Improving Prostate Treatment with Innovation

One of the turning points in the treatment of benign prostate hyperplasia was the invention of the irrigating cystoscope, and the many improvements made to it by Dr. Hampton Young, of Johns Hopkins University Hospital.

Following the development of the irrigated cystoscope and other critical tools, physicians continued to experiment with all sorts of other methods for treating an enlarged prostate. This included high-frequency currents to treat bladder tumors.

In roughly 1926, a physician by the name of Maximilian Stern introduced another innovative instrument to be used in prostatic procedures called the resectoscope.

A resectoscope is a tool that is inserted through the cystoscope sheath and has a tungsten wire loop on one end. Under direct vision by way of the cystoscope, Dr. Stern was able to cut slivers of prostate tissue with the loop, through which flowed an electrical cutting current.

Unlike cautery heat, these high-frequency currents did not penetrate and damage the surrounding tissue nearly as much. As a result, patients reported having fewer side effects and a lower risk of complications such as hemorrhage.

Though the electric current cut well, some physicians took issue with it not coagulating deep enough. Thus making it, in some cases, just as effective as using a knife.

This led to the invention of a modified resectoscope by a South Carolina urologist, with a background in electrical engineering, named Theodore Davis.

Not only did Davis use a larger instrument with a larger viewing window and a wider loop, but he also is credited with incorporating a current that cuts and coagulates. Davis even went so far as to invent a foot pedal, which allowed him to switch between the two during surgery.

Around the same time that Davis was improving the resectoscope, another doctor by the name of Joseph McCarthy was busy making further improvements.

Dr. McCarthy was able to successfully combine the improved resectoscope with the phonendoscope, which had a greatly improved viewing system.

By combining these two advancements, McCarthey created what would become known as the Stern-McCarthy resectoscope.

In our next article, we will take a look at the Stern-McCarthy resectoscope and its use in the treatment of an enlarged prostate, and also begin to look at the dominant treatment methods that emerged, some of which are still performed today.