Single use and reusable flexible ureteroscopies for the treatment of urinary stones: A comparative study of perioperative complications

Baboudjian, Michael; Gondran-Tellier, Bastien; Abdallah, Rony; Tadrist, Abel; Akiki, Akram; Gaillet, S.; Delaporte, V.; Karsenty, G.; Lechevallier, É.; Boissier, R.

doi:10.1016/j.purol.2020.11.014

Cited by 8 publications

(7 citation statements)

References 18 publications

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“…A study published in 2017 by Ofstead et al, showed the presence of bacteria, hemoglobin and protein inside reusable ureteroscopes after manual cleaning and sterilization by hydrogen peroxide gas but there are no clinical data proving the influence of these findings in the occurrence of post-operative infections following ureteroscopy (22). Despite these data, single-use ureteroscopes did not decrease the occurrence of infectious complications after ureteroscopy according to a recently published study showing that the scope is probably not the main source of post--operative infections in ureteroscopy cases (23).…”

Section: Potential Advantages Of Single-use Ureteroscopesmentioning

confidence: 94%

Single-use flexible ureteroscopes: update and perspective in developing countries. A narrative review

et al. 2022

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Flexible ureteroscopy is a well-established method for treatment of urinary stones but fl exible ureteroscopes are expensive and fragile devices with a very limited lifetime. Since 2006 with the advent of digital fl exible ureteroscopes a great evolution has occurred. The fi rst single-use fl exible ureteroscope was launched in 2011 and new models are coming to the market. The aim of this article is to review the characteristics of these devices, compare their results with the reusable devices and evaluate the cost-benefi ts of adopting single-use fl exible ureteroscopes in developing countries. Materials and Methods: an extensive review of articles listed at PubMed and published between 2000 and 2021 was performed. Results: Single-use fl exible ureteroscopes have a shaft with 65 to 68cm length and weight between 119 and 277g. Their defl ection goes up to 300 degrees. Their stone-free rates vary between 60 and 95% which is comparable to reusable scopes and operative times ranges from 54 to 86 minutes which are lower when compared to reusable fl exible scopes. Their costs vary between 800 and 3180 US dollars. Conclusion: single-use fl exible ureteroscopes are lighter and have superior quality of image when compared to fi beroptic ones. There are no defi nite data showing a higher stone-free rate or less complications with the use of single-use fl exible ureteroscopes. Each institution must perform a cost-benefi t analysis before making the decision of adopting or not such devices depending on the local circumstances.

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Section: Potential Advantages Of Single-use Ureteroscopesmentioning

confidence: 94%

Single-use flexible ureteroscopes: update and perspective in developing countries. A narrative review

et al. 2022

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“…Operating time was analysed in 18 of the studies. The use of suFURS was associated with a shorter mean operating time in 10 of the 16 flexible ureteroscopy studies, [9,10,[12][13][14][15][16][17][18][19], although this difference only achieved statistical significance in four of these studies [16][17][18][19]. A shorter operating time was associated with use of rFURS in the six remaining studies [11,[20][21][22][23][24], although a statistically significant difference was reported in only two of these studies [20,24].…”

Section: Operating Timementioning

confidence: 99%

“…A total of 10 studies analysed the impact of endoscope type on LOS [9][10][11]13,[15][16][17][19][20][21]. A shorter LOS was reported in the suFURS group in five studies [9][10][11]19,21], and a significant difference was reported in two of these studies [9,21].…”

Section: Length Of Hospital Staymentioning

confidence: 99%

“…The overall complication rate was reported in 13 studies [9][10][11]13,[15][16][17]19,[21][22][23][24]26]. The reported overall complication rate was higher for patients undergoing procedures with single-use endoscopes in seven studies [11,13,16,[21][22][23][24], although none of these studies reported a statistically significant difference. A meta-analysis was performed on 12 of these studies (Fig.…”

Section: Complication Ratementioning

confidence: 99%

“…A total of seven studies reported on the rate of postoperative infections [9,13,17,[19][20][21]25]. None of these studies reported a statistically significant difference in postoperative infection rate between single-use and reusable endoscopes.…”

Section: Complication Ratementioning

confidence: 99%

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Perspectives on technology: to use or to reuse, that is the endoscopic question—a systematic review of single‐use endoscopes

Anderson,

Patterson,

Skolarikos

et al. 2023

BJU International

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IntroductionThere is a growing interest in single‐use endoscopes within urology, with multiple new devices now available. Although these devices have been evaluated to show efficacy on benchtop‐models, there is a paucity of data comparing clinical outcomes. The aim of this meta‐analysis was to compare clinical outcomes of single‐use endoscopes to reusable endoscopes to better define their role within urology.MethodsA systematic search of electronic databases was performed. All studies comparing clinical outcomes of participants undergoing urological procedures with single‐use endoscopes to those treated with reusable endoscopes were included. Results are reported in accordance with the PRISMA 2020 statement.ResultsTwenty‐one studies on 3943 participants were identified. Six different single‐use flexible ureteroscopes and two different single‐use flexible cystoscopes were assessed. There were no differences in mean post‐operative infection rates (4.0% vs 4.4%, p=0.87) or overall complication rates (11.5% vs 11.9%, p=0.88) between single‐use and reusable endoscopes. For patients undergoing flexible ureteroscopy there were no differences in operative time (mean difference ‐0.05 minutes, p=0.96), hospital length of stay (mean difference 0.06 days, p=0.18), or stone‐free rates (74% vs 74.3%, p=0.54) between the single‐use and reusable flexible ureteroscope groups.ConclusionThis study is the largest to compare clinical outcomes of single‐use endoscopes to reusable endoscopes within urology, and has demonstrated no difference in LOS, complication rates and SFR, with a reduced OT associated with single‐use FC. It also highlights that the cost‐efficiency and environmental impact of single‐use endoscopes is largely dependent on the caseload and reprocessing facilities available within a given institution. Urologists can therefore feel confident that whether they choose to “use, or to reuse” for the financial and environmental implications, they can do so without negatively impacting patient outcomes.

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Single-Use Ureteroscopy and Environmental Footprint: Review of Current Evidence

et al. 2023

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Single use and reusable flexible ureteroscopies for the treatment of urinary stones: A comparative study of perioperative complications

Cited by 8 publications

References 18 publications

Single-use flexible ureteroscopes: update and perspective in developing countries. A narrative review

Single-use flexible ureteroscopes: update and perspective in developing countries. A narrative review

Perspectives on technology: to use or to reuse, that is the endoscopic question—a systematic review of single‐use endoscopes

Single-Use Ureteroscopy and Environmental Footprint: Review of Current Evidence

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