In 1805, a German army surgeon named cystourethroscope with an electric light source.
2.
Before or after insertion of the cystourethroscope, prime the disposable injection needle until the bulking material is seen at the needle tip.
3.
The cystourethroscope with a 0-to 30-degree lens is inserted to the urethrovesical junction and then withdrawn to observe the proximal urethra.
4.
The transurethral method uses a cystourethroscope with a 0-to 30-degree lens with the appropriate sheath ( 17-to 21-French with no fenestration ).
5.
The injection should gradually cause distention of the urethral mucosa, and this is observed by appropriate angling of the cystourethroscope lens during the injection ( Fig . 22.3 ).
6.
Once a proper injection site is located, angle the cystourethroscope so that the injection needle enters the urethra at a 30-to 45-degree angle, and insert the needle until the bevel cannot be seen.
7.
The cystourethroscope is used to observe the advancing needle, and the syringe is moved in short strokes to allow the needle tip to be seen under the tissue at the proximal urethra until the desired location is found.
8.
Being a gel, it can be injected through the operative channel of a regular cystourethroscope using a special 23-gauge needle or the Bulkamid ?Urethral Bulking System a specially designed lightweight urethroscopic instrument that facilitates injection ( Fig . 22.2 ).
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