Air cystoscopy: the history of an endoscopic technique from the late 19th century

Suspected venous air embolism during urinary tract endoscopy in a standing horse

“…The air and even carbon dioxide proved in human medicine to be an unphysiological medium for distending the bladder and it irritates the mucosa and could be painful for the patient (Schultheiss et al . ). However, in the experience of the authors, the fluid pressure is often insufficient to distend a pathologic bladder in horse.…”

“…In recent years VAE has not been reported as a result of urinary tract endoscopy in human medicine because the use of fluids for irrigation in modern endoscopy has become standard practice (Nicholson ; Schultheiss et al . ).…”

“…In recent years, diagnostic procedures for the urinary tract have also been performed with contrast‐enhanced CT which is considered to be the primary imaging technique for avoiding the risk of VAE (Schultheiss et al . ).…”

Air insufflation as an adjunct to flexible cystoscopy

“…Some of the earliest exponents of cystoscopy used air as the medium for bladder filling, e.g. in the descriptions of air cystoscopy by Pawlik in Prague and Kelly in America, around 1890 [3]. Fernand Cathelin of the Hôpital Necker in Paris presented a cystoscope à air in 1905, including the use of a syringe to inject air into the bladder [3].…”

“…There is a theoretical risk of air embolism, which has been reported, albeit rarely, in association with several endoscopic procedures, e.g. transvesical and transurethral prostatectomy, percutaneous nephrolithotomy and retrograde pyelography [3]. Air was used in the past for cystometry [8], but was abandoned in favour of CO 2 in response to a single report of air embolism [9].…”