An Audit on the Safety and Efficiency of Irrigation Fluid Disposal in Urology: Time to Implement Closed Waste Management Systems?

Efficient and safe disposal of irrigation fluid is critical in urological procedures due to high fluid volumes and exposure risks. This audit examines disposal practices using bucket and suction canister systems in a high-volume urology department in the UK and compares the findings with the potential implementation of an automated irrigation waste management system such as the Neptune® 3 (Stryker Corporation, Kalamazoo, Michigan). A retrospective audit of 224 procedures at Cheltenham General Hospital evaluated fluid disposal impacts on staff safety, operating room efficiency, and cost-effectiveness. We found that procedures using high volumes of irrigants, such as transurethral resection of the prostate (TURP) and percutaneous nephrolithotomy (PCNL), are associated with increased risks, including fluid spills, staff exposure to biohazards, and significant use of single-use plastics, resulting in elevated operational costs and frequent procedural interruptions. The Neptune® system proposes significant advantages, such as reducing fluid handling time, staff exposure, and plastic waste. Cost analysis suggests that initial investments in Neptune® would be offset by reduced consumable usage and increased efficiency. These findings support the implementation of closed fluid management systems to improve safety, efficiency, and environmental sustainability in endoscopic urology.