Early clinical outcomes using a 6.3 Fr single use ureteroscope compared to a 7.5 Fr device

Flexible ureteroscopy is a cornerstone in minimally invasive urology, providing effective management of kidney stones and other urological conditions. The emergence of single-use ureteroscopes addresses challenges associated with reusable devices, such as cross-contamination, maintenance costs, and degradation over time. This prospective, single-center study compared the performance of the 6.3 Fr single-use flexible ureteroscope to the 7.5 Fr model in the treatment of kidney stones ≤ 2 cm. Forty patients were divided into two groups of 20, with preoperative assessments including CT scans and urine cultures. All patients underwent flexible ureteroscopy with thulium fiber laser lithotripsy under general anesthesia, and stone-free rates (SFRs) were assessed via CT at one month postoperatively. The 6.3 Fr ureteroscope achieved a significantly higher SFR of 95% compared to 92.9% with the 7.5 Fr model (p = 0.042). Mean operative times were 58 min (6.3 Fr) vs. 62.5 min (7.5 Fr), with no statistically significant differences in laser time or total energy used. Energy efficiency was 0.047 mm³/J (6.3 Fr) vs. 0.035 mm³/J (7.5 Fr), while energy consumption was 20.89 J/mm³ vs. 28.34 J/mm³, respectively. Both devices exhibited low complication rates, with only minor complications (Clavien-Dindo grades 1 and 2) reported. Postoperative ureteral mucosal injury was assessed intraoperatively, and no cases exceeded Grade 1. This study highlights the safety and efficacy of the 6.3 Fr ureteroscope, demonstrating comparable or superior outcomes to the 7.5 Fr model in terms of SFR and operative time. While economic and sterility benefits were not evaluated, the findings support the adoption of smaller-diameter devices for minimally invasive procedures, though further studies are warranted to validate their broader clinical impact.