Clinical Outcomes of Single-Use vs Reusable Flexible Ureteroscopes in Management of Urolithiasis: A Comprehensive Systematic Review

Background: The widespread adoption of disposable flexible ureteroscopes (FURS) is attributed to their high sterility state, safety, and effectiveness compared with multiple-use flexible ureteroscopes. Aim: This systematic review aimed to study clinical outcomes of disposable vs reusable ureteroscopes in the management of upper tract urinary stones. Methods: Three electronic databases Web of Science, PubMed and Scopus were searched for relevant articles published over the past ten years. Prospective and retrospective cohort studies randomized clinical trials, and case-control studies were included in the current study. Selected articles were screened, and eligible studies were included for data synthesis and analysis. Results: The final full-article review included 19 studies, encompassing a total of 10,729 patients, 3,853 in the disposable FURS group and 6,876 in the multiple use FURS group. The stone-free rates (SFR), operative time (OT), length of hospital stay (LOS), and complication rates were investigated. Results demonstrated that reusable FURS had shorter operative times and lower complication risks, while single-use FURS achieved higher stone-free rates and shorter hospitalization durations. Additionally, no significant statistical differences were detected in SFR, OT and LOS. In the treatment of upper tract urolithiasis, single-use FURS demonstrated efficacy comparable to that of reusable FURS. Conclusion: This systematic review comprehensively compared disposable and reusable FURS in urolithiasis treatment, analyzing data from 19 studies involving 10,729 patients. The evidence demonstrates that single-use FURS offer significant clinical advantages. Future research on long-term economic analyses and sustainable device development is required to address the environmental concerns associated with disposable technologies