Pre-Use Ureteroscope Contamination after High Level Disinfection: Reprocessing Effectiveness and the Relation with Cumulative Ureteroscope Use

Legemate, Jaap D.; Kamphuis, Guido; Freund, Jan Erik; Baard, Joyce; Oussoren, Harry W.; Spijkerman, Ingrid J. B.; Rosette, Jean J.M.C.H. de la

doi:10.1097/ju.0000000000000108

Cited by 33 publications

(20 citation statements)

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“…In average, a digital ureteroscope is used 21 times before requiring repair, while the average fiberoptic ureteroscope is only used 6-15 times before going back to the manufacturer (26, 27). In a recent study by Legemate et al (28), reusable digital scopes had a slightly longer longevity (mean 27 cases; 20-56) compared to fiber optic flexible ureteroscopes (mean 24 cases;10-37). However, a wider look at all published literature reveal that new flexible scopes may last 5 to 159 cases (25-52).…”

Section: Resultsmentioning

confidence: 93%

A comprehensive literature-based equation to compare cost-effectiveness of a flexible ureteroscopy program with single-use versus reusable devices

et al. 2019

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Purpose: to critically review all literature concerning the cost-effectiveness of fl exible ureteroscopy comparing single-use with reusable scopes. Materials and Methods: A systematic online literature review was performed in PubMed, Embase and Google Scholar databases. All factors potentially affecting surgical costs or clinical outcomes were considered. Prospective assessments, case control and case series studies were included. Results: 741 studies were found. Of those, 18 were duplicated and 77 were not related to urology procedures. Of the remaining 646 studies, 59 were considered of relevance and selected for further analysis. Stone free and complication rates were similar between single-use and reusable scopes. Operative time was in average 20% shorter with digital scopes, single-use or not. Reusable digital scopes seem to last longer than optic ones, though scope longevity is very variable worldwide. New scopes usually last four times more than refurbished ones and single-use ureterorenoscopes have good resilience throughout long cases. Longer scope longevity is achieved with Cidex and if a dedicated nurse takes care of the sterilization process. The main surgical factors that negatively impact device longevity are lower pole pathologies, large stone burden and non-use of a ureteral access sheath. We have built a comprehensive fi nancial costeffective decision model to fl exible ureteroscope acquisition. Conclusions: The cost-effectiveness of a fl exible ureteroscopy program is dependent of several aspects. We have developed a equation to allow a literature-based and adaptable decision model to every interested stakeholder. Disposable devices are already a reality and will progressively become the standard as manufacturing price falls.

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Section: Resultsmentioning

confidence: 93%

A comprehensive literature-based equation to compare cost-effectiveness of a flexible ureteroscopy program with single-use versus reusable devices

et al. 2019

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“…According to the existing studies, most complications were grade I-III (98%) and the most common complication in grade II is urinary tract infection (31). Studies have shown that even when ru-fURS was cleaned manually and disinfected by hydrogen peroxide gas, contamination could still be found (7,8). This may lead to crossinfection between the patients (32).…”

Section: Discussionmentioning

confidence: 99%

“…However, the existing limitations on reusable flexible ureteroscope (ru-fURS) include a high initial purchase cost, high expenditures for repair, and a risk of cross-infection (6). Studies have shown that even when ru-fURS was cleaned manually and disinfected by hydrogen peroxide gas, contamination could still be found (7,8). For solving these problems with existing ru-fURS, a single-use flexible ureteroscope (su-fURS) has been proposed and has recently come to gain achievements (9,10).…”

Section: Introductionmentioning

confidence: 99%

Comparison Between Single-Use Flexible Ureteroscope and Reusable Flexible Ureteroscope for Upper Urinary Calculi: A Systematic Review and Meta-Analysis

Meng

Peng

et al. 2021

Front. Surg.

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Objective: This article explores the differences in the effectiveness and safety of the treatment of the upper urinary calculi between single-use flexible ureteroscope (su-fURS) and reusable flexible ureteroscope (ru-fURS).Methods: We systematically searched PubMed, Embase, Cochrane Library, Scopus database, and CNKI databases within a period from the date of database establishment to November 2020. Stata 16 was used for calculation and statistical analyses.Results: A total of 1,020 patients were included in the seven studies. The statistical differences were only found in the Clavien–Dindo grade II postoperative complication [odds ratio (OR) 0.47; 95% CI 0.23–0.98; p = 0.04]. No significant statistical differences were observed in operative time (OT), estimated blood loss (EBL), length of hospital stay (LOS), and stone-free rate (SFR).Conclusion: Our meta-analysis results demonstrate that su-fURS, compared with ru-fURS, has similar effectiveness and better security for treating upper urinary calculi.

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“…For the patients with high stone density and burden, we usually used high-energy and low-frequency to make the stone fragment first, then we used high-frequency and low-energy to make the fragmental stone dust. Many studies [13][14][15] have showed that for the less than 2cm renal stones, the post-operative stone-free rate of RIRS was higher and re-treatment rate was lower, and the complications were not increased significantly. For the patients with >2cm renal stone, the study [11] also have showed that FURSL can successfully treat patients with a high stone-free rate and a low complication rate, and with an average of 1.6 procedure per patient, which could be an alternative therapy to PCNL.…”

Section: Discussionmentioning

confidence: 99%

Outcomes of flexible ureteroscopy and laser lithotripsy (FURSL) for treatment of the upper urinary tract calculi: a single center experience

Tao¹,

Xu²,

Zang³

et al. 2021

Preprint

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purpose: To evaluate the efficacy and safety of flexible ureteroscopy and laser lithotripsy(FURSL) for treatment of the upper urinary tract calculi. Methods: We retrospectively analyzed 784 patients who underwent FURSL between January 2015 to October 2020 in our unit. The operative parameters, postoperative functional outcomes and complications were recorded respectively. Rusults: All patients underwent successful operation. The mean operative time was 46.9±15.8min. The average postoperative hospital stay was 1.2±1.1 days. The postoperative serum creatinine and hemoglobin were 76.2±10.2umol/L and 133.6±5.1g/L, which compared to preoperative, there were no sigificant statistical difference. Among 784 patients, 746 patients were followed up and 38 patients were lost. 700(93.8%) cases met the stone removal critetia and 46 cases(6.2%) did not meet the stone removal criteria for other treatments, such as extracorporeal shock wave lithotripsy, ureteroscopy and observed regularly. The stone free rate(SFR) is 92.5% after 1-3 months and SFR of middle and upper calyceal calculi was higher than that of lower calyceal calculi significantly. The most common complications were fever(58/784,7.4%),gross hematuria(540/784,68.88%) and lpsilateral low back pain(47/784,5.99). The incidence rate of serious complication was 1.28%(10/784), including 5 cases of septic shock and 5 cases of subcapsular hematoma, which were cured after active treatment. Conclusion: FURSL is a reliable treatment for small and medium calculi patients of upper urinary tract. The curative effect of stone removal is clear,the complications are few and the safety is high. However there are certain limitation to the efficacy in the treatment of large stone and lower calyceal calculi.

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Pre-Use Ureteroscope Contamination after High Level Disinfection: Reprocessing Effectiveness and the Relation with Cumulative Ureteroscope Use

Cited by 33 publications

References 0 publications

A comprehensive literature-based equation to compare cost-effectiveness of a flexible ureteroscopy program with single-use versus reusable devices

A comprehensive literature-based equation to compare cost-effectiveness of a flexible ureteroscopy program with single-use versus reusable devices

Comparison Between Single-Use Flexible Ureteroscope and Reusable Flexible Ureteroscope for Upper Urinary Calculi: A Systematic Review and Meta-Analysis

Outcomes of flexible ureteroscopy and laser lithotripsy (FURSL) for treatment of the upper urinary tract calculi: a single center experience

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