INTRODUCTION Flexible Ureterorenoscopy (fURS) is one of the best solution for treatment of renal calculi less than 2 cm and for upper tract urinary cancer (UTUC) conservative treatment. An adequate quality of vision is mandatory to help surgeon having better outcomes. No studies have been done, to our knowledge, about what fURS on the market has the best quality of vision. Material and Methods Seven different fURS were used to compare the image quality (Lithovue, OlympusV, OlympusV2, Storz FlexXC - in White Light and in ClaraChroma mode - , Wolf Cobra Vision, Olympus P6 and Storx Flex X2). Two standardized grids to evaluate contrast and image definition and 3 stones of different composition were filmed in four standardized different scenarios. These videos were shown to 103 subjects (51 urologists and 53 non-urologist) that had to evaluate them with a rating scale from 1(very bad) to 5(very good).
No difference in terms of scores was observed for sex of the participants. Digital scopes were rated better than fiber optics scopes. Overall, Flex XCWhiteLight and XCClaraChroma image quality resulted steadily better than other fURS (p < 0,0001). Olympus V generally provided a vision better than Lithovue. Cobra Vision and Olympus V2 had superimposable values which were significantly lower than Lithovue's ones. Olympus P6 and Storz X2 offered a low quality of vision compared to the others. In the medium simulating bleeding, Olympus V and V2 significantly improved their scores of 12% and 8,1%, contrary to the rest of scopes.
Digital scopes have a better image quality than fiber optical ones. The only disposable scope tested was comparable to the majority of other digital scopes. The best image quality was provided by Storz digital scopes, being Clara Chroma the favourite Spies Mode, according to literature.
Journal of endourology. 2018 Mar 21 [Epub ahead of print]
Michele Talso, Silvia Proietti, Esteban Emiliani, Andrea Gallioli, Laurian Dragos, Andrea Orosa Andrada, Pol Servián, Aarón Barreiro, Guido Giusti, Emanuele Montanari, Bhaskar K Somani, Olivier Traxer
Sorbonne Université, GRC n°20 LITHIASE RENALE, AP-HP, Hôpital Tenon, F-75020 PARIS, France, Urology, Paris, France., Sorbonne Université, GRC n°20 LITHIASE RENALE, AP-HP, Hôpital Tenon, F-75020 PARIS, France, Paris, France., Department of Urology Fondazione IRCCS Ca' Granda - Ospedale Maggiore Policlinico - Università degli Studi di Milano, Italy, Urology, Milan, Italy ; ., Sorbonne Université, GRC n°20 LITHIASE RENALE, AP-HP, Hôpital Tenon, F-75020 PARIS, France, Urology, Paris, France ; ., Sorbonne Université, GRC n°20 LITHIASE RENALE, AP-HP, Hôpital Tenon, F-75020 PARIS, France, Paris, France ; ., Ospedale San Raffaele, 9372, Department of Urology, IRCCS San Raffaele Scientific Institute, Ville Turro Division, Milan, Italy, Milano, Italy ; ., Department of Urology Fondazione IRCCS Ca' Granda - Ospedale Maggiore Policlinico - Università degli Studi di Milano, Italy, Urology, Milan, Italy ; ., University Hospitals Southampton NHS Trust, Urology, Southampton, United Kingdom of Great Britain and Northern Ireland.