Page 4 - CUA 2020_Technology and Training_v2

2020 CUA ABSTRACTS

Moderated Poster Session 5: Technical Advances in Urology,

Improving Patient Relations

MP-5.1 (Stryker) while the test video used the adaptor and an iPhone X (Apple,
A randomized controlled trial of “bag squeeze” to minimize U.S.). They were also asked how comfortable they would be to use the light
discomfort in male outpatient flexible cystoscopy adapter to perform common cystoscopy procedures.
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Mohamad Baker Berjaoui , Ishan Aditya , Jaime Herrera Caceres , Khaled Results: Thirty urology trainees and staff participated in this trial. For the
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Ajib , Yazan Qaoud , Jason Y. Lee , Alexandre Zlotta , Antonio Finelli , Robert urethra, all respondents rated a 4 (perceptible impairment but not annoy-
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J. Hamilton , Nathan Perlis , Girish S. Kulkarni , Neil E. Fleshner 1 ing) or 5 (no impairment) for overall video quality. For the bladder, 80%
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1 Urological Oncology, University Health Network, Princess Margaret of respondents rated a 2 (impairment was very annoying) or 3 (impairment
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Cancer Centre, Toronto, ON, Canada; School of Medicine, University of was annoying) for overall video quality. Most (96%) of evaluators rated a 4
Toronto, Toronto, ON, Canada (often) or 5 (always) on their comfort of using this adapter for the placement
Introduction: Among the most common symptoms of patients undergoing of a difficult catheter and removal of a ureteric stent.
flexible cystoscopy are pain and discomfort. Hydrodistension of prostate is Conclusions: The novel light adaptor caused minimal impairment when visu-
a commonly used, yet unproven technique used by physicians to minimize alizing the urethra but significant impairment in the bladder. Respondents
outpatient flexible cystoscopy-induced discomfort. This maneuver involves were also comfortable using the adapter for common bedside cystoscopic
the health professional performing a “bag squeeze” of the irrigation fluid procedures.
as one traverses the distal urinary sphincter until passing through the blad- Reference
der neck. Herein, we report results from a single-center, single-blinded, 1. International Telecommunication Union, Methodologies for the sub-
randomized trial to determine whether use of the “bag squeeze” technique jective assessment of the quality of television images BT.500-14. 2019
during flexible cystoscopy significantly alters pain scores.
Methods: Consenting participants were all male, outpatients, ambulatory MP-5.3
who had undergone a prior cystoscopy and not expected to require any Evaluation of a novel, single-use flexible cystoscope: A multi-
secondary procedures (e.g., stent, tumor fulguration, etc.). Men with prior institutional international study
urethral stricture or bladder neck contracture were excluded. They were ran- Victor Wong , Kymora Scotland , Justin Y.H. Chan , Ehab Tawfiek , Allen
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domized to group A (bag squeeze) or group B (no bag squeeze). Following Chiura , Demetrius Bagley , Ben H. Chew 1
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the procedure, all men responded to a Likert scale pain grid. Mean pain 1 Department of Urologic Sciences, University of British Columbia,
score differences between the groups were tested using a Students t-test Vancouver, BC, Canada; Department of Urology, University of California
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with two-sided alpha of 0.05. Los Angeles, Los Angeles, CA, United States; Department of Urology,
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Results: Two hundred patients were recruited and underwent a flexible El-Minia University Hospital, El-Minia, Egypt; Parirenyatwa Hospital,
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cystoscopy. Ten were deemed ineligible as they required secondary pro- Harare, Zimbabwe; Department of Urology, Thomas Jefferson University,
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cedures. Among the 190 eligible patients, 97 were randomized to squeeze Philadelphia, PA, United States
arm and 93 to no squeeze arm. Mean pain scores were 3.39 in the no bag Introduction: The flexible cystoscope is an indispensable tool in urology
squeeze arm and 1.91 in the bag squeeze arm (p<0.005). but also requires high acquisition (including a tower), maintenance, and
Conclusions: This study showed a statistically and clinically significant reprocessing costs. A potential solution to such problems is single-use
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decrease in pain score with pericystoscopic bag squeeze and accordingly cystoscopes. The aim of this study is to evaluate the NeoFlex Single-Use
should be considered a suitable, simple, and affordable method to improve Flexible Cystoscope (Neoscope Inc.) to standard-of-care reusable flexible
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patient comfort during flexible cystoscopy. cystoscopes (Olympus CYF-VH) in a bench-top and clinical setting. The
single-use cystoscope is powered and visualized by direct USB connection
MP-5.2 to a laptop, therefore, obviating the need for other expensive equipment,
Evaluation of a cystoscopy smartphone light adaptor on a such as controllers, towers, and monitors. This provides true portability and
urological endoscopy simulator may provide more accessibility in international settings.
Yanbo Guo , Anil Kapoor , Edward D. Matsumoto 1 Methods: The single-use digital flexible cystoscopes (Neoscope) were
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1 Urology, McMaster University, Hamilton, ON, Canada prospectively evaluated against reusable digital flexible cystoscopes in 25
Introduction: Cystoscopy is a vital tool that is often needed at the bedside. clinical procedures in multiple international sites. During clinical assess-
Current practice requires a significant amount of equipment to be brought to ment, performance in maneuverability, visualization, scope deflection,
the patient, including heavy light sources and dedicated cystoscopy towers. image colour, and illumination were investigated. Bench-top assessments
We developed an affordable universal adapter that uses the light from a were also conducted.
smartphone rather than a conventional light source, minimizing the incon- Results: Bench testing revealed smaller tip diameter (4.06 vs. 6.09 mm) in
venience and cost associated with bedside cystoscopy. Here, we evaluated the single-use cystoscopes. Deflection of the single-use scope was superior
the degradation of the video quality using this light adapter compared to a with an empty working channel (230/220) vs. the reusable (195/95) but
standard light source on a high-fidelity cystoscopy simulator. was more substantially decreased when an instrument was placed in the
Methods: A video of the urethra and bladder were produced. They were channel. Clinical use revealed satisfactory maneuverability, ease of use of
recorded using a HD video endoscopy tower (Stryker, U.S.), a flexible instruments, deflection, and visualization between the two scopes. Most
cystoscope (Olympus, Japan), and a urological endoscopy trainer (Limbs (96%; 24/25) clinical procedures conducted with the Neoflex single-use
& Things, U.K.). The videos were then evaluated using a double stimu- cystoscope were successful.
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lus impairment scale method. Viewers were shown a reference and test Conclusions: The Neoflex Single-use Flexible Cystoscope offers comparable
samples, and then asked to evaluate the level of impairment using a stan- maneuverability, imaging, and illumination to standard-of-care flexible reus-
dardized Likert scale. The reference video used a conventional light source able cystoscopes without the need for maintenance or repurposing. This
S104 CUAJ • June 2020 • Volume 14, Issue 6(Suppl2)
© 2020 Canadian Urological Association