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UPJ INSIGHT Conversion to Disposable Cystoscopes Decreased Post-procedure Encounters and Infections
By: Laura E. Geldmaker, BS, Mayo Clinic, Jacksonville, Florida; Bryce A. Baird, MD, Mayo Clinic, Jacksonville, Florida; Timothy D. Lyon, MD, Mayo Clinic, Jacksonville, Florida; Eric J. Regele, MD, Mayo Clinic, Jacksonville, Florida; Ethan J. Wajswol, MD, Mayo Clinic, Jacksonville, Florida; Ram A. Pathak, MD, Mayo Clinic, Jacksonville, Florida; Steven P. Petrou, MD, Mayo Clinic, Jacksonville, Florida; Daniela A. Haehn, MD, Mayo Clinic, Jacksonville, Florida; Nikunj M. Gajarawala, PA-C, Mayo Clinic, Jacksonville, Florida; Colleen T. Ball, MS, Mayo Clinic, Jacksonville, Florida; Gregory A. Broderick, MD, Mayo Clinic, Jacksonville, Florida; David D. Thiel, MD, Mayo Clinic, Jacksonville, Florida | Posted on: 30 Aug 2023
Geldmaker LE, Baird BA, Lyon TD, et al. Conversion to disposable cystoscopes decreased post-procedure encounters and infections compared to reusable cystoscopes. Urol Pract. 2023;10(4):312-317.
Study Need and Importance
With concerns developing over transmissible infectious diseases, the need for disposable medical equipment has heightened. Our practice evaluated the impact of converting office cystoscopy over to disposable cystoscopes on post-procedure encounters and infections compared to reusable cystoscopes.
What We Found
Our study revealed a substantial decrease in the number of encounters and infections 30 days after cystoscopy when a disposable cystoscope is used vs a reusable cystoscope (see Table).
Table. Association of Scope Type (Reusable vs Disposable) With Encounters, Cultures, and Hospitalizations Within 30 Days After Cystoscopy
| Outcomes 30 d post-cystoscopy | Reusable scope (N=494), No. (%) | Disposable scope (N=506), No. (%) | Unadjusted analysis | PS-weighted analysis | ||
|---|---|---|---|---|---|---|
| RR (95% CI) | P value | RR (95% CI) | P value | |||
| Encounter (phone call, ER visit, or clinic visit) | 35 (7.1) | 11 (2.2) | 3.26 (1.67-6.34) | < .001 | 3.47 (1.70-7.08) | < .001 |
| Urine culture | 73 (14.8) | 3 (0.6) | 24.92 (7.91-78.55) | .005 | 29.64 (7.91-111) | < .001 |
| Positive urine culture | 17 (3.4) | 1 (0.2) | 17.41 (2.33-130) | < .001 | 95.46 (8.68-1,050) | < .001 |
| Hospitalization for urinary tract infection | 1 (0.2) | 0 (0.0) | .49 | |||
| Abbreviations: CI, confidence interval; ER, emergency room; PS, propensity score; RR, relative risk. Only 1 patient was hospitalized for urinary tract infection; therefore, relative risks were not estimated, and the P value results from Fisher’s exact test. |
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Limitations
This is a retrospective review.
Interpretation for Patient Care
Our findings establish groundwork for future studies regarding disposable cystoscopes in urology. This influences patient care by potentially decreasing the number of post-procedure encounters as well as lowering overall infection rates.
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