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Eksperimental'naya i klinicheskaya urologiya

Sterilization of single-use flexible ureteroscopes: myths and reality

Number №4, 2023 - page 180-185
DOI: 10.29188/2222-8543-2023-16-4-180-185
For citation: Gorgotsky I.A., Aloyan A.A., Shkarupa A.A., Martov A.G., Petrov A.D., Konev S.D., Kulyash A.G. , Shkarupa D.D., Gadzhiev N.K. Sterilization of single-use flexible ureteroscopes: myths and reality. Experimental and Clinical Urology 2023;16(4):180-185; https://doi.org/10.29188/2222-8543-2023-16-4-180-185
Gorgockiy I.A. Aloyan A.A. Shkarupa A.A. Martov A.G. Petrov A.D. Konev S.D. Kulyash A.G. Shkarupa D.D Gadzhiev N.K.
Information about authors:
  • Gorgotsky I.A. – PhD, urologist, urological department of Saint Petersburg State University Hospital, Associate Professor of the Department of Hospital Surgery SPbU; Saint-Petersburg, Russia; RSCI Author ID 1141685, https://orcid.org/0000‑0002‑7860‑0626
  • Aloyan A.A. – urologist, urological department of Saint Petersburg State University Hospital; Saint-Petersburg, Russia; RSCI Author ID 1175552, https://orcid.org/0000‑0002‑6273‑4224
  • Shkarupa A.A. – 2nd year student of S.M. Kirov Military Medical Academy. S.M. Kirov; Saint-Petersburg, Russia
  • Martov A.G. – Dr. Sci., Professor, Corresponding Member of the Russian Academy of Sciences, Head of the Department of Urology and Andrology, Biomedical University of Innovation and continuing education A. I. Burnasyan Federal Medical Biophysical Center; Lomonosov Moscow State University Medical Research and Educational Center; Moscow, Russia; RSCI Author ID 788667, https://orcid.org/0000‑0001‑6324‑6110
  • Petrov A.D. – urologist, urological department of Saint Petersburg State University Hospital; Saint-Petersburg, Russia
  • Konev S.D. – head of epidemiology department, epidemiologist of Saint Petersburg State University Hospital, postgraduate student of the epidemiology department of North-Western State Medical University n.a. I.I. Mechnikov; Saint-Petersburg, Russia; RCSI Author ID 76128940
  • Kulyash A.G. – MD, clinical laboratory diagnostics, chief of the molecular-biological laboratory of Saint Petersburg State University Hospital; Saint-Petersburg, Russia; RSCI Author ID 1196609, https://orcid.org/0000‑0002‑9916‑6232
  • Shkarupa D.D. – Dr. Sc., Acting Director of Saint Petersburg State University Hospital; Saint-Petersburg, Russia; RSCI Author ID 560256, https://orcid.org/0000‑0003‑0489‑3451
  • Gadzhiev N.K. – Dr. Sci., urologist, deputy director for medical part of Saint Petersburg State University Hospital, Professor of the Department of Hospital Surgery of SPbU; Saint-Petersburg, Russia; RSCI Author ID 819314, https://orcid.org/0000‑0002‑6255‑0193
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Introduction. Retrograde flexible ureteroscopy is the most safe and effective method of treatment of patients with kidney stones and urothelial tumors. Since 2017, disposable flexible ureteroscopes (URS) have been introduced into clinical practice. Single use scopes are equal in visualization and usability to reusable ones, and there is no need for complex maintenance. However, the cost of disposable endoscopes remains relatively high for clinics in developing countries, prompting many specialists to sterilize the disposable device and then reuse it again.

Materials and Methods. Seven disposable flexible URS, after bi- and unilateral ureteropyeloscopy were sterilized according to the standard for reusable instruments immediately after surgery. After a complete sterilization cycle, samples were taken from various surfaces (insertion part, handle, control lever, port of the working channel, port of the irrigation channel, flush from the working channel) for bacteriological investigation.

Results. Bacterial growth was detected on all flexible URS included in the study. All detected bacterial species belonged to the cutaneous bacterial microflora. The most frequently contaminated parts of the endoscope were the handle (n=4), the control lever (n=3) and the outer surface of the inserted part of the endoscope (n=2).

Conclusions. Every single-use flexible URS that underwent a complete sterilization cycle was found to be contaminated with bacteria. Despite the technical feasibility, reuse of disposable instruments may be potentially harmful to the patient.

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Keywords: flexible ureteroscopy; laser lithotripsy; disposable; single use ureteroscope; sterilization; bacterial contamination