Single-use versus reusable ureteroscopes yield similar outcomes in intrarenal surgery for urinary stones: Study

The researchers found that both scopes demonstrated similar outcomes in operative time, stone-free rates, incidence of post-operative fever, and UTIs. The results indicate that the choice between the two hinges on factors, such as cost, availability, and surgeon preference.

Flexible ureterolithotripsy is a frequent urological procedure, usually used for stone removal from the kidney and upper ureter. For that procedure, reusable uretero-scopes were the standard tool, but recent concerns regarding sterility and maintenance and repair costs created the opportunity to develop new technologies.

The first single-use digital flexible ureteroscope was introduced in 2016. Since then, other single-use ureteroscopes have been developed, and studies compared them with reusable ureteroscopes and yielded conflicting results. Therefore, Mikhael Belkovsky, Surgical Technique & Experimental Surgery Department, Universidade de São Paulo, São Paulo, Brazil, and colleagues aimed to describe the literature that compares the performance of single-use and reusable flexible ureteroscopes in retrograde intrarenal surgery for urinary stones.

For this purpose, the researchers performed a systematic review in October 2022 according to the PRISMA (Preferred Reporting Items for Systematic Reviews and MetaAnalyses) and Cochrane Handbook. A search in online databases retrieved 10,039 articles. After screening, twelve articles were selected for the Meta-Analysis.

Based on the review, the researchers reported the following findings:

• No differences were found in stone-free rate (OR 1.31), operative time (MD 0.12), incidence of post-operative fever (OR 0.64), or incidence of post-operative urinary tract infection (OR 0.63 ).
• No differences were observed in the studied variables.

In conclusion, both scopes demonstrated comparable outcomes in operative time, stone-free rates, the incidence of postoperative fever, and UTIs.

"Hence, the device choice should rely on the cost analysis, availability, and surgeons' preference," the researchers wrote.

Reference:

Belkovsky M, Passerotti CC, Maia RS, de Almeida Artifon EL, Otoch JP, Da Cruz JAS. Comparing outcomes of single-use vs reusable ureteroscopes: a systematic review and meta-analysis. Urolithiasis. 2024 Feb 28;52(1):37. doi: 10.1007/s00240-024-01537-8. PMID: 38413490.