, Volume 46, Issue 6, pp 587–593 | Cite as

Clinical outcomes and costs of reusable and single-use flexible ureterorenoscopes: a prospective cohort study

  • R. MagerEmail author
  • M. Kurosch
  • T. Höfner
  • S. Frees
  • A. Haferkamp
  • A. Neisius
Original Paper


The purpose of this study is to analyze clinical outcomes and costs of single-use flexible ureterorenoscopes in comparison with reusable flexible ureterorenoscopes in a tertiary referral center. Prospectively, 68 flexible ureterorenoscopies utilizing reusable (Flex-X2S, Flex-XC, Karl Storz) and 68 applying single-use flexible ureterorenoscopes (LithoVue, Boston Scientific) were collected. Clinical outcome parameters such as overall success rate, complication rates according to Clavien–Dindo, operation time and radiation exposure time were measured. Cost analysis was based on purchase costs and recurrent costs for repair and reprocessing divided by number of procedures. In each group 68 procedures were available for evaluation. In 91% of reusable and 88% of single-use ureterorenoscopies stone disease was treated with a mean stone burden of 101 ± 226 and 90 ± 244 mm2 and lower pole involvement in 47 and 41%, respectively (p > 0.05). Comparing clinical outcomes of reusable vs. single-use instruments revealed no significant difference for overall success rates (81 vs. 87%), stone-free rates (82 vs. 85%), operation time (76.2 ± 46.8 vs. 76.8 ± 40.2 min), radiation exposure time (3.83 ± 3.15 vs. 3.93 ± 4.43 min) and complication rates (7 vs. 17%) (p > 0.05). A wide range of repair and purchase costs resulted in total to $1212–$1743 per procedure for reusable ureterorenoscopy whereas price of single-use ureterorenoscopy was $1300–$3180 per procedure. The current work provided evidence for equal clinical effectiveness of reusable and single-use flexible ureterorenoscopes. 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 warranty conditions.


Single use Disposable Flexible ureterorenoscopy Costs Clinical outcome 



No funding has been granted for the study.

Compliance with ethical standards

Conflict of interest

R. Mager, M. Kurosch, T. Höfner, S. Frees, A. Haferkamp and A. Neisius declare that they have no conflict of interest.

Ethical approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

Informed consent

Informed consent was obtained from all individual participants included in the study.

Supplementary material

240_2018_1042_MOESM1_ESM.docx (98 kb)
Supplementary material 1 (DOCX 97 KB)


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Copyright information

© Springer-Verlag GmbH Germany, part of Springer Nature 2018

Authors and Affiliations

  1. 1.Department of Urology and Pediatric UrologyUniversity Medical Center MainzMainzGermany

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