Hf02-10 the Introduction and Evolution of Fluoroscopy in Early Urology: From X-Ray Vision to Intraoperative Imaging

You have accessJournal of UrologyHistory of Urology Forum II (HF02)1 May 2024HF02-10 THE INTRODUCTION AND EVOLUTION OF FLUOROSCOPY IN EARLY UROLOGY: FROM X-RAY VISION TO INTRAOPERATIVE IMAGING Katherina Y. Chen, Kaitlin L. Berry, and Noah S. Schenkman Katherina Y. ChenKatherina Y. Chen , Kaitlin L. BerryKaitlin L. Berry , and Noah S. SchenkmanNoah S. Schenkman View All Author Informationhttps://doi.org/10.1097/01.JU.0001008760.25751.09.10AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: Fluoroscopy is an essential tool in urology that is frequently utilized during endourologic surgeries. It allows for visualization of stones and contrast and even provides a road map when one gets lost during a procedure. Prior to the introduction of fluoroscopy, the practice of urology mostly relied on cystoscopy. However, in 1895, when Wilhelm Conrad Röntgen discovered the X-ray and published his findings, the use of fluoroscopy spread rapidly. METHODS: A review of the literature, including book chapters and journal articles on fluoroscopy and its introduction to urology was performed. RESULTS: After Röntgen published his paper, Thomas Edison began experimenting with X-rays and invented a crude fluoroscope one year later. Despite the not-infrequent loss of hands and mysterious deaths in those early days, fluoroscopy quickly became a routine medical tool. John Macintyre was the first to capture an image of a stone in the silhouette of the kidney using fluoroscopy in 1896, a diagnosis confirmed in a subsequent surgery. Theodore Tuffier furthered its use in 1897, when he imaged the ureter by passing a radiolucent ureteral catheter into a ureteral orifice and used lead wire to make it radiopaque. Later iterations would see the ureteral catheter made radiopaque by impregnating its walls with iron oxide. Wittek's introduction of air as a contrast medium in 1904 to visualize bladder stones marked a significant advancement. The next contrast medium invented was a solution of bismuth subnitrate and starch, which was soon superseded by a silver colloidal suspension due to its superior imaging quality. This was used for the first retrograde pyelogram. Nevertheless, the toxicity of silver led to the adoption of safer sodium iodide solutions as the contrast of choice. The intravenous pyelogram was later accidentally discovered when high doses of iodide-containing compounds were used to treat patients with syphilis and Earl Osborne, a syphilologist, noted that their urinary bladders were visible on radiographs. Finally, in 1928 Moses Swick performed the first human intravenous urogram with a soluble iodinated pyridine compound solution (Uroselectan), which became the standard for the next two decades. CONCLUSIONS: Fluoroscopy has become indispensable to the field of urology, transforming from its early days marked by mysterious deaths and illnesses to a critical intraoperative tool. The field owes a debt of gratitude to these trailblazers for providing modern medicine with a reliable and efficient means to visualize the urinary system during surgery. Source of Funding: None © 2024 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 211Issue 5SMay 2024Page: e276 Advertisement Copyright & Permissions© 2024 by American Urological Association Education and Research, Inc.Metrics Author Information Katherina Y. Chen More articles by this author Kaitlin L. Berry More articles by this author Noah S. Schenkman More articles by this author Expand All Advertisement PDF downloadLoading ...