ABSTRACT
The innovations of a rod-lens optical system by Harold H. Hopkins in 1959 and fiberoptic light transmission by Karl Storz in 1960 brought about a revolution in urological endoscopy. In the last four decades the number of possible endo-urological interventions has increased and this has dramatically reduced the need for open surgery. Advances in the management of children have lagged behind those in adult practice, principally due to the size of the pediatric urethra. In an infant boy the caliber of the urethral meatus is approximately 8 Fr, the proximal urethra and bladder neck are often difficult to negotiate and, unless care is taken, trauma is a likely consequence of rigid instrumentation. In girls there are fewer restrictions, as the urethra is shorter, more compliant and straight. Technological progress has brought ever-smaller endoscopes with better illumination and camera technology that can produce clear images from within the smallest infant and even fetal urinary tracts. Optimization of instrument channel size, miniaturization of instruments to use down it and the development of new modalities of power application (laser, electrohydraulic lithotripsy and ultrasound) as well as diathermy allow therapeutic interventions to be carried out.
