Single use versus reusable digital flexible ureteroscopes: A prospective comparative study

Abstract

Objectives To compare the performance and surgical outcomes of two different single‐use digital flexible ureteroscopes with a reusable video flexible ureteroscope. Methods Patients undergoing retrograde flexible ureteroscopy at Nepean Hospital, Sydney, Australia, were included in this study. Three different flexible ureteroscopes were used in this study: (i) single‐use digital LithoVue (Boston Scientific, Marlborough, MA, USA); (ii) single‐use digital PU3022A (Pusen, Zhuhai, China); and (iii) reusable digital URF‐V2 (Olympus, Tokyo, Japan). Visibility and maneuverability was rated on a 5‐point Likert scale by the operating surgeon. Operative outcomes and complications were collected and analyzed. Results A total of 150 patients were included in the present study. Of these, 141 patients had ureteroscopy for stone treatment, four for endoscopic combined intrarenal surgery and five for diagnostic/tumor treatment. There were 55 patients in the LithoVue group, 31 in the PU3022A group and 64 patients in the Olympus URF‐V2 group. The URF‐V2 group had higher visibility scores than both the single‐use scopes and higher maneuverability scores when compared with the PU3022A. The LithoVue had higher visibility and maneuverability scores when compared with the PU3022A. There were no differences in operative time, rates of relook flexible ureteroscopes, scope failure or complication rates observed. Conclusions Single‐use digital flexible ureteroscopes have visibility and maneuverability profiles approaching that of a reusable digital flexible ureteroscope. Single‐use flexible ureteroscopes achieve similar clinical outcomes to the more expensive reusable versions.

Comparison of single-use and reusable flexible ureteroscope for renal stone management: a pooled analysis of 772 patients

“…The case-control study performed by Usawachintachit et al found that the overall mean procedure time of single-use FURS was 10 min shorter than that of reusable FURS (19). Conversely, Kam et al found that single-use FURS was 10 min longer than that of the reusable FURS group (14). However, JK thought that the lower image quality associated with single-use FURS was responsible for this difference, although the operative duration is closely linked with the experience of the surgeon (14).…”

“…Four included studies provided enough data available on operative time (14,(18)(19)(20). In Kam's study, two different models of single-use FURS were compared with the same traditional FURS.…”

“…Four included studies with 842 participants had enough data relevant to perioperative complications (14,(18)(19)(20), and ORs were used for statistical analysis. Due to the detection of high statistical heterogeneity (I 2 =56%), a randomeffect model was used.…”

“…Previous studies have indicated that reusable FURS rated highly in terms of manoeuvrability and image quality (14,15). Clinical studies have indicated that single-use digital FURS performed comparably to current reusable FURS in terms of the SFR, operative time and complication rate (16).…”

Editorial Comment to Single use versus reusable digital flexible ureteroscopes: A prospective comparative study

“…In this study, Kam et al . prospectively assessed both single‐use and reusable flexible ureteroscopes . Specifically, the single‐use LithoVue (Boston Scientific, Marlborough, MA, USA) and PU3022A (Pusen, Zhuhai, China) were compared with the reusable digital URF‐V2 (Olympus, Tokyo, Japan), utilizing a 5‐point Likert scale to subjectively assess visibility and maneuverability.…”