The following excerpt is adapted from the article by Prof. P.P. Figdor “Vienna’s significance in the history of urology”, which was printed in Europe - The Cradle of Urology. This EAU History Office publication was edited by Dr. J. Mattelaer and Prof. D. Schultheiss.

Even after the fall of the Holy Roman Empire of German Nation, known as Heiliges Römisches Reich Deutscher Nation, in 1806, the Imperial and Royal (K.u.K.) Habsburgian Austro-Hungarian Monarchy continued to rule over a territory of immense dimensions. Vienna as its capital was not only the eminent political, but also the scientific and the cultural centre. The question of when precisely Vienna received its high standing in urology is difficult to answer. Hence here is a brief overview of major contributions of Viennese urology to the fields of surgery and endoscopy.

Urological surgery
The academic reputation of Vienna as an influential urology centre arose from the in-depth knowledge and excellence of its surgery experts. This reputation rapidly evolved from the middle of the 19th century onwards. The international significance of Vienna in the scene of urological surgery and endoscopy is reflected in the large number of prominent personalities such as Alexander Brenner sen. (1859-1936), Leopold von Dittel (1815-1898), Josef Englisch (1835-1915), Anton Frisch (1849-1917), Josef Grünfeld (1840-1910), Viktor von Ivánchich (1812-1892), Moritz Schustler (1855-1920), Robert Ultzmann (1842-1889) and Otto Zuckerkandl (1861-1921) amongst many others.

The first milestone towards the improvement in treating urological diseases in the capital of the Austro-Hungarian Empire was the arrival of Francesco Pajola (Venice, 1741-1816) who was invited to work in Vienna in both 1804 and 1808.

Although officially invited by the court to visit a brother-in-law of count Ludwig von Cobenzl (1753-1809), Foreign Affairs minister, as well as Court- and State Vice-Chancellor of the K.u.K. Monarchy, Pajola, kindly responded to the request of Viennese physicians to introduce them to his method of lateral lithotomy.

At the time, lateral lithotomy was-a standard surgical intervention, not limited to urological procedures only. Accordingly, it is of no surprise that with the invention of lithotripsy (which probably represents the first specifically urological surgical procedure), a public academic protest against this novel method for removing bladder stones began. While this open and at times unreasonable debate on lithotripsy lasted for more than twenty years in Paris, neither in London nor Vienna did this academic dispute have any major significance.

It is a well-known historical fact that the head of surgical clinic at the University of Vienna, Vincenz Ritter von Kern (1760-1829), published two blunt pamphlets against lithotripsy in 1826 and 1828. In these he openly condemned the methods developed in Paris by Civiale and Leroy D’Etoilles. Yet, already Joseph Freiherr von Wattmann (1789-1866), former assistant of Kern and his successor, as well as Wattmann’s assistants Franz Schuh (1804-1865) and Johann Heinrich von Dumreicher (1815-1880) had great interest in lithotripsy. Wattmann performed his first lithotripsy in May 1827 and published a detailed account of early lithotripsy procedures in his 1835 edition entitled Über die Steinzerbohrung und ihr Verhältniß zum Blasenschnitte. Moreover, Dumreicher’s assistant Leopold von Dittel sen. (1815-1898), who was originally interested in orthopaedics, performed numerous lithotripsies in the 1950s. Following the example of his friend Sir Henry Thompson (1820-1904), Dittel published case reports on 800 lithotripsies.

The first lithotripsy in Vienna was successfully performed in January 1827 by the surgeon Ritter von und zu Eisenstein, who spent six months in Paris in 1825 and 1826. The patient, Mr. Gronauer, suffering from a bladder stone for thirty years, tolerated all 14 sessions of the lithotripsy (each lasting a quarter of an hour) from January to March 1827 - well and without any complications. In fact he was able to go to work the day after the procedures. All operations were performed at the patient’s apartment. Fourteen days after the treatment the complete absence of the bladder stone and its fragments has been confirmed via rectal and catheter examinations performed by several prominent experts, including a professor of the Josephian Academy Christoph Bonifaz Zang (1772-1835) who was also the physician-in-ordinary to Emperor Franz I.

More than 200 acknowledged Austrian and foreign physicians attended these lithotripsy sessions. The list of participants included among others the rector Ludwig Freiherr von Türckheim (1777-1846) and both deans of the University in Vienna, the surgeon of the General Hospital Franz Xaver Ritter von Rudtdorffer (1760-1833, who compiled a detailed description of Pajola’s lithotomy), Joseph Freiherr von Wattmann-Maellcamp-Beaulieu (1789-1866), professor of surgery at the same university, and Ferdinand Joseph von Zimmermann (1775-1845), professor and vice-chancellor of the Josephinian Academy.

Vienna’s contribution to endoscopy
In the 19th century, there were two periods that highlighted many outstanding contributions of Vienna in endoscopy. The first period refers to the early development of endoscopy (1805–1807) with Ilg’s pioneering instrument design (“Viennese model”, presented in January 1807), which resulted from a detailed investigation of Bozzini’s original light conductor – the Frankfurter Lichtleiter. The second phase, which dates back to the seventh and the eighth decade of the 19th century is defined by the construction of post-revolutionary direct endoscopes of Joseph Grünfeld (manufactured by H. Reiner) and the onset of indirect endoscopy following the invention of Nitze-Leiter instruments.