Presented by: Eyal Riemer MD
Hadassah Hospital Jerusalem, Urology Department.

Introduction

Ureteroscopy for the treatment of urolithiasis is one of the most common procedures in the world of endourology. This study seeks to compare single use with multi use flexible scopes in holmium laser lithotripsy ureteroscopy procedures.

Materials

A retrospective observational study was performed over a database of 2380 ureteroscopy procedures collected since October 2013 by the endourology unit of a single tertiary center. From the database, only cases that were performed using a flexible scope were included. The data was divided into two categories according to the type of flexible scope used: procedures performed with a multi use flexible scope (MU) and procedures performed with a single use flexible scope (SU). The outcomes analyzed were Surgical Time (ST), which was measured from the beginning of the surgeon’s performance to it’s end, and Energy Density (ED), which is the total laser energy divided by the stone’s volume. Statistical analysis was performed using SPSS version 29.

Results

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1200 cases were included. 974 cases in the MU group and 226 cases in the SU group. Significant difference was found in ST: 33.37±18.04 minutes in the MU group vs. 38.16±18.50 in the SU group, with a p value smaller than 0.001. In ED no significant difference was found: 19.09±62.36 Joules per cubic millimeter in the MU group vs. 19.81±16.84 Joules per cubic millimeter in the SU group, with a p value of 0.375.

Conclusion

Our data displays a slight elongation in ST when using single use flexible scopes, and no significant difference in ED. An interesting finding is the difference in standard deviation in ED between the groups, of more the 300%. This finding may imply that the single use flexible scopes were more predictable and allowed for more precision when using the laser. This finding should be further investigated, as it may have an implication on clinical practice.

Funding

None

Lead Authors

Amitay Lorber, MD
Hadassah Hospital Jerusalem, Urology Department, Endourology Unit.

Co-Authors

Leonid Boyarsky, MD
Hadassah Hospital Jerusalem, Urology Department.

Ofer Gofrit, MD
Hadassah Hospital Jerusalem, Urology Department.

Mordechai Duvdevani, MD
Hadassah Hospital Jerusalem, Urology Department, Endourology Unit.