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Urologic Endoscopic Procedure: Cystoscopic Examination01:28

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Meaning of Cystoscopic Examination:Cystoscopy is an essential diagnostic tool in urology that is used to assess the structure and function of the genitourinary system. It provides a direct view of the urethra, bladder, and, in some cases, the ureteral openings. This procedure helps detect structural abnormalities, infections, cancers, and blockages in the urinary tract. There are two types of cystoscopy:Flexible cystoscopy is commonly performed in outpatient settings due to its less invasive...
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Uroflowmetry is a non-invasive urodynamic test designed to measure various aspects of urination, including volume, flow rate, and the time to void. This test is crucial for diagnosing and assessing conditions such as bladder outlet obstruction, bladder dysfunction, incomplete bladder emptying, incontinence, and urinary tract blockages caused by benign prostatic hyperplasia (BPH) and urethral strictures.Pre-Test Instructions:Before a uroflowmetry test, patients are typically advised to drink...
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Disposable versus Reusable Cystoscopes: A Micro-Costing Value Analysis in High-Volume and Low-Volume Urology

James A Young1, Evan B Garden1, Osama Al-Alao1

  • 1Department of Urology, Icahn School of Medicine at Mount Sinai, New York, New York.

Urology Practice
|May 5, 2023
PubMed
Summary

Reusable cystoscopes are more cost-effective than single-use cystoscopes, especially in high-volume settings. While single-use cystoscopes offer portability, their high initial cost limits their current widespread adoption.

Keywords:
cost-benefit analysiscosts and cost analysiscystoscopesdisposable equipmentequipment and supplieshospital

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Area of Science:

  • Urology
  • Medical Device Technology
  • Health Economics

Background:

  • Disposable single-use cystoscopes offer comparable quality to reusable ones, eliminating reprocessing needs.
  • However, the high cost of single-use cystoscopes remains a significant barrier to adoption.
  • This study compares the cost-effectiveness of single-use and reusable cystoscopes in different clinical settings.

Purpose of the Study:

  • To conduct a micro-costing analysis comparing the Ambu® aScope™ 4 (single-use) and Olympus® CYF-VHR/V2 (reusable) cystoscopes.
  • To evaluate the cost-effectiveness of each device in both high-volume and low-volume urology practices.
  • To determine the break-even point for reusable cystoscope cost-effectiveness.

Main Methods:

  • A micro-costing analysis was performed, including initial purchase price, accessories, sterilization, repairs, and personnel costs.
  • Data from January to December 2019 was collected, recording the number of cystoscopies performed at each center.
  • Costs were amortized over 5 or 10 years and calculated on a per-case basis for annual total cost analysis.

Main Results:

  • In high-volume settings (1,984 procedures), reusable cystoscopy cost $65.98/case vs. $227.18/case for single-use. Reusable became cost-effective after 294 cases.
  • In low-volume settings (245 procedures), reusable cost $232.62/case vs. $461.18/case for single-use. Reusable became cost-effective after 19 cases.
  • Per-case costs significantly favored reusable cystoscopes in both analyzed settings.

Conclusions:

  • Micro-costing analysis indicates reusable cystoscopes are more cost-effective on a per-case basis.
  • The current pricing of single-use cystoscopes may be prohibitive for both large and small facilities.
  • Single-use cystoscopes serve as valuable adjuncts when portability and efficiency are paramount, despite cost considerations.