Comparison of pre- and post-surgical images of reusable and single use flexible ureteroscopes: a qualitative analysis

INTRODUCTION: Given the fragility of reusable ureterorenoscopes, many single use instruments have appeared on the market. Unfortunately, reuse of these scopes occurs in undeveloped countries in order to cut costs. This raises safety concerns for the patient. The aim of this article was to macroscopically evaluate the changes that single use flexible ureterorenoscopes (su-fURS) suffer after a retrograde intrarenal surgery (RIRS), and to compare them to reusable fURS. MATERIAL AND METHODS: Pre and post-operative images of the instruments used in 23 RIRS were obtained. All the cases had renal calculi of the inferior calix between 10–15 mm, and all of them were treated with Holmium laser. The ureterorenoscopes used were: Storz(®) Flex X2, Storz(®) Flex XC, Pusen(®) 3022, OTU(®) Wiscope, AnQIng(®) Innovex and Boston Scientific(®) LithoVue. Qualitative comparisons of these were made. RESULTS: After su-fURS usage, significant damage was observed, especially on the distal tip. Deflection was not compromised. Reusable fURS did not sustain any damage after their use. CONCLUSIONS: fURS are delicate equipment, especially if they are of single use. The considerable damage sustained by single use scopes could mean that reuse of these instruments is dangerous and should be avoided.