Single use flexible ureteroscopes: Current status and future directions

Abstract

IntroductionSingle use ureteroscopes are a technological innovation that have become available in the past decade and gained increased popularity. To this end, there are now an increasing number of both benchside and clinical studies reporting outcomes associated with their use. Our aim was to deliver a narrative review in order to provide an overview of this new technology.MethodsA narrative review was performed to gain overview of the history of the technology's development, equipment specifications and to highlight potential advantages and disadvantages.ResultsFindings from preclinical studies highlight potenial advantages in terms of the design of single use ureteroscopes such as the lower weight and more recent modifications such as pressure control. However, concerns regarding plastic waste and environmental impact still remain unanswered. Clinical studies reveal them to have a non inferior status for outcomes such as stone free rate. However, the volume of evidence, especially in terms of randomised trials remains limited. From a cost perspective, study conclusions are still conflicting and centres are recommended to perform their own micro cost analyses.ConclusionsMost clinical outcomes for single use ureteroscopes currently match those achieved by reusable ureteroscopes but the data pool is still limited. Areas of continued debate include their environmental impact and cost efficiency.

Controversies in ureteroscopy: lasers, scopes, ureteral access sheaths, practice patterns and beyond

“…Approximately 30 models are now available from different companies. Reducing the infection and contamination risk, potential cost benefit and preservation of reusable (RU) ureteroscope represent the main arguments for their adoption ( 11 ). Newer generation models are now available, and a recent meta-analysis of clinical studies reveal a non-inferior status regarding outcomes such as stone free rate (SFR) and complication burden when compared to RU scopes ( 12 ).…”

Single use flexible ureteroscopes: a review of current technologies and cost effectiveness analysis

“…Innovations such as the introduction of a working channel, better light transmission, and the enhancement of tip deflection have allowed for a riskfree inspection of the entire renal pelvicalyceal system. In addition, the emergence of disposable instruments, the first of which was Lithovue manufactured by Boston Scientific (2015), aided in the spread of fURS [4]. Despite the advantages of reusable fURS, the repair cost, deterioration of technical characteristics over time, and the potential risk of bacterial contamination even after complete sterilization are additional arguments in favor of disposable alternatives [5].…”