Presentation Authors: Michael Sourial*, Bodo Knudsen, Columbus, OH
Introduction: A single-use flexible cystoscope with integrated grasper (Isiris, Coloplast, Denmark) has recently become commercially available. The objective of this study was to compare the costs of stent removal in an outpatient clinical environment between the single-use Isiris system (Coloplast, Denmark) to our existing approach using a reusable cystoscope and stent grasper.
Methods: The number of stent removal procedures at our tertiary center was recorded as a proportion of all cystoscopic procedures performed between February 2016 and February 2017. Elements included in the micro-cost assessment included: the original purchasing price of an Olympus digital reusable cystoscope, repair fee (based on a one year contract), sterilization equipment and accessory costs, reprocessing costs of the cystoscope, and labor costs. Costs were estimated on a per-use basis. This was compared to the purchasing price of Isiris.
Results: A total of 1775 cystoscopic procedures were performed, and the reusable cystoscope was used for stent removal in 871 cases. The per-use cost for stent removal procedures using the reusable cystoscope was estimated to be $161.85. The per-use purchasing price for the Isiris device is $200. After 704 stent pulls, micro-costing analysis appears to favor the reusable cystoscope compared to the disposable.
Conclusions: Based on this micro-cost analysis, per-use costs appear to favor the reusable cystoscope for stent removal. It appears that centers with high volumes of stent pulls may find the reusable cystoscope and stent grasper more cost-beneficial than the single-use system. Further study addressing performance and convenience of single-use system is needed.