Comparison of a single-use, digital flexible ureteroscope with a reusable, fiberoptic ureteroscope for management of patients with urolithiasis

• Main Authors: Panagiotis Mourmouris, Lazaros Tzelves, Grigorios Raptidis, Marinos Berdempes, Titos Markopoulos, Grigorios Dellis, Ioannis Siafakas, Andreas Skolarikos
• Format: Article
• Language: English
• Published: PAGEPress Publications 2021-10-01
• Series: Archivio Italiano di Urologia e Andrologia
• Subjects: Urolithiasis; Flexible ureteroscope; Kidney stone disease; Digital ureteroscope; Single-use ureteroscope; Fiber-optic ureteroscope
• Online Access: https://www.pagepressjournals.org/index.php/aiua/article/view/9966
• ISSN: 1124-3562; 2282-4197

Objectives: Ureteroscopy is one of the commonest procedures performed to manage urolithiasis. Flexible ureteroscopy has been traditionally based on reusable, fiber-optic ureteroscopes. Technology advancements permitted the development of single-use scopes with digital image. The aim of this study is to compare efficacy and safety between a reusable, fiberoptic ureteroscope with a single-use, digital scope. Patients and methods: We collected data based on chart review from a prospectively collected database on a tertiary, high-volume hospital in Greece. Baseline, perioperative and postoperative data were gathered and analyzed. Chi-square and Fisher's exact test was used to compare qualitative data and unpaired t-test for continuous data, with a statistical significance set at a = 0.05. Results: 40 patients underwent flexible ureteroscopy with a single- use digital scope, while 37 with the reusable scope. The two groups were matched regarding baseline characteristics and stone-related parameters. After data analysis, a shorter operative time in favor of single-use flexible ureteroscope was detected (45 vs 65 min, p = 0.001), while safety was also in favor of this type of scope with a significantly higher immediate stonefree rate (70% vs 43%, p = 0.005). Overall complications did not differ between the two groups, although a lower sepsis rate was detected in patients treated with single-use scope. Conclusions: Our findings indicate that single-use, digital ureteroscopes are a viable alternative for flexible ureteroscopy and management of urolithiasis, especially in centers with deficient facilities for sterilization and ensured funds for more expensive reusable scopes.