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Background and objective <p>Flexible cystoscopy is integral to outpatient urology, particularly for surveillance of non–muscle-invasive bladder cancer. Real-world economic data comparing reusable (RU) and single-use (SU) cystoscopes in German outpatient practice are scarce. We evaluated procedure-level costs and multidisciplinary user perceptions under routine conditions.</p> Methods <p>A micro-costing analysis was performed in a German outpatient urology centre (337 cystoscopies/year). Capital investment (5-year amortisation), maintenance, reprocessing, consumables, and labour were included. Baseline and full-equipment replacement scenarios were modelled, and break-even thresholds calculated. A standardised survey of 13 physicians and 25 nursing staff from five practices assessed technical performance and workflow domains (5-point Likert scale). Groups were compared using Mann–Whitney U tests with Cliff’s delta.</p> Results <p>Mean per-procedure cost was €27.25 for RU and €179.00 for SU. RU became cost-effective beyond 67 procedures annually; this threshold increased to 265 procedures when modelling full equipment renewal (€43,050). Physicians rated RU superior for manoeuvrability (<i>p</i> = 0.02) and SU superior for logistics (<i>p</i> = 0.02), with no differences in image quality, ergonomics, diagnostic confidence, or overall impression. Nursing staff favoured SU across all domains (all <i>p</i> &lt; 0.001), particularly reprocessing workload and reliability. Limitations include single-centre design, evaluation of one device per category, context-specific reimbursement structures, and absence of primary environmental or patient-reported outcomes.</p> Conclusions <p>In high-volume outpatient settings, RU cystoscopes are economically advantageous. However, SU devices offer substantial workflow benefits. Device selection should be context-specific, integrating case volume, infrastructure, and multidisciplinary perspectives.</p>

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Reusable vs single-use flexible cystoscopes in outpatient urology: a real-world micro-costing and user evaluation

  • 期刊论文

  • 出版模式：

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  • 发表日期：

    2026年7月28日

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  • Felix Seelemeyer,
  • Rouvier Al-Monajjed,
  • Jan Philipp Radtke,
  • Stephan Nüesch,
  • Jan Herden,
  • Sassan Nazari,
  • Ruben Gößmann

摘要

Background and objective

Flexible cystoscopy is integral to outpatient urology, particularly for surveillance of non–muscle-invasive bladder cancer. Real-world economic data comparing reusable (RU) and single-use (SU) cystoscopes in German outpatient practice are scarce. We evaluated procedure-level costs and multidisciplinary user perceptions under routine conditions.

Methods

A micro-costing analysis was performed in a German outpatient urology centre (337 cystoscopies/year). Capital investment (5-year amortisation), maintenance, reprocessing, consumables, and labour were included. Baseline and full-equipment replacement scenarios were modelled, and break-even thresholds calculated. A standardised survey of 13 physicians and 25 nursing staff from five practices assessed technical performance and workflow domains (5-point Likert scale). Groups were compared using Mann–Whitney U tests with Cliff’s delta.

Results

Mean per-procedure cost was €27.25 for RU and €179.00 for SU. RU became cost-effective beyond 67 procedures annually; this threshold increased to 265 procedures when modelling full equipment renewal (€43,050). Physicians rated RU superior for manoeuvrability (p = 0.02) and SU superior for logistics (p = 0.02), with no differences in image quality, ergonomics, diagnostic confidence, or overall impression. Nursing staff favoured SU across all domains (all p < 0.001), particularly reprocessing workload and reliability. Limitations include single-centre design, evaluation of one device per category, context-specific reimbursement structures, and absence of primary environmental or patient-reported outcomes.

Conclusions

In high-volume outpatient settings, RU cystoscopes are economically advantageous. However, SU devices offer substantial workflow benefits. Device selection should be context-specific, integrating case volume, infrastructure, and multidisciplinary perspectives.