Mp10-17 practice and Attitudes Towards Single-Use Flexible Ureteroscopes and Next-Generation Concepts: Results of a Worldwide Survey

Abstract

The increasing use of flexible ureteroscopy has occurred against a background of the development of single-use flexible ureteroscopes (su-fURS). We assessed current su-fURS practice and attitudes toward next-generation technologies through a worldwide survey of endourologists.METHODS: An anonymous online questionnaire on su-fURS and practice patterns consisting of 30 items was sent to Endourology Society members in January 2021. Responses were collected through QualtricsXM over a 1-month period. The study was reported according to the Checklist for Reporting Results of Internet E-Surveys (CHERRIES).RESULTS: Questionnaires were answered by 208 surgeons (response rate 14%). U.S surgeons accounted for 30% of all respondents. fURS was routinely performed by respondents with 54% performing >101 cases/year. 26% of surgeons did not use su-fURS, 43% used it for <25% of their cases, while 2% used it for all cases. 34% noted a decrease in OR time when using su-fURS. The three most common indications were lower pole (LP) stone, stone >2 cm, and horseshoe kidney. Cost was ranked the number 1 most important limiting factor in its adoption (Fig. 1). Image quality (39%) was ranked the most important characteristic in current devices. For improvements in scope design, the top 3 features were smaller shaft size (19%), vision (16%), and wireless connectivity (14%). When asked about the importance of next-generation technologies in su-fURS, fragment suction capability was the most popular and considered very important/essential by 70% (Fig. 2).CONCLUSIONS: In this survey, su-fURS was not used by 26% of surgeons, and sparingly used by the majority. The most common indications for use of a su-fURS were LP stone, stone >2 cm, and horseshoe kidney. The major limitation in adoption was the cost. Suction and pressure sensor were considered the most important future developments.