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added that the "urologist may consider using the [single-use] scope in
cases in which reusable scope damage is anticipated."
Picking up on that point, a June 2018 Thomas Jefferson University
study, "Bad Out of the Box: A Report on Pre-operative Failure Rates
of Reusable Flexible Ureteroscopes at a Single Institution"
(osmag.net/jM8RPp), said that when evaluating single-use versus
reusables, often overlooked is how often urologists encounter an
unsuitable reusable flexible ureteroscope at the beginning of a case.
The subsequent 3-month trial found that single-use scopes could fill
"an essential and immediate role" because roughly 1 in 8 initially
opened reusable flexible ureteroscopes weren't fit for use.
As far as how well single-use models perform compared to
reusables, there doesn't appear to be a notable variation in effec-
tiveness between single-use and reusable. For example, a
November 2018 Urolithiasis journal paper, "Clinical outcomes and
costs of reusable and single-use flexible ureterorenoscopes: a
prospective cohort study" (osmag.net/eTGu5U), found "no signifi-
cant difference" for overall success rates, stone-free rates, opera-
tion time, radiation exposure time and complication rates. It ampli-
fied the other studies' findings on the ambiguity of cost benefit:
"Partially overlapping ranges of costs for single-use and reusable
scopes stress the importance to precisely know the expenses and
caseload when negotiating purchase prices, repair prices and war-
ranty conditions."
But what about the environmental impact of thousands of single-use
scopes being thrown out on a daily basis? One vendor of single-use
scopes responds to this ugly truth with the counterpoints that
employing single-use scopes also lowers waste from disinfecting
brushes, towels and test strips; reduces water and energy costs; and
eliminates staff exposure to toxic chemicals and disinfecting consum-
