The Miller Integrated Cystoscope is the first small-diameter (17 Ch), rigid, multipurpose, operating cystoscope (biopsy, urethrotomy, ureteric catheterization, cutting, retrieval of stones and foreign bodies, and injection) designed with patient comfort in mind. Despite a small outside diameter, the 8.7-Ch instrument channel conducts a 7.5-Ch accessory including the unique rigid Endoknife, which converts it into an optical urethrotome and rigid Endoneedle which can deliver local anesthetic and other pharmacologic agents into the bladder, prostate, and urethra of both male and female patients. The simplicity of design has dispensed with the need for more costly and conventional instrumentation (e.g., optical urethrotome, Albarron lever) at a fraction of the cost. The urologist can not only inspect the lower urinary tract (Cf fiberscopes) but also perform endoscopic procedures short of a full transurethral prostatectomy with maximum patient comfort.