Reusable vs. single-use cystoscope for removal of double-j stent: a prospective randomized comparison and cost analysis

M. Alkhamees, A. Alothman, M. Alzughaibi, A. AlAsker, Y. Ghazwani, E. Masuadi, I. Alshohayeb, S.B. Hamri

Department of Urology, College of Medicine, Majmaah University, Majmaah, Saudi Arabia. m.alkhamees@mu.edu.sa

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• Urology

OBJECTIVE: Two main types of cystoscopes, reusable cystoscope (RC) and disposable cystoscope, (DC) are used for the removal of ureteric stents. This study aimed to prospectively compare the effectiveness of disposable and reusable cystoscopes for the removal of ureteric stents.

PATIENTS AND METHODS: Patients who recently underwent double-J stent insertion were recruited and randomly assigned to the disposable and reusable cystoscope groups. Data were collected prospectively, which included pain scores (10-point visual analog scale), operation time, complications, and a 5-point Likert scale satisfaction assessment for surgeons, nurses, and patients. A cost analysis was also performed. The association between categorical data was assessed using the Chi-square/Fisher’s exact test. The t-test was used to assess the mean difference in surgery time.

RESULTS: Overall, 128 patients (mean age, 46.8 years) were included in the study; 64 procedures were completed using each cystoscope type. Stent removal satisfaction among surgeons and patients was equivalent in both groups, while nurses favored the disposable cystoscope. A significant reduction of 23% in the procedural time and 27% in the total operative time was observed in the disposable cystoscope group. Pain score was the same for both groups. Two patients in the reusable cystoscope group had UTI. No complications were reported in the disposable cystoscope group.

CONCLUSIONS: Both disposable and reusable cystoscopes are comparable in terms of pain score and surgeons’ and patients’ satisfaction. Disposable cystoscope is more cost effective than reusable cystoscope.

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