoscope in 1878. From that point on, there has been constant innovation and development that has led to the instruments urologists use today. Cystourethroscopy is one of the most common procedures performed by a urologic surgeon. It allows for direct visualization of the urethra, urethral sphincter, prostate, bladder, and ureteral orifices. There are various indications to perform a cystoscopy, and it can be performed as a simple office procedure or as a procedure in the operating room with the patient under general anesthesia. There are both flexible and rigid cystoscopes and a variety of tools that can be incorporated during cystoscopy, depending on the situation. Cystoscopy is mostly a diagnostic procedure, but there are a limited number of therapeutic procedures that can also be performed. Below, we will discuss the general anatomy of the urethra and bladder, indications for cystoscopy, contraindications, equipment that can be used, technique, and potential complications of cystoscopy.