Single-use Flexible Ureteropyeloscopy - A Systematic Review: Beyond the Abstract

The rationale behind disposable flexible ureteroscopes (FURS) is to counterbalance significant costs that are associated with repair and sterilisation of conventional FURS with a reliable, cost-effective, user-friendly, single-use alternative. Recently, innovative technical progression in endourology is reflected by the variety of single-use FURS that are commercially available worldwide. Despite the progression of single use FURS into urological clinical practice, robust comparative data assessing technological design and clinical efficacy are lacking. The aim of our systematic review was to comparatively evaluate the mechanical, optical and clinical outcomes of single use FURS with conventional reusable FURS for the treatment of stone disease.

Our main findings were that in vitro, porcine and/or cadaveric data were available on LithoVue™, Polyscope™ and SemiFlex™ single use FURS. Clinical data on patients undergoing treatment for stone disease was available with LithoVue™ and Polyscope™ single-use FURS. When the clinical efficacy of both scopes was analysed, the single use devices performed well when complication rates and stone free rates were compared with conventional reusable FURS. Our findings suggest that new single-use FURS are non-inferior to reusable FURS in terms of clinical outcomes or complication rates.

We believe that selective usage of single-use FURS in low-volume endourological centres may limit the costs associated with repairing reusable FURS. Further detailed evaluation of clinical outcomes and cost-benefit analyses in the form of randomised controlled trials will determine whether single-use FURS can reliably compete with reusable FURS in high-volume stone centres.

Written by: Niall Davis, PhD and Damien Bolton, Professor and Head of Department of Urology at Austin Hospital, Melbourne, Australia
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