OBJECTIVES: In recent years, single-use flexible cystoscopes have become available, offering an alternative to the traditional reusable scope. The most important differentiator between the two is the cost and time associated with reprocessing reusable scopes. The aim of this study was to estimate the cost of performing cystoscopy at a mid-volume, U.S. academic medical center.

METHODS: Data was collected during a two-week period in November of 2019. Data regarding the acquisition and repair costs of reusable cystoscopes were collected retrospectively. For each reusable cystoscope, all repair costs per scope were totaled and divided by the total number of months in service, then extrapolated across a 1-year horizon. Fixed costs associated with consumable items for reprocessing were identified and quantities of items used were calculated following 6 reprocessing cycles. These were similarly extrapolated. Staff costs were included in reprocessing for time spent in handling of scopes. Capital equipment was depreciated over 5-year useful lifespans. Overhead was included by taking 5-20% of the total cost per use of reusable capital, reprocessing, and repairs. Total cost per use was derived by dividing total annual costs by the annual procedure volume of 1,440.

RESULTS: The cost per use to perform cystoscopy at a U.S. academic medical center with reusable flexible cystoscopes including capital equipment, reprocessing and repairs, include the following: capital equipment: $45.01, reprocessing: $35.94, repairs: $63.78, total: $144.73, total with overhead (5-20%): $151.97-$173.67.

CONCLUSIONS: This study found the average costs per use of performing cystoscopy with reusable scopes amounted to: $151.97-$173.67; a 2023 systematic review found an average of $178.28, which is in line with the findings from this study (especially when considering ever increasing costs). Given the differences in capital, repair and processing costs across institutions, each facility should consider their respective inputs when examining a possible conversion to single-use cystoscopes.