The following is a summary of “Clinical comparative study of single-use and reusable digital flexible ureteroscopy for the treatment of lower pole stones: a retrospective case-controlled study,” published in the July 2024 issue of Urology by Jing et al.
This study aimed to evaluate the clinical efficacy and safety of single-use versus reusable digital flexible ureteroscopy (FURS) in the management of lower pole renal stones. A total of 213 patients were enrolled, with 135 undergoing reusable FURS and 78 undergoing single-use digital FURS. Comparative analysis included demographic data, clinical variables, anatomical parameters of the lower calyx, and perioperative indicators. Among these patients, 36 with an infundibula ureter angle (IPA) of less than 45° underwent mini-percutaneous nephrolithotomy (mini-PCNL), comprising 25 from the reusable FURS group and 11 from the single-use FURS group. The demographic and clinical variables between the two FURS groups were similar. The success rates for stone localization showed no significant statistical difference (P > 0.05).
While lithotripsy success rates were comparable in patients with an IPA of 45° or greater (P > 0.05), single-use FURS demonstrated superior outcomes in patients with an IPA of less than 45° (χ2 = 6.513, P = 0.011). The average working fiber length in the reusable and single-use FURS groups was 3.20 ± 0.68 mm and 1.75 ± 0.47 mm, respectively, showing a significant difference (t = 18.297, P < 0.05). The use of a stone basket was significantly more common in the reusable FURS group (31/135, 23.0%) compared to the single-use group (8/78, 10.3%) (χ2 = 5.336, P = 0.021). Additionally, the single-use FURS group had shorter operation times and higher stone-free rates (SFR) compared to the reusable FURS group (P < 0.05 for both parameters, χ2 = 4.230, P = 0.040). No significant differences were observed between the groups regarding intraoperative conversion to mini-PCNL and postoperative complications (P > 0.05). In conclusion, both single-use and reusable FURS are viable options for the treatment of lower pole stones (≤ 2 cm).
However, single-use FURS offers advantages in terms of higher lithotripsy success rates, reduced operation times, and improved stone-free rates, making it a preferable choice in certain clinical scenarios.
Source: bmcurol.biomedcentral.com/articles/10.1186/s12894-024-01541-5#Sec1