Comparison of two digital, single use flexible ureterorenoscopes (Boston Scientific LithoVue and Pusen PU3022)- A prospective study
The widespread use of reusable endoscopes has gained increasing attention due to the rise of multi-drug resistant pathogens and concerns that current sterilizing techniques may be inadequate for completely preventing the transmission of these pathogens between patients. This has led to the development and increased use of single use endoscopes. In urology, no literature exists directly comparing the performance of commercial digital, single use flexible ureterorenoscopes. We aimed to compare two single use, digital flexible ureterorenoscopes (Pusen PU3022 and Boston Scientific LithoVue) and to compare them to a reusable, video ureterorenoscope (Olympus URF-V2)
A prospective, comparative study was conducted at Nepean Hospital, NSW, Australia. The clinical outcomes for patients undergoing flexible ureterorenoscopy between July 2016 and Sept 2017 were included for analysis. The first group underwent surgery using the single use LithoVue (Boston Scientific) and the second group used the single use PU3022 (Pusen). A representative sample of patients undergoing surgery with the re-useable URF-V2 (Olympus) was chosen for comparison. All operators were asked to rate on a 5-point Likert scale the visibility and maneuverability of the endoscope for each case. Data was analyzed using SPSS 24.0. Continuous variables were analyzed with non-parametric Kruskal-Wallis tests and Mann-Whitney U tests. Categorical variables were analyzed using Fisher&[prime]s exact test.
One hundred and thirty-three renal units were treated in 116 patients. Mean age was 55yrs, 32% were female and 95% of cases were performed for renal calculi. There were 49 cases in the LithoVue group, 27 in the Pusen PU3022 group and 49 in the Olympus URF-V2 group. There was a significant difference in visibility (out of 5) between the three groups (p
Our study is the first to directly compare two different single use, digital flexible ureterorenoscopes. Our study shows that the performance of single use ureterorenoscopes is approaching that of the reusable video, ureterorenoscopes. In the era of multi-resistant organisms and increasing concern over current sterilizing techniques for fragile ureterorenoscopes, the single use ureterorenoscopes are an increasingly feasible alternative to traditional, expensive, reusable ureterorenoscopes.
Funding: Five Boston Scientific LithoVue and five Pusen PU3022 ureterorenoscopes were provided by their respective companies for this study.