Reusable Ureteroscopy

How to cite: Humphreys MR. “Reusable Ureteroscopy.” Grand Rounds in Urology. November 13, 2025. Accessed Apr 2026. https://grandroundsinurology.com/reusable-ureteroscopy/

Summary

Mitchell R. Humphreys, MD, Chair, Department of Urology, Professor of Urology, Mayo Clinic, Phoenix, Arizona, presents an argument in favor of reusable ureteroscopes, emphasizing environmental stewardship, long-term cost efficiency, and system-level sustainability. He argues that while both reusable and single-use scopes have roles in modern practice, reusable ureteroscopy remains the most responsible and cost-effective option for high-volume centers.

He begins with a historical overview of ureteroscopy, tracing technological evolution from early fiberoptic endoscopes to modern digital reusable systems. Dr. Humphreys contextualizes the rise of single-use scopes, noting that early iterations were poorly adopted and that widespread uptake followed commercial repositioning rather than clear clinical superiority.

Dr. Humphreys reviews global medical waste data, highlighting that plastic pollution has increased dramatically following the COVID-19 pandemic. Quantitative analyses show that, for an equivalent number of procedures, single-use ureteroscopes generate more than four times the waste as reusable scopes.

Economic analysis is reviewed in detail. In a prospective, year-long institutional study using barcode tracking, reusable ureteroscopes averaged 12.5 cases between repairs, with a total per-case cost of approximately $850, including reprocessing and repair. Cost-benefit modeling demonstrated that single-use scopes become substantially more expensive beyond approximately 100 cases per year. Similar findings from external institutions are discussed, reinforcing that reusable scopes are more cost-effective in moderate- to high-volume settings.

Device reliability and safety are also examined using data from the FDA MAUDE database. Although surgeon error remains the most common cause of scope failure, single-use scopes were significantly more likely to result in early procedure termination and device malfunction compared with reusable scopes. Dr. Humphreys emphasizes that the rapid proliferation of disposable scope models may contribute to variable quality and performance.

Dr. Humphreys offers a balanced perspective. Reusable ureteroscopy, combined with improved handling, reduced scope damage, and investment in reprocessing efficiency, offers a sustainable path forward. Recycling initiatives for disposable scopes are acknowledged but remain limited in adoption and impact. Dr. Humphreys argues that responsible reuse, rather than a disposable-first mindset, best aligns clinical excellence with environmental responsibility.

About the 32nd Annual Perspectives in Urology: Point Counterpoint conference: Presented by Program Chair and Grand Rounds in Urology Editor-in-Chief E. David Crawford, MD, this conference brought together leading experts in urology, medical oncology, and radiation oncology to discuss and debate the latest topics in genitourinary cancers, primarily prostate cancer and bladder cancer. This interactive conference offered topical lectures, pro/con debates, interesting-case presentations, interactive panel discussions, and interactive audience and faculty networking.