To assess whether the introduction of single use flexibles ureteroscopes (su-fURS) at our high-volume centre had an advantageous impact on the turn-over and breakage rates of reusable fURS (re-fURS).
We analysed re-fURS number of usages and breakages at our centre between February 2015 and December 2018. We recorded the number of usages for analysed scope between the first usage until a breakage requiring reconditioning. Usage count was restarted following each reconditioning episode. Since su-fURS (Lithovue, Boston Scientific, USA) were introduced at our center in September 2016, we had the chance to compare different re-fURS life cycles according to both su-fURS availability and usage intensity (i.e., number of su-fURS used during each re-fURS life cycle). We then explored the relationship between su-fURS usage intensity and reusable scope survival (i.e., number of utilizations before any breakage requiring reconditioning) using locally weighted scatterplot smoothing (LOWESS) approach.
Five different re-fURSs were employed at our centre, for a total of 1820 usages and 40 breakages requiring reconditioning. The overall mean (SD) number of usages before breaking was 40 (22). After su-fURS introduction, mean (SD) re-fURS number of usages increased from 35 (22) to 49 (20), (+ 40%, p = 0.02). The relationship between su-fURS usage intensity and reusable scopes survival showed a linear survival increase after 10 or more su-fURS scopes were used per life cycle.
The life cycle of re-fURS increased by 40% after the introduction of su-fURS. Ten or more used su-fURS per life cycle were associated with increased re-fURS survival.
This is a preview of subscription content, access via your institution.
Buy single article
Instant access to the full article PDF.
Tax calculation will be finalised during checkout.
Ziemba JB, Matlaga BR (2017) Epidemiology and economics of nephrolithiasis. Investig Clin Urol 58:299–306. https://doi.org/10.4111/icu.2017.58.5.299
Türk C, Vice-chair AS, Neisius A, Petrik A, Seitz C, Thomas K et al (2019) EAU guidelines on urolithiasis. EAU, Arnhem
Semins MJ, George S, Allaf ME, Matlaga BR (2009) Ureteroscope cleaning and sterilization by the urology operating room team: the effect on repair costs. J Endourol 23:903–905. https://doi.org/10.1089/end.2008.0489
Butticè S, Sener TE, Netsch C, Emiliani E, Pappalardo R, Magno C (2016) LithoVueTM: a new single-use digital flexible ureteroscope. Cent Eur J Urol 69:302–305. https://doi.org/10.5173/ceju.2016.872
Doizi S, Kamphuis G, Giusti G, Andreassen KH, Knoll T, Osther PJ et al (2017) First clinical evaluation of a new single-use flexible ureteroscope (LithoVue): a European prospective multicentric feasibility study. World J Urol 35:809–818. https://doi.org/10.1007/s00345-016-1936-x
Ventimiglia E, Somani BK, Traxer O (2019) Flexible ureteroscopy: reuse? Or is single use the new direction? Curr Opin Urol. https://doi.org/10.1097/MOU.0000000000000700
Davis NF, Quinlan MR, Browne C, Bhatt NR, Manecksha RP, D’Arcy FT et al (2018) Single-use flexible ureteropyeloscopy: a systematic review. World J Urol 36:529–536. https://doi.org/10.1007/s00345-017-2131-4
Proietti S, Dragos L, Molina W, Doizi S, Giusti G, Traxer O (2016) Comparison of new single-use digital flexible ureteroscope versus nondisposable fiber optic and digital ureteroscope in a cadaveric model. J Endourol 30:655–659. https://doi.org/10.1089/end.2016.0051
Johnston TJ, Baard J, de la Rosette J, Doizi S, Giusti G, Knoll T et al (2018) A clinical evaluation of the new digital single-use flexible ureteroscope (UscopePU3022): an international prospective multicentered study. Cent Eur J Urol 71:453–461. https://doi.org/10.5173/ceju.2018.1787
Dale J, Kaplan AG, Radvak D, Shin R, Ackerman A, Chen T et al (2017) Evaluation of a novel single-use flexible ureteroscope. J Endourol. https://doi.org/10.1089/end.2016.0237
Talso M, Proietti S, Emiliani E, Gallioli A, Dragos L, Orosa A et al (2018) Comparison of flexible ureterorenoscope quality of vision: an in vitro study. J Endourol 32:523–528. https://doi.org/10.1089/end.2017.0838
Talso M, Goumas IK, Kamphuis GM, Dragos L, Tefik T, Traxer O et al (2019) Reusable flexible ureterorenoscopes are more cost-effective than single-use scopes: results of a systematic review from PETRA Uro-group. Transl Androl Urol 8:S418–S425. https://doi.org/10.21037/tau.2019.06.13
CDC (2008) Guideline for disinfection and sterilization in healthcare facilities—peracetic acid sterilization 2008. https://www.cdc.gov/infectioncontrol/guidelines/disinfection/sterilization/peracetic-acid.html. Accessed 30 Nov 2019
Legemate JD, Kamphuis GM, Freund JE, Baard J, Zanetti SP, Catellani M et al (2019) Durability of flexible ureteroscopes: a prospective evaluation of longevity, the factors that affect it, and damage mechanisms. Eur Urol Focus. https://doi.org/10.1016/j.euf.2018.03.001
Ofstead CL, Heymann OL, Quick MR, Johnson EA, Eiland JE, Wetzler HP (2017) The effectiveness of sterilization for flexible ureteroscopes: a real-world study. Am J Infect Control 45:888–895. https://doi.org/10.1016/j.ajic.2017.03.016
Legemate JD, Kamphuis GM, Freund JE, Baard J, Oussoren HW, Spijkerman IJB et al (2019) Pre-use ureteroscope contamination after high level disinfection: reprocessing effectiveness and the relation with cumulative ureteroscope use. J Urol 201:1144–1151. https://doi.org/10.1097/JU.0000000000000108
Taguchi K, Usawachintachit M, Tzou DT, Sherer BA, Metzler I, Isaacson D et al (2018) Micro-costing analysis demonstrates comparable costs for lithovue compared to reusable flexible fiberoptic ureteroscopes. J Endourol 32:267–273. https://doi.org/10.1089/end.2017.0523
Mager R, Kurosch M, Hofner T, Frees S, Haferkamp A, Neisius A (2018) Clinical outcomes and costs of reusable and single-use flexible ureterorenoscopes: a prospective cohort study. Urolithiasis 46:587–593. https://doi.org/10.1007/s00240-018-1042-1
Usawachintachit M, Isaacson DS, Taguchi K, Tzou DT, Hsi RS, Sherer BA et al (2017) A prospective case-control study comparing lithovue, a single-use, flexible disposable ureteroscope, with flexible, reusable fiber-optic ureteroscopes. J Endourol 31:468–475. https://doi.org/10.1089/end.2017.0027
Martin CJ, McAdams SB, Abdul-Muhsin H, Lim VM, Nunez-Nateras R, Tyson MD et al (2017) The economic implications of a reusable flexible digital ureteroscope: a cost-benefit analysis. J Urol 197:730–735. https://doi.org/10.1016/j.juro.2016.09.085
Ozimek T, Schneider MH, Hupe MC, Wiessmeyer JR, Cordes J, Chlosta PL et al (2017) Retrospective cost analysis of a single-center reusable flexible ureterorenoscopy program: a comparative cost simulation of disposable fURS as an alternative. J Endourol 31:1226–1230. https://doi.org/10.1089/end.2017.0427
Pietropaolo A, Skolarikos A, Liatsikos E, Rukin N, Niewad EB, Sener E et al (2019) Worldwide survey of flexible ureteroscopy (FURS) practice: a survey from EAU sections of young academic urologists (YAU) and uro-technology (ESUT). Eur Urol Suppl 18:e2846–e2847. https://doi.org/10.1016/S1569-9056(19)33033-7
Marchini GS, Torricelli FC, Batagello CA, Monga M, Vicentini FC, Danilovic A et al (2019) A comprehensive literature-based equation to compare cost-effectiveness of a flexible ureteroscopy program with single-use versus reusable devices. Int Braz J Urol 45:658–670. https://doi.org/10.1590/S1677-5538.IBJU.2018.0880
Somani BK, Talso M, Bres-niewada E (2019) Current role of single-use flexible ureteroscopes in the management of upper tract stone disease. J Endourol. https://doi.org/10.1089/end.2016.0237
Dragos LB, Somani BK, Keller EX, De Coninck VMJ, Herrero MR, Kamphuis GM et al (2019) Characteristics of current digital single-use flexible ureteroscopes versus their reusable counterparts: an in-vitro comparative analysis. Transl Androl Urol. https://doi.org/10.21037/tau.2019.09.17
Al-Balushi K, Martin N, Loubon H, Baboudjian M, Michel F, Sichez P-C et al (2019) Comparative medico-economic study of reusable vs. single-use flexible ureteroscopes. Int Urol Nephrol 51:1735–1741. https://doi.org/10.1007/s11255-019-02230-1
Davis NF, McGrath S, Quinlan M, Jack G, Lawrentschuk N, Bolton DM (2018) Carbon footprint in flexible ureteroscopy: a comparative study on the environmental impact of reusable and single-use ureteroscopes. J Endourol 32:214–217. https://doi.org/10.1089/end.2018.0001
Conflict of interest
Prof. Olivier Traxer is a consultant for Coloplast, Rocamed, Olympus, EMS, Boston Scientific and IPG.
Research involving human participants and/or animals
Experimental units are represented by flexible ureteroscopes.
Obtained in every case.
Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.
Below is the link to the electronic supplementary material.
About this article
Cite this article
Ventimiglia, E., Smyth, N., Doizi, S. et al. Can the introduction of single-use flexible ureteroscopes increase the longevity of reusable flexible ureteroscopes at a high volume centre?. World J Urol (2021). https://doi.org/10.1007/s00345-021-03808-0
- Flexible ureteroscopy
- Single use