F

Lens

ii . 12°, 30°, 70°, 90°, and 120 lenses

0 lens only

Flexibility

None

Maximum deflection in one plane is 180-120

Diathermy

Resection

Upper tract manipulation (e.g., ureteric catheterization or stent insertion) Lithoclast Bladder washout

Biopsy

Electrocautery or laser ablation of small tumors Retrograde pyelography Insertion/removal of ureteric stents

Advantages

Better visualization due to superior optics

Better irrigation flow

Larger working channel

Able to washout the bladder

Manage large bladder tumors

Less discomfort

Does not require sedation or anesthesia Can be performed supine

Flexibility—better visualization of bladder neck

Disadvantages

Usually requires sedation, spinal, or general anesthesia Rigid—can miss bladder neck lesions Usually done in the dorsolithotomy position

Small working channel—biopsies may be inadequate

Unable to wash bladder out

View suboptimal if hematuria

Unable to manage large bladder tumors

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