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Single-use flexible ureteroscopes: update and perspective in developing countries. A narrative review.
Eduardo Mazzucchi1, Giovanni Scala Marchini1, Fernanda Christina Gabrigna Berto2
1Seção de Endourologia, Divisão de Urologia, Hospital das Clínicas, Faculdade de Medicina da Universidade de São Paulo - FMUSP, São Paulo, SP, Brasil.
Summary
Single-use flexible ureteroscopes offer comparable stone-free rates to reusable scopes, with potentially lower operative times. Cost-benefit analysis is crucial for adoption, especially in developing nations.
Area of Science:
- Urology
- Medical Devices
- Health Economics
Background:
- Flexible ureteroscopy is a key treatment for urinary stones.
- Reusable flexible ureteroscopes are costly and prone to damage.
- Advancements include digital and single-use flexible ureteroscopes.
Purpose of the Study:
- Review characteristics of single-use flexible ureteroscopes.
- Compare outcomes with reusable devices.
- Evaluate cost-benefits for developing countries.
Main Methods:
- Extensive literature review of PubMed articles (2000-2021).
Main Results:
- Single-use scopes: 65-68cm length, 119-277g weight, up to 300° deflection.
- Stone-free rates: 60-95% (comparable to reusable).
- Operative times: 54-86 minutes (lower than reusable). Costs: $800-$3180.
Conclusions:
- Single-use scopes are lighter with superior image quality over fiberoptic types.
- No definitive data on higher stone-free rates or fewer complications.
- Institutions should conduct local cost-benefit analyses for adoption.
