Clinical comparative study of single-use and reusable digital flexible ureteroscopy for the treatment of lower pole stones:a retrospective case-controlled study

Abstract Objectives:To compare the clinical efficacy and safety of single-use and reusable digital flexible ureteroscopy for the treatment of lower pole stones. Methods:We enrolled 135 patients underwent reusable flexible ureteroscopy (FURS) and 78 patients underwent single-use digital FURS. Demographic,clinical variables,anatomical parameters of the lower calyx and perioperative indicators were compared in the two groups. Results: 36 patients in the infundibuloureter angle (IPA) ＜45° subgroup had a mini-percutaneous nephrolithotomy (mini-PCNL), including 25 patients in the reusable FURS group and 11 patients in the single-use FURS group.The demographic and clinical variables in the two FURS groups were comparable.There was no statistical difference in the success rate of stone searching(P>0.05). In terms of the success rate of lithotripsy,there was also no statistical difference in the IPA ≥45°subgroup(P>0.05),whereas single-use FURS was superior in the IPA<45°subgroup(χ2=6.513,P=0.011).The length of the working fiber in the reusable FURS and single-use FURS groups was 3.20±0.68 mm and 1.75±0.47 mm, respectively(t=18.297, P<0.05).The use of a stone basket in the reusable FURS (31/135,23.0%) was significantly higher than that in the single-use FURS(8/78,10.3%) (χ2=5.336, P=0.021).Compared with the reusable FURS group, the single-use FURS group had shorter operation times(P<0.05) and higher stone-free rate(SFR) (χ2=4.230, P=0.040).There was no statistical difference in the intraoperative transfer of mini-PCNL and postoperative complications between the two groups(P>0.05). Conclusions:Single-use and reusable FURS are alternative methods for removal of lower pole stones (i.e., 2 cm or less). Single-use FURS has a high success rate of lithotripsy,shorter operation time,and high stone-free rate.