Clinical Scorecard: Assessing the Environmental Effects of Current Endoscopic Technologies in Urology: A Systematic Review of Reusable and Disposable Scopes

At a Glance

Key Highlights

• Single-use cystoscopes reduce water use and waste compared to reusable devices but have higher overall environmental impact in flexible ureterorenoscopes (fURS).
• Life Cycle Assessment (LCA) shows single-use fURS have approximately threefold higher CO2 equivalent emissions than reusable fURS.
• Disability-Adjusted Life Years (DALYs) evaluation via ReCiPe2016(H) method aids in translating environmental impact data for medical professionals.

Guideline-Based Recommendations

Diagnosis

• Consider environmental impact data when selecting endoscopic devices for urological procedures.

Management

• Favor reusable flexible ureterorenoscopes over single-use devices to reduce environmental footprint where feasible.
• Implement standardized research methodologies such as LCA to assess device environmental impacts.

Monitoring & Follow-up

• Continuously evaluate environmental metrics including CO2 equivalents and waste generation associated with device use.
• Incorporate DALYs assessments to monitor broader health and environmental outcomes.

Risks

• Single-use devices generate significantly more waste and have higher carbon footprints, potentially increasing environmental health risks.
• Reprocessing reusable devices requires water and energy, necessitating optimization to minimize environmental burden.

Patient & Prescribing Data

Patients undergoing urological endoscopic procedures requiring flexible ureterorenoscopy or cystoscopy

Reusable scopes demonstrate lower environmental impact and waste generation compared to single-use devices, supporting their preferential use when clinically appropriate.

Clinical Best Practices

• Adopt Life Cycle Assessment (LCA) methodologies aligned with ISO 14040/44 standards to evaluate device environmental impacts.
• Utilize renewable energy sources in healthcare settings to reduce carbon footprint associated with device reprocessing.
• Encourage collaborative research to standardize environmental impact assessments across urological procedures.
• Balance clinical efficacy with environmental sustainability when selecting endoscopic technologies.

References

• Peyrottes and Thibaut Long-Depaquit et al. Systematic Review on Environmental Impact of Urological Scopes
• Life Cycle Assessment of Flexible Ureterorenoscopes Comparing Single-Use and Reusable Devices