Less Is More: Going Green in Urological Procedures

Operating rooms produce significant waste that is disproportionate compared with other departments within health care systems. In this pilot study, we aim to quantify the recyclable and nonrecyclable waste generated by urologic procedures at our institution as well as survey other urologists' recycling practices.

Data were collected from January 2022 to October 2024 for 5 urologic procedures: ureteral stent exchange, ureteroscopy and laser lithotripsy for stone removal, percutaneous nephrolithotomy, robotic-assisted radical prostatectomy, and radical cystectomy. Weight was collected before start of case and at completion and categorized into 2 groups: nonrecyclable solid waste and combined recyclable material. Each procedure had weights collected in 3 separate cases. To survey other hospitals' recycling, a nonvalidated 11-question survey on recycling practices was sent to urologists within the 8 AUA sections.

The average total waste weight in kg (nonrecyclable solid waste/recyclable waste) included stent exchange (1.87/1.2), ureteroscopy and laser lithotripsy for stone removal (3.7/1.0), percutaneous nephrolithotomy (6.5/1.65), robotic-assisted radical prostatectomy (11.3/2.97), and radical cystectomy (11.69/2.67). We received 30 responses to our survey covering all 8 AUA sections. Fourteen of 34 (41.2%) academic hospitals had recycling in the operating room vs 6 of 21 (28.6%) community hospitals; 38.8% felt knowledgeable of the items to recycle and 11.1% received proper training on recycling in the operating room.

This pilot study highlights the waste generated in urology operating rooms, with a significant proportion that is recyclable. This presents an opportunity for intervention with recycling initiatives in the operating room.