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      Single use flexible ureteroscopes: Current status and future directions

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          Abstract

          Introduction

          Single use ureteroscopes are a technological innovation that have become available in the past decade and gained increased popularity. To this end, there are now an increasing number of both benchside and clinical studies reporting outcomes associated with their use. Our aim was to deliver a narrative review in order to provide an overview of this new technology.

          Methods

          A narrative review was performed to gain overview of the history of the technology's development, equipment specifications and to highlight potential advantages and disadvantages.

          Results

          Findings from preclinical studies highlight potenial advantages in terms of the design of single use ureteroscopes such as the lower weight and more recent modifications such as pressure control. However, concerns regarding plastic waste and environmental impact still remain unanswered. Clinical studies reveal them to have a non inferior status for outcomes such as stone free rate. However, the volume of evidence, especially in terms of randomised trials remains limited. From a cost perspective, study conclusions are still conflicting and centres are recommended to perform their own micro cost analyses.

          Conclusions

          Most clinical outcomes for single use ureteroscopes currently match those achieved by reusable ureteroscopes but the data pool is still limited. Areas of continued debate include their environmental impact and cost efficiency.

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          Most cited references65

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          Burden of Urolithiasis: Trends in Prevalence, Treatments, and Costs.

          The recent evolution of management options for urolithiasis has presented a unique dilemma for the modern urologist. A comprehensive understanding of epidemiological trends along with current provider preferences in treating urinary stones would be beneficial.
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            Health Care Pollution And Public Health Damage In The United States: An Update.

            An up-to-date assessment of environmental emissions in the US health care sector is essential to help policy makers hold the health care industry accountable to protect public health. We update national-level US health-sector emissions. We also estimate state-level emissions for the first time and examine associations with state-level energy systems and health care quality and access metrics. Economywide modeling showed that US health care greenhouse gas emissions rose 6 percent from 2010 to 2018, reaching 1,692 kg per capita in 2018-the highest rate among industrialized nations. In 2018 greenhouse gas and toxic air pollutant emissions resulted in the loss of 388,000 disability-adjusted life-years. There was considerable variation in state-level greenhouse gas emissions per capita, which were not highly correlated with health system quality. These results suggest that the health care sector's outsize environmental footprint can be reduced without compromising quality. To reduce harmful emissions, the health care sector should decrease unnecessary consumption of resources, decarbonize power generation, and invest in preventive care. This will likely require mandatory reporting, benchmarking, and regulated accountability of health care organizations.
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              Carbon Footprint in Flexible Ureteroscopy: A Comparative Study on the Environmental Impact of Reusable and Single-Use Ureteroscopes.

              There are no comparative assessments on the environmental impact of endourologic instruments. We evaluated and compared the environmental impact of single-use flexible ureteroscopes with reusable flexible ureteroscopes.
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                Author and article information

                Contributors
                jonesurology@gmail.com
                Journal
                BJUI Compass
                BJUI Compass
                10.1002/(ISSN)2688-4526
                BCO2
                BJUI Compass
                John Wiley and Sons Inc. (Hoboken )
                2688-4526
                05 July 2023
                November 2023
                : 4
                : 6 ( doiID: 10.1002/bco2.v4.6 )
                : 613-621
                Affiliations
                [ 1 ] Department of Urology Haukeland University Hospital Bergen Norway
                [ 2 ] Department of Clinical Medicine University of Bergen Bergen Norway
                [ 3 ] EAU YAU Urolithiasis group Armhem Netherlands
                [ 4 ] Department of Urology IRCCS Ospedale San Raffaele Milan Italy
                [ 5 ] Department of Urology University Hospital Southampton UK
                Author notes
                [*] [* ] Correspondence

                Patrick Juliebø‐Jones, Department of Urology, Haukeland University Hospital, Bergen, Norway.

                Email: jonesurology@ 123456gmail.com

                Author information
                https://orcid.org/0000-0003-4253-1283
                https://orcid.org/0000-0003-3654-1629
                https://orcid.org/0000-0002-6248-6478
                https://orcid.org/0000-0002-3216-4937
                Article
                BCO2265
                10.1002/bco2.265
                10560621
                37818020
                eff77966-3539-4f2e-9604-2448a465d14e
                © 2023 The Authors. BJUI Compass published by John Wiley & Sons Ltd on behalf of BJU International Company.

                This is an open access article under the terms of the http://creativecommons.org/licenses/by/4.0/ License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited.

                History
                : 18 May 2023
                : 21 March 2023
                : 04 June 2023
                Page count
                Figures: 1, Tables: 2, Pages: 9, Words: 7041
                Categories
                Review
                Reviews
                Custom metadata
                2.0
                November 2023
                Converter:WILEY_ML3GV2_TO_JATSPMC version:6.3.4 mode:remove_FC converted:08.10.2023

                disposable,ureteroscopy,urinary calculi,urolithiasis
                disposable, ureteroscopy, urinary calculi, urolithiasis

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