Comparison of single-use flexible URS and re-usable flexible URS: Effectiveness, reliability, cost-efficiency analysis

Abstract

Comparison of Single-use Flexible Ureterorenoscopy (SF-URS) with Reusable Fiberoptic Flexible Ureterorenoscopy (RF-URS) is one of the most popular subject in Endourology. Flexible Ureterorenoscopy (F-URS) is the gold standard method used in the treatment of kidney and ureteral stones smaller than 2 cm and together with ESWL.SF-URS has been widely used along with RF-URS. Our study aims to analyze retrospectively RF-URS and SF-URS in terms of effectiveness, reliability and cost. 200 patients who underwent F-URS due to renal stones were included in our study. Patients were divided into 2 groups: 100 patients who underwent SF-URS and 100 patients who underwent RF-URS. Mean age of the two groups was 49.58, 50.24 in the RF-URS and SF-URS groups, respectively. The presence of hypertension and diabetes, Body Mass-Index (BMI), and stone characteristics were recorded, and postoperative stone-free rates, duration of hospital stay, duration of operation, postoperative hemoglobin loss, postoperative urosepsis, and auxiliary procedures were evaluated. A cost effective analysis was carried out. The demographic data and stone characteristics of both groups were similar and there was no statistically significant difference (p> 0.05). The SF-URS group was found to be more advantageous in terms of the duration of operation (p<0.05). Other operational data were similar to each other and no statistically significant difference was found (p>0.05). The RF-URS group was found to be more advantageous after a cost-effective analysis (p<0.05). SF-URS has an advantage over RF-URS in terms of image quality, ease of use and duration of operation. RF-URS was found to be more advantageous in a cost-effective analysis. In terms of other operational data, both procedures were similar. Well-designed prospective randomized controlled trials are needed.

Key words: Flexible URS, kidney stone, RIRS, stone