Flexible ureteroscopy: reuse? Or is single use the new direction?

Purpose Of Review: Single-use flexible ureteroscopes (su-fURS) aim at overcoming the main limitations of conventional reusable ureteroscopes in terms of acquisition and maintenance costs, breakages, and reprocessing. However, little data exist to date regarding the superiority of su-fURS at this regard. We aimed to perform a systematic literature review on available su-fURS performance with a focus on clinical data for all articles in the last 10 years.

Complications of ureteroscopy: a complete overview.

Introduction: The aim of this paper was to give a complete overview of all published complications associated with ureteroscopy and their according management and prevention in current urological practice.

Materials And Methods: This review was registered in PROSPERO with registration number CRD42018116273. A bibliographic search of the Medline, Scopus, Embase and Web of Science databases was performed by two authors (V.

Reusable flexible ureterorenoscopes are more cost-effective than single-use scopes: results of a systematic review from PETRA Uro-group.

Clinical data suggest an equipoise between single-use (disposable) and reusable flexible ureterorenoscope (fURS) in terms of scope characteristics, manipulation, view and clinical outcomes. The procedural cost of reusable fURS is dependent on the initial and repair cost, maintenance and scope sterilization and on the number of procedures performed/repair. We conducted a systematic review on the procedural cost ($) of fURS based on the individual authors reported data on the number of procedures performed before repair and to see if it is a feasible option compared to single use fURS.

The laser of the future: reality and expectations about the new thulium fiber laser-a systematic review.

The Holmium:yttrium-aluminum-garnet (Ho:YAG) laser has been the gold-standard for laser lithotripsy over the last 20 years. However, recent reports about a new prototype thulium fiber laser (TFL) lithotripter have revealed impressive levels of performance. We therefore decided to systematically review the reality and expectations for this new TFL technology.

Pictorial review of tips and tricks for ureteroscopy and stone treatment: an essential guide for urologists from PETRA research consortium.

With an increase in the number of ureteroscopy (URS) procedures, URS is now performed more widely and is becoming a standard procedure for all urologists. There is also a rise in the complexity of these procedures and URS is now offered for treatment of stones as well as for diagnosis and treatment of urothelial tumours. We wanted to provide a 'pictorial review' of the 'tips and tricks' of URS, as the finer and technical details are often easier to understand and remember with images rather than through textual explanations.

Characteristics of current digital single-use flexible ureteroscopes versus their reusable counterparts: an comparative analysis.

Background: Single-use flexible ureterorenoscopes (fURSs) have been recently introduced aiming to offer solutions to the sterilization, fragility and cost issues of the reusable fURSs. In order to be a viable alternative, the single-use scopes must prove similar capabilities when compared to their reusable counterparts. The goal of our study was to compare the current reusable and single-use digital fURSs regarding their deflection, irrigation and vision characteristics.

Does working channel position influence the effectiveness of flexible ureteroscopy? Results from an in vitro study.

Objective: To evaluate whether the position of the working channel affects the effectiveness of flexible ureteroscopy.

Materials And Methods: We compared the ureteroscopes Flex-X2S and Flex-XC (working channel at the 9 and 3 o'clock positions, respectively) in eight cavities of a K-Box model, simulating the distribution of the right and left intrarenal calyces. In the first and second settings, each cavity contained a 1-cm stone, lying on the bottom and fixed on the anterior sheet covering the box, respectively.

Radiation exposure in prone vs. modified supine position during PCNL: Results with an anthropomorphic model.

Introduction: Radiation exposure during urological procedures is still of concern in the urology community. It has been reported that percutaneous nephrolithotomy (PCNL) in supine position has less irradiation, as the puncture is mostly done under ultrasound guidance. However, it can also be done under fluoroscopy guidance.

Endourologic Management (PCNL, URS, SWL) of Stones in Solitary Kidney: A Systematic Review from European Association of Urologists Young Academic Urologists and Uro-Technology Groups.

Urolithiasis in solitary kidney (SK) presents significant management dilemma as any insult to the kidney or its drainage can lead to significant morbidity. The treatment options include shock wave lithotripsy (SWL), percutaneous nephrolithotomy (PCNL), and ureteroscopy (URS). Our aim was to conduct a systematic review of literature on all available endourologic techniques reporting on the management of stones in an SK.

Size is Not Everything That Matters: Preoperative CT Predictors of Stone Free After RIRS.

Objective: To define computed tomography (CT) predictors of residual fragments after retrograde intrarenal surgery (RIRS) for kidney stones up to 20 mm in patients never submitted to surgical procedures for stone removal.

Methods: From August 2016 to August 2017, symptomatic adult patients with kidney stones less than 20 mm treated by RIRS had their pre- and postoperative CT prospectively evaluated in search for predictors of residual stone fragments. Stone size, stone volume, number of stones, stone density, and location were evaluated in preoperative CT and analyzed as predictors for residual stone fragments on 90 POD CT.

Computed tomography window affects kidney stones measurements.

Objectives: Measurements of stone features may vary according to the non-contrast computed tomography (NCCT) technique. Using magnified bone window is the most accurate method to measure urinary stones. Possible differences between stone measurements in different NCCT windows have not been evaluated in stones located in the kidney.

Preclinical comparison of superpulse thulium fiber laser and a holmium:YAG laser for lithotripsy.

Purpose: A superpulse (500 W peak power) thulium fiber laser operating at a 1940 nm wavelength, suitable for lithotripsy, has recently been developed. The goal of this study was to compare stone fragmentation and dusting performance of the prototype superpulse thulium fiber laser with leading commercially available, high-power holmium:YAG lithotripters (wavelength 2100 nm) in a controlled in vitro environment.

Methods: Two experimental setups were designed for investigating stone ablation rates and retropulsion effects, respectively.

Next-Generation Fiberoptic and Digital Ureteroscopes.

The versatility of ureteroscopy is attributable to tremendous technological innovations over the past decades. This article provides an overview on emerging technologies in the light of past achievements, current limitations, and possible future directions. Instrument size reduction, pressure and temperature control, active suction of stone dust, multiple-axis tip deflection, variable working channel positions, robotics, ergonomics, image quality, enhanced imaging technology, three-dimensional visualization, and the competition between reusable and single-use ureteroscopes are detailed.

Consultation on UTUC, Stockholm 2018 aspects of risk stratification: long-term results and follow-up.

Purpose: To summarize current knowledge on upper urinary tract carcinoma (UTUC) regarding risk stratification, long-term results, and follow-up.

Methods: A scoping review approach was applied to search literature in Pubmed, Web of Science, and Embase. Consensus was reached through discussions at Consultation on UTUC, September 2018, Stockholm.

Consultation on UTUC, Stockholm 2018 aspects of diagnosis of upper tract urothelial carcinoma.

Purpose: To summarize knowledge on upper urinary tract carcinoma (UTUC) regarding diagnostic procedures, risk factors and prognostic markers.

Methods: A scoping review approach was applied to search literature in Pubmed, Web of Science, and Embase. Consensus was reached through discussions at Consultation on UTUC in Stockholm, September 2018.

What Is Moses Effect: A Historical Perspective.

The Moses effect (ME) was described >30 years ago during normal laser functioning in a fluid medium. Recently, a laser device equipped with a pulse-modulating system called Moses™ technology (MT; Lumenis) was marketed for both stone lithotripsy and prostate endoscopic surgery. We aimed to perform a literature revision of ME from a historical perspective up until its present-day applications.

A Prospective Study Analyzing the Association Between High-grade Ureteral Access Sheath Injuries and the Formation of Ureteral Strictures.

Objective: To assess the intermediate- and long-term effect of high-grade ureteral injuries from ureteral access sheaths.

Methods: Patients undergoing ureteroscopy for upper tract calculi were prospectively enrolled at 2 sites from 2010 to 2015. A 12/14 French sheath was used and the ureter was inspected with a flexible ureteroscope during withdrawal of the sheath and recorded.

Adverse events associated with currently used medical treatments for cystinuria and treatment goals: results from a series of 442 patients in France.

Objective: To evaluate medical treatments, in terms of adverse events (AEs) and therapeutic goals, in a large series of patients with cystinuria.

Patients And Methods: Data from 442 patients with cystinuria were recorded retrospectively. Crystalluria was studied in 89 patients.