Flow matters: Irrigation flow differs in flexible ureteroscopes of the newest generation

Stephan Kruck, Aristoteles G. Anastasiadis, Georgios Gakis, Ute Walcher, Joerg Hennenlotter, Axel S. Merseburger, Arnulf Stenzl, Udo Nagele*

*Corresponding author for this work
10 Citations (Scopus)


The development of new-generation flexible ureteroscopes has improved diagnostic and therapeutic endourological procedures. Despite technical improvement irrigation flow and quality of vision is often unsatisfactory. This study describes inter-manufactural differences in the latest available flexible ureteroscopes in terms of irrigation flow in correlation to different deflection angles and the use of 1.9 Fr. stone baskets. Irrigation flow measurements were performed in five new-generation flexible ureterorenoscopes with 3.6 Fr. working channels: Wolf (Uretero-Renoscope 270°), Storz (Flex-X2 and Flex-X c), ACMI (DUR-D) and Olympus (URF Type P5) in 0°, 90° and 180° deflection. All measurements were carried out five times with an empty working channel as well as with inserted 1.9 Fr. stone baskets. Mean flow rates with empty instruments (SD) counted 50 ml/min (0.8), 50 (1.0), 48 (1.7), 48 (1.6) and 44 (0.7) for ACMI, Wolf, Storz (FlexX2 and Flex-X c), and Olympus, respectively. Stone baskets significantly reduced irrigation flows in all tested ureteroscopes (p < 0.05). In channels with inserted baskets, the highest flow rates were measured for ACMI and Wolf with 12 ml/min (0.7) each. The lowest reduction of flow rate was detected in the ACMI and the Wolf ureteroscope (76.0%, 38 ml/min each). Measurements after flexion showed no significant differences between the ureteroscopes. Latest generation of flexible ureteroscopes offer various new product developments, including excellent deflection capacities. This study showed inter-manufactural differences in terms of irrigation flow rates with either empty or occupied working channels resulting in significant alterations in endoscopic view.

Original languageEnglish
JournalUrological Research
Issue number6
Pages (from-to)483-486
Number of pages4
Publication statusPublished - 12.2011

Research Areas and Centers

  • Research Area: Luebeck Integrated Oncology Network (LION)


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