Disposable versus Reusable Ureteroscopes: A Prospective Multicenter Randomized Comparison

Area of Science:

• Urology
• Minimally Invasive Surgery
• Medical Device Technology

Background:

• Retrograde Intrarenal Surgery (RIRS) is a common procedure for kidney stones.
• Flexible ureteroscopes are crucial tools in RIRS, with both reusable and disposable options available.
• Comparing the efficacy and safety of reusable versus disposable flexible ureteroscopes is essential for optimizing patient outcomes.

Observation:

• A multicenter randomized clinical trial compared reusable and disposable flexible ureteroscopes in 180 patients undergoing RIRS.
• Stone-free rates (SFRs) and procedure costs were comparable between the two groups.
• Disposable ureteroscopes demonstrated significantly lower post-operative complication and infection rates.

Findings:

• Patients undergoing RIRS with disposable ureteroscopes experienced fewer hospitalizations and shorter antibiotic therapy durations.
• The overall complication rate was significantly lower with disposable scopes (3.3%) compared to reusable ones (8.8%).
• Disposable ureteroscopes showed a marked reduction in post-operative infections, with no cases of urosepsis or positive blood cultures, unlike the reusable group.

Implications:

• Disposable flexible ureteroscopes offer a safer alternative for RIRS, reducing patient morbidity.
• The findings support the adoption of disposable ureteroscopes to enhance patient safety in RIRS.
• Further research could explore long-term cost-effectiveness and environmental impact.