The first to examine the ureter through an internal approach, called ureteroscopy, rather than surgery was Hampton Young in 1929. This was improved on by VF Marshall who is the first published use of a flexible endoscope based on fiber optics, which occurred in 1964. The insertion of a drainage tube into the renal pelvis, bypassing the uterers and urinary tract, called nephrostomy, was first described in 1941. Such an approach differed greatly from the open surgical approaches within the urinary system employed during the preceding two millennia.