Tuesday, April 15, 2014

Historical Contribution: 1918, HH Young, High Frequency Current for Extraction of Calculi

Hugh Hampton Young
1918

Young HH.  The Employment of the High Frequency Current for the Extraction of Calculi Incarcerated in the Lower End of the Ureter.  Journal of Urology. 1918;2:35-38

At the turn of the century, the management options for ureteral stones were limited and most were treated with open surgery.  In this 1918 manuscript, HH Young describes an "exhaustive study," in which one distal stone was able to be freed from the distal ureter by manipulating it with a ureteral catheter, but most stones were removed by suprpubic cystotomy with use of "dilating instruments, forceps or scissors."

Known for his innovation, HH Young developed an instrument and "[t]he technique which is presented herewith consists in the employment of high frequency spark to incise the mucous membrane covering the incarcerated calculus, thus enlarging the ureteral orifice to a degree sufficient to permit its passage into the bladder."
Using a device similar to our modern day bugbee electrocautery, HH Young incised the distal ureter in three patients, described their clinical presentation, treatment and outcomes.  He describes one of the first endoscopic operations on the upper tract that involved more than a catheter, wire or simple dilation.  This opened the possibilities of the wide variety of endoscopic operations urologists perform on a daily basis.  In HH Young's words, "this operation is simple, can be carried out without anesthetia, and does not produce more than a slight hemorrhage."

Read the entire manuscript using the link above or here.

HISTORICAL CONTRIBUTIONS highlight the greatest academic manuscripts from the Brady Urological Institute over the past 100 years.  As the Brady Urological Institute approaches its centennial, we will present a HISTORICAL CONTRIBUTION from each of the past 100 years.  In the most recent experience, the most highly cited article from each year is selected; older manuscripts were selected based on their perceived impact on the field.  We hope you enjoy! 

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