OBJECTIVES: Flexible ureteroscopes are among the most delicate endoscopes – they are used for examining the kidney and ureter and are also utilized to treat kidney stones. Small size results in flexible ureteroscopes being susceptible to damage from instrumentation and also results in their classification as high-risk endoscopes for the purpose of reprocessing. Recently, single-use digital flexible ureteroscope have been introduced to address these challenges. Organizations must consider the cost of single-use devices against the costs associated with reusable devices. An analysis was performed to advise organizations on the various costs associated with reusable flexible ureteroscopes.

METHODS: A comprehensive literature review of the various costs associated with reusable ureteroscopes was undertaken. When available, the findings of systematic reviews and meta-analyses were employed, and when not, the median values from the data provided by multiple studies were utilized. The costs analyzed included the amortized cost of the reusable ureteroscope, reprocessing costs, repair costs, incremental operating room time, and the incremental cost associated with postoperative infections.

RESULTS: In the base case analysis, the per-case cost for utilizing a reusable flexible ureteroscope was found to be $1,787: amortized cost of the ureteroscope-$50 (systematic review and 3 studies), reprocessing cost-$107 (3 studies), repair cost-$441 (meta-analysis of 18 studies), cost of incremental OR time-$619 (4 studies), cost of incremental postoperative infections-$570 (2 studies).

CONCLUSIONS: Organizations should consider this analysis and adjust parameters based on their costs, history, and experience with reusable flexible ureteroscopes. Those customized, facility-specific findings may advise on the selection of single-use digital flexible ureteroscope for all ureteroscopy procedures or for use in select, high-risk procedures.