Abstract: PD42-09
Sources of Funding: None

Introduction

Conventional videocystoscopy (CVC) requires sterile fluid irrigant, a high power external light source, a cystoscope, and a video monitor/camera system. The high equipment cost makes the widespread use of videocystoscopy prohibitive in underserved populations. We developed the Endockscope (ES), a novel and affordable videocystoscopy system, which utilizes a mobile phone for image display and a solar-rechargeable LED-flashlight as a light source and sought to compare the resultant endoscopic view with CVC in real clinical settings using both air and fluid as an irrigant.

Methods

Patients scheduled for in-office videocystoscopy for either bladder tumor surveillance or stent removal were considered eligible. Each patient first received CVC visualizing the bladder in a systematic manner using normal saline, a video monitor, external light source, and flexible fiberoptic cystoscope. Without removing the cystoscope, the ES was attached to the cystoscope using the iPhone 6S as a video monitor/camera and the flashlight as the light source. The cystoscopy was then repeated with fluid irrigant (Endockscope-Fluid, ES-F) and then the fluid was drained and replaced with the same volume of air (Endockscope-Air, ES-A). All three exams were recorded and then sent to 11 expert endourologists for grading on a variety of metrics (1-5 scale, 5 being best): image quality/resolution, brightness, color quality, sharpness, overall quality, and whether the video was acceptable for diagnostic purposes (yes/no).

Results

Ten patients underwent CVC, ES-F, and ES-A cystoscopy (J.L. or R.V.C.). Six of the 10 patients had CVC videos deemed acceptable for diagnostic purposes and thus were compared with ES. The CVC videos scored higher on every metric relative to both the ES-F and ES-A (p < 0.05). The largest difference noted between CVC and ES videos was brightness (p < 0.0001). ES-F videos trended toward higher ratings than ES-A on all metrics, although none reached statistical significance (p > 0.05); 52% and 44% of the ES-F and ES-A videos, respectively, were considered acceptable for diagnostic purposes (p = 0.384).

Conclusions

The Endockscope mobile cystoscopy system using a fluid irrigant may be a reasonable option in settings where electricity or access to conventional videocystoscopic equipment is unavailable.

Funding

None