ArticleBMC urology2026
Reusable vs single-use flexible cystoscopes in outpatient urology: a real-world micro-costing and user evaluation.
Article in BMC urology, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
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Authors and funding
7 authors.
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No grant is acknowledged in the PubMed record.
Abstract
BACKGROUND AND
objectiveFlexible 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.
methodsA 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.
resultsMean 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.
conclusionsIn 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.
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