150 patients were prospectively accrued from January 2016 to November of 2017. Each patient underwent ureteroscopy with either of the aforementioned scopes. After the procedure each surgeon was asked to rate visibility and maneuverability on a 5-point Likert scale (1- Bad, 5- very good). The study team analyzed the comparative data using a fisher’s exact test. All demographic and continuous variables were analyzed using a non-parametric Kruskal-Wallis test or a Mann-Whitney U test.
The LithoVue scope was used in 55 cases, Pusen scope in 33, and the Olympus reusable scope in 64 cases. Analysis found no differences in patient demographics nor in operating time, radiation dose, and rate of residual stone fragments post-op. 14 ureteroscopes failed during the study period due to mechanical issues. Failure rate was not found to be different across the 3 scopes. There were, however, differences between scopes in regards to maneuverability and visualization. The LithoVue scored higher in both visibility and maneuverability in comparison to the Pusen scope (p-value< 0.01, p-value< 0.05) and was found to be equivalent to the Olympus reusable scope in terms of maneuverability.
To conclude, the study team determined that current single-use scopes’ performance are approaching the high-end reusable scopes. They also note that as the cost of single-use scopes continues to decline, while their performance increases, they provide a feasible replacement to reusable scopes during ureteroscopy. This is especially useful in complex stone cases where scope damage is highly likely.
Presented by: Jonathan Kam, MD
Written by: Anthony Warner, Department of Urology, University of California-Irvine at the 2018 AUA Annual Meeting - May 18 - 21, 2018 – San Francisco, CA USA