Evaluation of a single-use flexible cystoscope: A multi-institutional international study.

INTRODUCTION Acquisition costs and prohibitively expensive technical support for endoscope maintenance, repair and reprocessing have deterred adoption of flexible cystoscopes by many urologists internationally. This study evaluated the performance of a novel single use digital cystoscope which can directly connect to a laptop or computer monitor for visualization, obviating the need for a tower. METHODS The performance characteristics of flexible single use cystoscopes (NeoScope) were prospectively evaluated versus a reusable flexible cystoscope (Olympus) in three clinical cases and two independent benchtop testing episodes in Canada. Cystoscope maneuverability, imaging, deflection, irrigation and ease of use of instrumentation were investigated. Additional investigations were performed during clinical use in Zimbabwe (7 patients), Egypt (10 patients) and Dominica (5 patients). RESULTS Bench testing revealed smaller tip diameter (4.06 vs 6.09 mm) and shorter (35.4 vs 38 cm) single use cystoscopes versus reusable cystoscopes. Deflection of the single use scope was superior with an empty working channel (230 up/220 down) versus the reusable (195 up/95 down) but showed a more substantial decrease in deflection on placement of instruments including a grasper. Clinical use revealed satisfactory maneuverability, ease of use of instruments, deflection and visualization. CONCLUSIONS Benchtop testing performance of the single use digital flexible cystoscopes was inferior compared to reusable digital cystoscopes. However, these single use endoscopes offer adequate illumination, imaging and maneuverability. Direct connection to any computer monitor allowed truly portable use, allowing for treatment of patients in a variety of clinical settings without the need for ancillary equipment.