The Role of Flexible Cysto-Nephroscope in Enhancing Stone-Free Rates of Percutaneous Nephrolithotomy: A Global Survey
Author(s)
Kirsten Nielsen, Cand.merc.(si.).
Global Health Economist, AMBU A/S, Ballerup, Denmark.
Global Health Economist, AMBU A/S, Ballerup, Denmark.
OBJECTIVES: Percutaneous nephrolithotomy (PCNL) is a procedure for removing kidney stones usually performed using a rigid nephroscope. Although flexible cysto-nephroscopes (fCNS) are generally believed to improve clinical outcomes, no definitive study confirms their impact on SFR. This study aims to evaluate practices and beliefs of urologists regarding fCNS use during PCNL and its perceived impact on SFR.
METHODS: A double-blinded online survey was distributed to 100 urologists; 50 from the US, and 10 each from Germany, UK, Spain, Italy, and France. Data collection was facilitated by a third-party consultancy in June 2024. Descriptive and correlation analyses were performed in RStudio (Fisher’s exact test, Chi-squared test, and logistic regression models).
RESULTS: 94% of respondents reported using a fCNS to inspect for remaining stones at the end of the PCNL, and 85% believed this increased the SFR. This belief was similar across private (82.9%) and public (86.2%) institutions, between academic/teaching institutions (87.8%) and non-academic/teaching institutions (85%), and consistent across all surveyed countries, highest in Italy (100%) and lowest in the UK (70%). A significant association was found between the belief that using fCNS for inspection during PCNL increased the SFR and its actual use (p=0.004; OR =14.36). No significant associations were found between institution type (private/public) and the belief that inspection with fCNS increased the SFR (p=0.883). The department’s annual PCNL volume did not significantly affect belief in fCNS ‘s benefits during PCNL (p=0.744).
CONCLUSIONS: This study highlights a strong preference among urologists that usage of fCNS during PCNL improves SFR, regardless of country, institutional, or academic setting. Despite lack of definitive studies proving its effectiveness, urologists in this study regarded fCNS as a valuable tool for improving PCNL outcomes. Further research is needed to substantiate these findings and provide concrete evidence of the benefits.
METHODS: A double-blinded online survey was distributed to 100 urologists; 50 from the US, and 10 each from Germany, UK, Spain, Italy, and France. Data collection was facilitated by a third-party consultancy in June 2024. Descriptive and correlation analyses were performed in RStudio (Fisher’s exact test, Chi-squared test, and logistic regression models).
RESULTS: 94% of respondents reported using a fCNS to inspect for remaining stones at the end of the PCNL, and 85% believed this increased the SFR. This belief was similar across private (82.9%) and public (86.2%) institutions, between academic/teaching institutions (87.8%) and non-academic/teaching institutions (85%), and consistent across all surveyed countries, highest in Italy (100%) and lowest in the UK (70%). A significant association was found between the belief that using fCNS for inspection during PCNL increased the SFR and its actual use (p=0.004; OR =14.36). No significant associations were found between institution type (private/public) and the belief that inspection with fCNS increased the SFR (p=0.883). The department’s annual PCNL volume did not significantly affect belief in fCNS ‘s benefits during PCNL (p=0.744).
CONCLUSIONS: This study highlights a strong preference among urologists that usage of fCNS during PCNL improves SFR, regardless of country, institutional, or academic setting. Despite lack of definitive studies proving its effectiveness, urologists in this study regarded fCNS as a valuable tool for improving PCNL outcomes. Further research is needed to substantiate these findings and provide concrete evidence of the benefits.
Conference/Value in Health Info
2025-11, ISPOR Europe 2025, Glasgow, Scotland
Value in Health, Volume 28, Issue S2
Code
MT41
Topic
Clinical Outcomes, Medical Technologies
Disease
Urinary/Kidney Disorders