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| Home > Publications database > Reusable vs single-use flexible cystoscopes in outpatient urology: a real-world micro-costing and user evaluation. |
| Home > Publications database > Reusable vs single-use flexible cystoscopes in outpatient urology: a real-world micro-costing and user evaluation. |
| Journal Article | DKFZ-2026-01889 |
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2026
BioMed Central
London
Abstract: 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.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.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.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.
Keyword(s): Cystoscopes: economics (MeSH) ; Humans (MeSH) ; Cystoscopy: economics (MeSH) ; Cystoscopy: instrumentation (MeSH) ; Equipment Reuse: economics (MeSH) ; Ambulatory Care: economics (MeSH) ; Equipment Design (MeSH) ; Germany (MeSH) ; Disposable Equipment: economics (MeSH) ; Urology: economics (MeSH) ; Urology: instrumentation (MeSH) ; Costs and Cost Analysis (MeSH) ; Cost-Benefit Analysis (MeSH) ; Bladder cancer ; Break-even analysis ; Flexible cystoscopy ; Health economics ; Micro-costing ; Reusable devices ; Single-use devices
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