2. UroToday Home
  3. Recent Abstracts
  4. Endourology & Urolithiasis
  5. Minimally Invasive Procedures

EAU 2018: Clinical Outcomes and Costs of Reusable and Single-use Flexible Ureterorenoscopes

Copenhagen, Denmark (UroToday.com) Dr. Mager, clinical urologist from the University Medical Center Mainz in Mainz, Germany, presents his findings on a particularly popular debate: reusable scopes versus single-use scopes. Flexible ureteroscopy is the staple of any ureteral stone clinic with scopes that feature very fine mechanics for high maneuverability and thin working channels to allow for minimal damage to the ureter. Though the ureteroscopy procedure produces high stone free rates in patients, as Dr. Mager explains, ureteroscopes withstand frequent damage which necessitates a quite cost intensive repair or replacement cycles within medical centers. There may be a large cost saving potential from transitioning the ureteroscopy procedure to solely use single-use scopes. Dr. Mager and his colleagues set out to answer this question by comparing the clinical outcomes and costs of reusable and single-use flexible ureterorenoscopes at their own referral center. 

To test the perioperative implications of the reusable versus single-use ureterorenoscopes, patients were recruited to undergo ureteroscopy using a reusable or single-use scope. Flex-X2S and Flex-Xc by Karl Storz and LithoVue™ by Boston Scientific were used in this study. Perioperative data was collected regarding patient demographics and surgical data. The mean costs per procedure were provided in this study by analyzing the range between market price (MP) and the manufacturers’ suggested retail price (MSRP). These prices included costs for purchase, repair, and processing. 

Following the study’s completion, 136 patients were recruited in total with 68 patients prospectively assigned to each arm. Six reusable scopes were used throughout the duration of the study with 9 damages over 68 procedures. The costs experienced using these types of scope was $1212 for MP to $1743 for MSRP, per use. Sixty-nine single-use scopes were used with 1 defective device that was able to be returned under warranty and replaced. These scopes ranged from $1300 for MP to $3180 for MSRP, per use. Stone free rates, success rates, radiation exposure, and operating time were similar between both groups. Complication rates were slightly higher for the single-use scopes, but this value was not significant. 

Dr. Mager signed off his lecture by explaining that this current study showed the two scopes have very similar clinical effectiveness and are both highly efficacious in the field. Dr. Mager also described that the center should choose their scopes based on what best suits the institution and is dependent on how many cases are carried out each year. 


Presented by: Mager R. MD,

Co-Authors: Kurosch M. , Höfner T. , Frees S. , Haferkamp A. , Neisius A.
Author Information: University Medical Center Mainz, Dept. of Urology and Pediatric Urology, Mainz, Germany

Written by: Zachary Valley MD, Department of Urology, University of California-Irvine at the 2018 European Association of Urology Meeting EAU18, 16-20 March, 2018 Copenhagen, Denmark