Prospective comparison of flexible fiberoptic and digital cystoscopes.
OBJECTIVE
To compare the optics, performance, and durability of digital (DC) and fiberoptic (FC) cystoscopes.


METHODS
In an office setting, we randomly assigned staff urologists to 1 of the 4 cystoscopes, the Gyrus-ACMI ICN-0564 (AD), Gyrus-ACMI ACN-2 (AF), Olympus CYF-V2 EndoEYE Cysto-Nephro Videoscope (OD), Olympus CYF-5 Cysto-Fiberscope (OF), to perform diagnostic or surveillance cystoscopy and stent removal. The documented metrics included a subjective surgeon assessment of cystoscope optics and function characteristics on a 10-point scale (1, poor to 10, excellent). The measurement of the upward and downward cystoscope deflection and damage and repairs were all documented.


RESULTS
A total of 1022 cases were performed. The DC and FC were used 690 and 332 times, respectively. Two repairs (0.2%) were documented (1 AF and 1 AD); both resulted directly from incorrect cystoscope handling/cleaning. The mean operative time per case for the DC and FC was 4.5 and 4.6 minutes, respectively (P = .66). The mean surgeon optical ranking for the DC and FC was 8.4 and 7.8, respectively (P = .0076). The mean surgeon deflection ranking for the DC and FC was 8.6 and 8.0, respectively (P = .0001). The mean surgeon retroflex deflection ranking for the DC and FC was 8.4 and 7.8, respectively (P = .001). The mean overall cystoscope score surgeon ranking for the DC and FC was 8.6 and 7.9, respectively (P = .0001).


CONCLUSIONS
In the office setting, with proper care, FCs and DCs are durable for office applications. Overall, surgeons significantly preferred the DCs as demonstrated by discrepancies in both use and differences in the subjective metrics.
Okhunov
Zhamshid
Z
Department of Urology, Columbia University Medical Center, New York, New York 10032, USA.
Hruby
Gregory W
GW
Mirabile
Gabriella
G
Marruffo
Franzo
F
Lehman
Daniel S
DS
Benson
Mitchell C
MC
Gupta
Mantu
M
Landman
Jaime
J
D000368:Aged; D020684:Cystoscopes; D003558:Cystoscopy; D004867:Equipment Design; D005336:Fiber Optic Technology; D006801:Humans