A visit to the De Leval collection of urological instruments

Prof. De Leval recently invited Prof. Philip Van Kerrebroeck, Chair of the EAU History Office and Mr. Loek Keizer, historian and editor at the EAU Central Office, to view his fascinating collection. Earlier this year, at the EAU24 Historical Exhibitionin Paris, Prof. De Leval had loaned us his beautiful reproduction model of an 1852 Desormeaux endoscope (a very early gazogène-lit cystoscope) to be displayed. 

Also, during the visit, Prof. De Leval kindly donated a specimen of surgically prepared veal tendon (these were previously used as slings in continence surgery) to the EAU to be displayed in the EAU's Museum for the History of Urology at the EAU headquarters in Arnhem. More on that below.

In this article, we will show some of the most interesting instruments of the “De Leval Collection”.

These are Grünfeld tubes, invented by Joseph Grünfeld (1840-1910), a dermatologist and venereologist in Vienna. These are very early urethoscopes; the picture also shows the light source and head-reflector for directing that light down the urethra. The image below, from the EAU's online European Museum of Urology shows Grünfeld using his tubes on a male (!) patient.

The slots seen in the side of the tubes in this second image allowed instruments to be passed into the urethra such as swabs to clear away pus or blood, small blades to cut through stricture or probes to apply caustics.

This is a Fraisse Urethroscope, a more advanced instrument than Grünfeld’s simple tubes. It is lit by a tiny electric light bult at the end. The scope is seen in this manual of urethroscopy from 1920, which is also in the De Leval collection.

The Punch Prostatectomy was an alternative to, and slightly preceded, TURP and was introduced in the early 20th century. Below you can see a prostatic punch. The most common model seen is usually the Gersholm Thompson punch, this is a Braasch-Bumpus punch.

The instrument is in its original box still includes the descriptive leaflet. This explains that the punch is a modification by Hermon Bumpus (1888 – 1977) of the original, designed by William Braasch (1878 – 1975). They were both professors of urology at the Mayo Clinic. The Bumpus scope, like the Braasch cystoscope on which it is based, has direct visualisation, that is, there is no complex lens system, it’s a little looking down a rigid sigmoidoscope!

This unusual looking instrument allows the controlled injection of contrast down the urethra to carry out a urethrogram. It clamps to the penis which the nozzle in the meatus. Like many of the instruments in the history of urology, a rather uncomfortable looking device!

This is not a James Bond gun from a 1970’s film! It is a resectoscope for TURP. It is a Scott Rotating Resectoscope and it has a pistol grip to assist comfort and accuracy.

This instrument set in its original leather case was made by the famous French instrument makers, Charrière. It is a 19th-century lithotrity set. Lithotrity, like modern cystolitholapaxy is the transurethral crushing and removal of bladder stones. It was pioneering minimally invasive surgery and began in earnest in France in the 1820’s. This set contains lithotrites worked by a rack and pinion (the ebony handles to turn the wheels can be seen) and a percussion type (to be hit by the hammer). There is a metal catheter to empty, wash out and refill the bladder and a three branched extractor to remove urethral stone fragments. 

Urethral stricture was a common problem encountered by urologists in the past, more so than now due to untreatable gonorrhoea in the pre-antibiotic age. Multiple dilators and urethrotomes appeared over the years with surgeons constantly modifying and adapting older instruments. This particular example was designed by Ernest Desnos (1852 – 1925) of the Necker hospital in Paris. Desnos also wrote one of the earliest histories of urology, hence the EAU History Office grants the annual Ernest Desnos Prize for extraordinary contributions to the history of urology. 

The EAU History Office is very grateful to profesor de Leval for donating this sterilised medical veal tendon to the museum. It represents one stage in the history of continence surgery and was used as a sling. This example of an alloplastic sling was still in its sealed transportation box and is perfectly preserved in its glass tube. It is an excellent addition to the museum and tells part of the story of ‘sling’ continence surgery, the history of which has of course been quite controversial.