Presentation (CTI)

OBJECTIVES: Cystourethroscopy is a minimally invasive procedure to diagnose and treat abnormalities in the urethra and bladder. Reusable devices are standard practice, but infection risks and opportunities to improve facility workflows have prompted interest in single use alternatives. This study compares infections and antibiotic use following cystourethroscopy in hospital outpatient (OP) and ambulatory surgery center (ASC) settings.
METHODS: CMS Institutional and IQVIA claims and prescription data with index procedures in 2024 were analyzed at 10 and 30-days post procedure. Procedures were identified using CPT codes for cystourethroscopy. Device type was inferred from the presence of C1747 (single use) versus absence (reusable). Urinary tract infection (UTI), sepsis and other infections were defined by ICD-10 diagnosis codes. Antibiotic use was measured based on national drug codes.
RESULTS: IQVIA medical claims captured 577,348 procedures (4.2% single use, 31% in ASC). CMS Institutional claims captured 169,682 Hospital OP procedures (9.4% single use). UTI rates were consistently lower for single use scopes at all timepoints and care settings in both datasets. In CMS data, UTI rates were 9.9% (single use) vs. 13.6% (reusable) at 10 days and 14.9% (single use) vs. 18.7% (reusable) at 30 days. ASC settings exhibited lower UTI rates than Hospital OP settings for both device types (e.g., Hospital OP single use 11.2% vs ASC single use 7.0%). Sepsis rates were low (4.7% or less at 30 days) with lower rates observed for single use scopes in Hospital OP settings. Antibiotic prescriptions were higher in Hospital OP settings (IQVIA OP: 77.9% single use vs 65.9% reusable; IQVIA ASC: 44.7% single use vs 39.9% reusable).
CONCLUSIONS: Single use cystourethroscopy devices were associated with lower infection rates compared to reusable devices and ASC settings demonstrated lower UTI rates than Hospital OP settings. Antibiotic usage varied by care setting and did not correlate with infection rates.