In 2017 such a crisis occurred in our hospital, leading to disruption of our busy cystoscopy tumor surveillance service. At the same time, we introduced the grasper incorporating a disposable cystoscope in our service and was readily available over the shelf for J stent removal. We used these scopes off label to detect bladder tumors. As the grasper incorporated scope has its limitations and was not designed with the aim of diagnosis, skepticism rose whether it is comparable to the standard reusable scope in detecting bladder tumors. The forceps at the tip of the scope significantly limits its ability to bend in a retrograde fashion. Other caveats included a lack of a working channel for biopsy or fulguration. Despite these disadvantages, the mere presence of an off-shelf cystoscope provided an immediate solution to our cystoscopy cumulative waiting lists.
We exclusively used the disposable scope since Oct 2017. We studied the bladder cancer detection rate for each cystoscopy session and compared it with historical reusable cystoscopy sessions. A total of 390 patients underwent 1211 cystoscopies. Indication for cystoscopy was prior malignancy (97.7%), haematuria (1.6%) or bladder mass (0.6%). There were 608 reusable and 603 disposable cystoscopies. There was no significant difference in positive findings (20.2% vs 18.4%, p=0.425) or cancer detection rates (15.6% vs 14.4%, p 0.574) among the two groups, respectively. We conclude that the disposable grasper integrated cystoscope is comparable to a reusable cystoscope in detecting bladder cancer. The development of a dedicated diagnostic disposable cystoscope has several advantages but has not materialized in everyday use. Until then, the grasper disposable scope may fill the gap as an alternative to the conventional reusable cystoscope.
Written by: Raouf M Seyam, Omar M Zeitouni, Tarek M Alsibai, Abdulrahman J AlAyoub, Osamah M Al-Qassab, Mhd A AlDeiry, Ahmad O Zino, Hasan S Hulwi, Alaa A Mokhtar, Mahmoud Shahbaz, Noor N Junejo, Mohamed F Alotaibi, Hassan M Alzahrani, Khaled I Alothman, Sultan S Alkhateeb, Turki O Al-Hussain, Waleed M Altaweel
Department of Urology, King Faisal Specialist Hospital and Research Centre, Riyadh, Saudi Arabia. ., College of Medicine, Alfaisal University, Riyadh, Saudi Arabia., Department of Urology, King Faisal Specialist Hospital and Research Centre, Riyadh, Saudi Arabia., Department of Pathology, King Faisal Specialist Hospital and Research Centre, Riyadh, Saudi Arabia.
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