Cost-Effectiveness of 90-day Single-use Flexible Cystoscope Trial: Single Center Micro-Costing Analysis and User Satisfaction

Mark A. Assmus, Amy E. Krambeck, Matt S. Lee, Deepak K. Agarwal, Matthew Mellon, Marcelino E. Rivera, Tim Large

Research output: Contribution to journalArticlepeer-review

4 Scopus citations


Objective: To evaluate cost-effectiveness and user satisfaction of a single-use flexible cystoscope at a tertiary care center we conducted a 90-day trial. Single-use flexible cystoscope advancements have introduced alternative options to reusable scopes. However, there is a paucity of cost-effectiveness and provider satisfaction studies examining the implementation of a hospital-based transition to single-use cystoscopes. Methods: Following institutional device-approval we initiated a 90-day trial period (November 1, 2020-January 29, 2021) where all flexible, transurethral, and percutaneous, urologic care was provided with a disposable AMBU aScope. We performed a micro-costing analysis examining payor per case cost of the reusable flexible cystoscope (including servicing and processing) to the disposable units. Provider surveys assessed visual quality, deflection, ease of working channel and overall satisfaction on a 10-point Likert scale. Results: Over the 90-day period, we encountered 84 cases (78 operative, 5 inpatient, 1 emergency department) where flexible cystoscopy was required. One disposable flexible cystoscope was successfully used in 78 of 84 (93%) cases. Of the 6 failures, 2 were due to an inability to access a disposable scope/monitor. Per use cost of the reusable flexible cystoscope at our center was $272.41 versus $185.00 for the single use. Extrapolating our average case volume and conservative failure rate (3 single use failures/month, requiring reusable), transitioning to predominately single use scopes results in $39,142.84 annual cost savings. Conclusions: This single center 90-day trial of disposable flexible cystoscopy identified per-use costs to be less when a single-use flexible cystoscope was utilized at a high-volume tertiary care center.

Original languageEnglish (US)
Pages (from-to)61-66
Number of pages6
StatePublished - Sep 2022

Bibliographical note

Funding Information:
Thank you to AMBU for loaning the mobile single use cystoscope monitors for the duration of our 90-day trial. Financial Disclosure: Amy E. Krambeck: Consultant for Boston Scientific, Ambu, Virtuoso and Lumenis. Data safety monitoring board for Sonomotion; Matthew S. Lee: None; Deepak K. Agarwal: None; Matthew Mellon: None; Marcelino E Rivera: Consultant Boston Scientific, Lumenis; Tim Large: Consultant Boston Scientific, Lumenis. Funding: None to disclose.

Publisher Copyright:
© 2022 Elsevier Inc.


  • Cost-Benefit Analysis
  • Cystoscopes
  • Cystoscopy/methods
  • Equipment Design
  • Humans
  • Personal Satisfaction

PubMed: MeSH publication types

  • Journal Article


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