I remember well using the "work horse" of American urology—the Brown-Buerger cystoscope. In my early days, a good cystoscopy required the insertion of three different instruments, including one for retrograde examination. Although the images were good, the light bulbs tended to burn out without any warning signals. Hugh Judge Jewett of the Johns Hopkins Hospital frequently berated the operating room nurse because the bulb in his cystoscope burned out. A burned-out bulb at the tip of the instrument required withdrawing the instrument, unscrewing the tip of the instrument to remove and replace the bulb, screwing the tip back on, reinserting the cystoscope and proceeding with the examination. No wonder then that these examinations were done under general anesthesia.
Today it is hard to imagine that we once used large funnel-shaped glass beakers on unstable metal stands to irrigate for cystoscopies. When one of these tipped over, shattering glass and spreading water all over the floor of the operating room, it was an unwelcome and disruptive interruption of the procedure. Today, using plastic bags and fluids other than the water used into the mid 1900s are some of the