Category: Clinical Stones: Ureteroscopy

MP24-17 - A clinical evaluation of the new digital single-use flexible ureteroscope (UscopePU3022) and comparison to standard ureteroscopes: an international prospective multicentred study

Sun, Sep 23
10:00 AM - 12:00 PM

Introduction & Objective :

Single-use flexible ureteroscopes (f-URS) have recently been introduced into clinical practice. We assessed the clinical performance of a new digital single-use f-URS (UscopePU3022).


Methods :

A prospective cohort study was carried out across 11 international centres (July-Oct 2017). The UscopePU3022    was assessed using either a visual analogue scale* or a Likert scale across the following parameters: ease of insertion; deflection, image quality, manoeuvrability and an overall assessment of performance.

Visual analogue scale across parameters: Ease of insertion (0 = difficult and 10 = easy); Maneuverability, visual quality and overall assessment (0 = poor and 10 = very good); use in clinical practice (0 = absolutely not and 10 = definitely)


Results :

A total of 56 procedures were performed in 11 centres with the indication for f-URS being renal stones in 83%. The median score for ease of scope insertion was 10 (3-10). Intraoperative manoeuvrability was rated as “good” in 38% and “very good” in 52%. Visual quality was rated as “poor or bad” in 18%, “fair” in 37% and “good or very good” in 43%. Two scopes failed intraoperatively (4%) with one due to loss of deflection and the other due to loss of vision. Pre-operative and post-operative median upward and downward deflection was 270 degrees.


Compared to standard f-URS manoeuvrability was rated as “equivalent” in 30% and “better” in 60%; visual quality score was rated as “worse” in 38%, “equivalent” in 23% and “better” in 39%; median thumb and wrist fatigue scores were rated as “better” in 84% and 87%, respectively; and overall performance was rated as “worse” in 55%, “equivalent” in 16% and “better” in 29%. When asked if they would use UscopePU3022 in their daily practice if the costings were equivalent or better the median score was 7/10 (2-10).



Conclusions :

UscopeTM3022 performed well with regards to manoeuvrability, deflection and limb fatigue and appears to be at least non-inferior to standard f-URS with regards to these parameters. Poor image quality is a concern for UscopePU3022 with it receiving a low overall performance rating when compared to standard f-URS. Despite this it scored highly when investigators were asked if they would use it in their practice if it was cost-effective to do so.


 

Thomas J. Johnston

Urology SpR
Cambridge University Hospitals, Urology, Cambridge, United Kingdom
Bury St Edmunds, England, United Kingdom

Joyce Baard

Urologist
AMC University Hospital, Urology, Amsterdam, The Netherlands
Amsterdam, Noord-Holland, Netherlands

J De La Rosette

Professor
AMC University Hospital, Urology, Amsterdam, The Netherlands
Amsterdam, Noord-Holland, Netherlands

Steeve S. Doizi

Urologist
Sorbonne Université, GRC n°20, Groupe de Recherche Clinique sur la Lithiase Urinaire, AP-HP, Hôpital Tenon, F-75020 Paris, France
Paris, Ile-de-France, France

Guido Giusti

Head of European Training Center in Endourology
Ospedale San Raffaele-Turro IRCCS , Milan, Italy
Milan, Lombardia, Italy

Thomas Knoll

Associate Professor
Department of Urology, Sindelfingen-Boeblingen Medical Center, University of Tuebingen, Germany
Tuebingen, Thuringen, Germany

Silvia Proietti

Urologist
Ospedale San Raffaele Turro, Milan, Italy
Milan, Lombardia, Italy

Dr Silvia Proietti graduated at University of Perugia (Italy) in 2006 with full marks cum laude.
During her residency, she won LLP-Erasmus Student Placement and she spent 4 months at Guy’s and St Thomas’ NHS Foundation Trust of London, under the direction of Professor Prokar Dasgupta; she also developed particular interest in functional urology, under the supervision of Professor Antonella Giannantoni.
She then graduated at School of Urology of University of Perugia on October 2006 with full marks cum laude.
From 2012 to April 2015 she was member of staff of Urology Department at Humanitas Clinical and Research Center in Milan and in particular at the “Stone Center” directed by Dr Guido Giusti.
In 2015, she did a 6-month fellowship in endourology at Tenon University Hospital under the direction of Professor Olivier Traxer.
She is currently working at Urology Department of San Raffaele Hospital, Ville Turro Division, in Milan, principally performing endourological treatment of stones and upper urinary tract tumors, which represent her main field of interest.
She is ViceDirector of the European Training Center of Endourology (ETCE) under the direction of Dr Giusti.
She is author of several papers published in peer-reviewed Journals and she won several awards at National and International meetings.

Marianne Brehmer

Senior Consultant, MD, PhD
Danderyd University Hospital, Urology, Stockholm, Sweden
Danderyd, Stockholms Lan, Sweden

Dr. Marianne Brehmer is MD, PhD, specialized in advanced endourology. She is involved in several national and international scientific groups and she is main supervisor for PhD-students at the Karolinska Institutet. Since February 2017 she is responsible for the advanced endouroloy activity at Danderyd University Hospital, Stockholm, Sweden. Dr. Brehmer was educated at the Karolinska Institutet, Stockholm, Sweden. She has been qualified urologist since 1994. She got her PhD degree in 1999 and did a post-doc in Edinburgh, UK, 2000-2001.Dr. Brehmer got her endourology training in Stockholm, Örebro and Edinburgh. She was for 3 years responsible for the stone and endourology activity at Uppsala University Hospital. In 2003 she moved to the department of urology at the Karolinska University Hospital where she for 10 years was the chairperson of the Stone and Endourological Team. During three years, 2013-2016, Dr. Brehmer was the Head of department at the department of urology, Aarhus University Hospital, Denmark where she was developing and performing advanced endourology in the department. Dr. Brehmer has since many years been active in developing and improving the training of urologists. She was 2002-2013 the Swedish delegate for the European Board of Urology, EBU, where she was the president 2008‐2010. During her time in the EBU she was in charge of developing a system for certification of subspeciality centres.

Esteban Emiliani

Urologist
Department of Urology, Fundació Puigvert, Autonomous University of Barcelona, Barcelona, Spain
Barcelona, Catalonia, Spain

Esteban Emiliani
Endourolgist at Fundacion Puigvert, Universidad Autonoma de Barcelona, Spain.
Special Interest & Research: Endourologic treatment of stone disease and upper urinary tract urothelial tumors. Lasers basic and clinical research.

EUSP fellowship programme from the European Association of Urology. Endourological Society fellowship:
- Tenon Hospital, endourology department, Univérsité Pierre et Marrie Curie, Paris 20, France. (Prof. Oliver Traxer) and MPUH, Nadiad, India (Prof. Mahesh Desai)



Daniel Perez-Fentes

Professor
Santiago de Compostela Hospital, Urology, Santiago de Compostela, Spain
Santiago de Compostela, Galicia, Spain

Palle J S. Osther

Professor of Clinical Urology
Lillebaelt Hospital, Urology, Vejle, Denmark
Vejle, Syddanmark, Denmark

Prof. Osther attended University Southern Denmark where he received his medical approval and M.D. in 1984. He was consultant urological surgeon at Odense University Hospital from 2000-2002; and at Lillebaelt Hospital from 2002 to 2004, when he became chair of the department. He received the Ph.D. degree for scientific work on pathophysiology of calcium nephrolithiasis in 1995.

Prof. Osther is currently Professor and consultant urological surgeon at Department of Urology and Director of Urological Research Center at Lillebaelt Hospital, University of Southern Denmark, Vejle, Denmark. His research interests focus on urolithiasis, upper urinary tract urothelial carcinoma, urinary tract pain, uroradiology, erectile dysfunction and prostate cancer. In his clinical practice he mainly deals with urinary stone disease and other upper urinary tract pathologies. In his areas of interest he has published extensively, and he has had numerous scientific presentations worldwide. He has been invited as guest surgeon for live surgery at several international urological meetings. During 15 years he was chairman of the Scandinavian Cooperative Group for Urinary Stones and he took the initiative to the Scandinavian Course on Urinary Stone Disease. In the period 2009-2013 he was Chairman of the EAU Section of Urolithiasis (EULIS), and he was president of the 2nd Meeting of EULIS in Copenhagen 2013. He has received several scientific awards, and he is and has been advisor for several Ph.D. students.

Prof. Osther is an honorary member of EAU Section of Urolithiasis (EULIS) and has been involved as reviewer in European Guidelines on Urolithiasis. He has been board member of the EAU Section Office, member of the Scientific Committees of Challenges in Endourology and Experts In Stone Disease. He chaired a sub-committee of the latest International Consultation on Stone Disease. Prof. Osther is member of the Editorial Board of several peer-reviewed journals.

C Seitz

Urologist
Medical University of Vienna, Urology, Vienna, Austria
Vienna, Burgenland, Austria

N Neal

Urologist
Oxford University Hospitals, Urology, Oxford, United Kingdom
Oxford, England, United Kingdom

Ben W. Turney

Bernard Senior Clinical Researcher in Urology
Nuffield Department of Surgical Sciences
Oxford, England, United Kingdom

Nm Hasan

Urologist
Danderyd University Hospital, Urology, Stockholm, Sweden
Danderyd, Blekinge Lan, Sweden

Olivier O. Traxer

Professor
Sorbonne Universite, GRC n020 Lithiase Renale, AP-HP, Hospital Tenon, F-75020 Paris, France
Paris, Ile-de-France, France

Oliver Wiseman

Urologist
Cambridge University Hospitals, Urology, Cambridge, United Kingdom
CAMBRIDGE, England, United Kingdom

Oliver is a Consultant Urologist based at Cambridge University Teaching Hospitaks NHS Trust Cambridge, UK. He specialises in the treatment of kidney stones, their metabolic management and in the devlopment of patient reported outcomes for stone disease. He runs a number of training courses teaching stone surgery, and has been invited to operate and lecture nationally and internationally on stone disease.
He qualified in Cambridge and following basic surgical training, he underwent specialist training in urology in London, including at Guys Hospital and UCLH ("The Institute of Urology"). He has published widely including articles relating to the management of patients with renal stone disease.
He is a trustee of BAUS, honorary treasurer elect of BAUS, a member of the BAUS Section of Endourology Committee, and on the Endourological Society Awards and Medals Committee. He is training program director for Urology for the East of England.