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European Urology
Volume 50, issue 3, pages 395-634, September 200650th Volume Editorials
A Landmark Paper for Endourology
Jens Rassweiler 
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Published online 18 July 2006, pages 395 - 399
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Article Outline
The beginning of the 80s was an exciting time in urology! On one hand, on the basis of the studies of Ferdinand Eisenberger and colleagues [1], Christian Chaussy and colleagues [2] treated the first patient with extracorporeal shock wave lithotripsy (ESWL); on the other hand, Peter Alken and colleagues [3] as well as John Wickham and colleagues [4] started percutaneous surgery for renal stones. The author of this editorial was lucky to be very close to these new developments while working as a young resident at the Katharinenhospital Stuttgart. One must imagine that, besides the use of the Zeiss-loop, ureteral stenting was not accepted at this time. Eisenberger always referred to stents as “Steckerln” (Bavarian for small sticks)!
On the basis of this attitude, the use of a ureteroscope represented a true revolution. Accordingly Pérez-Castro and Martínez-Piñeiro [5] start the introduction of their 1982 report with the sentence: “Ureteroscopy was a forbidden field to our speciality.” In 1978, Lyon and colleagues [6] reported the first distal ureteroscopy, followed by a 1979 report of intraureteral lithotripsy performed by Teichmann [7]. Both used pediatric cystoscopes. By 1980, Perez-Castro in cooperation with Karl Storz developed the first ureteroscope: a 12F, 50-cm long, rigid instrument with a separate optic (0°, 70°) and a 4F working channel. In 1981, Reuter [8] used this instrument for the first electrohydraulic and ultrasonic lithotripsy. Soon modifications were developed by the manufacturers (Storz, Wolf) including oblique integrated optics with a straight working channel (compact systems) and further miniaturization down to 7.5F instruments.
Whereas in the beginning, ESWL and endourology (percutaneous nephrostolithotomy, ureteroscopy) were thought to be competitive procedures, urologists soon realized that only the combination enabled optimal stone management—until today [9]. Improvements in flexible instruments now allow intrarenal surgery to fulfill the dream of early endoscopists: to explore the entire urinary tract from the urethral meatus to the papilla.
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References
- [1] F. Eisenberger, C. Chaussy, K. Wanner. Extrakorporale awendung hochernergetischer stosswellen. Ein neuer aspekt in der behandlung des harnsteinleidens. Akt Urol 8 (1977) (3 - 15)
- [2] C. Chaussy, E. Schmiedt, D. Jocham, W. Brendel, B. Forssmann, W. Walther. First clinical experience with extracorporeally induced destruction of kidney stones by shock waves. J Urol 127 (1982) (417 - 420)
- [3] P. Alken, R. Hutschenreiter, M. Guenther, M. Marberger. Percutaneous stone manipulation. J Urol 125 (1981) (463 - 466)
- [4] J.E. Wickham, M.J. Kellet. Percutaneous nephrolithotomy. Br J Urol 53 (1981) (297 - 299) Crossref.
- [5] E.E. Pérez-Castro, J.A. Martínez-Piñeiro. Ureteral and renal endoscopy. Eur Urol 8 (1982) (117 - 120)
- [6] E.S. Lyon, S.J. Kyker, H.W. Schoemberg. Transurethral ureteroscopy in women. A ready addition to the urological armamentarium. J Urol 119 (1978) (35 - 37)
- [7] H.H. Teichmann. Intraureterale lithotripsie. Urologe A 19 (1979) (231 - 233)
- [8] H.J. Reuter. Atlas of urologic endoscopy. (Thieme, Stuttgart, New York, 1982)
- [9] J. Rassweiler, R. Gumpinger, K. Miller, F. Hölzermann, F. Eisenberger. Multimodal treatment (extracorporeal shock wave lithotripsy and endourology) of complicated renal stone disease. Eur Urol 12 (1986) (294 - 403)
Footnotes
Klinikum Heilbronn, Department of Urology, Am Gesundbrunnen 20, 74074 Heilbronn, Germany
Tel. +49 7131 492401; Fax: +49 7131 492429.
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