Single-use vs. reusable flexible ureteroscopes: what do our patients prefer?

PURPOSE: Numerous studies have compared reusable flexible ureteroscopes (RUFU) and single-use flexible ureteroscopes (SUFU). However, patients' opinions (PO) have not yet been assessed. This study aimed to evaluate PO regarding RUFU versus SUFU. METHODS: A multicenter anonymous survey was conducted among patients consulting for urolithiasis in eight French centers between September 2024 and April 2025. Participants completed a nine-item questionnaire validated by an expert panel, assessing demographic and medical characteristics, ureteroscope preferences, environmental considerations (EC), scenario-based choices, and willingness to pay. RESULTS: 186 patients were analyzed. Median age was 55years and 60.2% were male. Overall, 68.3% preferred SUFU, 14.0% preferred RUFU, and 17.7% had no preference. The main reason for choosing SUFU was the perceived risk of cross-contamination (67%), followed by EC and risk of cancellation (8.6% each). Preference for RUFU was mainly driven by EC (84.6%). Half of participants wished to be informed about the type of ureteroscope used, but majority preferred the final decision to be made by urologist. EC were considered important by 81.7% of participants. In the event of cancellation due to RUFU damage and unavailability of a SUFU, opinions were divided: 44.1% found this acceptable, 44.1% did not, and 11.8% had no opinion. Finally, 64.5% were willing to pay the price difference to obtain their preferred ureteroscope. CONCLUSION: This first study assessing PO on ureteroscope choice found a preference for SUFU, mainly due to the absence of cross-contamination risk despite EC. These findings support patient involvement in ureteroscope selection.