To understand the current practice of flexible ureteroscopy (fURS), we conducted a worldwide survey among urologists with a special interest in endourology.
A 42-question survey was designed after an initial consultation with European Association of Urology young academic urologists (YAU) and uro-technology (ESUT) groups. This was distributed via the SurveyMonkey® platform and an ESUT meeting to cover practice patterns and techniques in regard to ureteroscopy usage worldwide.
A total of 114 completed responses were obtained. A safety guidewire was reportedly used by 84.5% of endourologists, an access sheath was always or almost always used by 71% and a reusable laser fibre was used by two-thirds of respondents. While a combination of dusting and fragmentation was used by 47% as a preferred mode of intra-renal stone treatment, some used dusting (43%) or fragmentation with basketing (10%).Disposable scopes were only used by 40% and three quarters of them used it for challenging cases only. Antibiotic prophylaxis was limited to a single peri-operative dose by two-thirds (67%) of respondents. The procedural time was limited to between 1-2 hours by two-thirds (70%) of respondents and very rarely (7.4%) it exceeded 2 hours. The irrigation method varied between manual pump (46%), mechanical irrigation (22%) or gravity irrigation (27%).
Our survey shows a wide variation in the available endourological armamentarium and surgical practice amongst urologists. However, there seems to be a broad agreement in the use of peri-operative antibiotics, access sheath usage, method of stone treatment and the use of post-operative stent.
Central European journal of urology. 2019 Oct 14 [Epub]
Amelia Pietropaolo, Ewa Bres-Niewada, Andreas Skolarikos, Evangelos Liatsikos, Panagiotis Kallidonis, Omar Aboumarzouk, Thomas Tailly, Silvia Proietti, Oliver Traxer, Guido Giusti, Nick Rukin, Mehmet Özsoy, Michele Talso, Sener Tarik Emre, Esteban Emiliani, Gokhan Atis, Bhaskar K Somani
University Hospital Southampton NHS Foundation Trust, Department of Urology, Southampton, United Kingdom., Roefler Memorial Hospital, Department of Urology, Pruszków, Poland., University of Athens, 2 Department of Urology, Athens, Greece., University of Patras, Department of Urology, Patras, Greece., NHS Greater Glasgow and Clyde, Department of Urology, Glasgow, United Kingdom., Universitair Ziekenhuis Gent, Department of Urology, Gent, Belgium., IRCCS San Raffaele Scientific Institute, Ville Turro Division, Department of Urology, Milan, Italy., Tenon Hospital, Assitance Publique-Hopitaux De Paris, Pierre et Marie Curie University, Department of Urology, Paris, France., Metro North Hospitals and Health Service, Brisbane, Australia., Medical University of Vienna, Vienna General Hospital, Department of Urology, Vienna, Austria., ASST Vimercate Hospital, Department of Urology, Vimercate, Monza Brianza, Italy., Marmara University, Department of Urology, Istanbul, Turkey., Fundació Puigvert, Urolithiasis Division, Barcelona, Spain., Istanbul Medeniyet University, Department of Urology, Istanbul, Turkey.