Why the flexible cystoscope has not yet been widely introduced?: A questionnaire to Japanese urologists

The flexible cystoscope has not been as widely accepted in the field of urology as in other fields. The results of this investigation provided implications for determining the reasons for the under-use of flexible cystoscopy as well as for the drawbacks of the flexible cystoscope.

We performed an investigation by sending a questionnaire to urologists asking them to compare the flexible cystoscope with the rigid cystoscope in order to determine why use of the former lags behind that of the latter.

We received answers from 420 urologists. We classified the urologist into four groups according to their years of experience. We also classified patients, for whom flexible cystoscopy was carried out, into four groups. The majority of the urologists in all groups thought that the flexible cystoscope provided a small field of vision and rough images. Urologists thought that the flexible cystoscope was inferior to the rigid cystoscope in terms of manipulability in biopsy. However, doctors who examined many patients using flexible cystoscopy believed that it was advantageous in terms of decreasing the patients' pain and they have experienced no problem in clinical practice.

Lack of experience in using the flexible cystoscope appears to be the main reason for the negative impression it generates. The flexible cystoscope can be routinely used in place of the rigid counterpart for urological investigations and it is recommended that it be used more widely for the benefit of the patients.