Cystoscopy

Emerging Technologies

How Did a Disposable Cystoscope Perform in Detecting Bladder Cancer?

“These scopes were associated with cost reduction, less stent dwell time, less morbidity, and improved patient satisfaction.”

A urology department that performs between 70 and 80 diagnostic flexible cystoscopies each month saw its reusable cystoscopes too often failing leakage tests, resulting in service interruptions and patient appointment delays.

Urologists at a Saudi Arabian hospital decided to study the feasibility of using a new, disposable grasper incorporated flexible cystoscope off-label for diagnosing bladder cancer. At the time of the study, no single-use cystoscope was approved for this use in Saudi Arabia. The scope the urologists used had previously been clinically tested for removing ureteric stents.

The authors concluded the disposable grasper integrated cystoscope is comparable to a reusable cystoscope in detecting bladder cancer.

Between March 2016 and November 2018, 608 cystoscopy procedures were done with the reusable version and 603 cystoscopies were performed with the single-use scope. The reusable cystoscope detected cancer in 95 of 608 procedures (15.6%) and the single-use scope resulted in 88 cancer detections out of 603 (14.4%) cystoscopies. Protocols for surveillance at the authors’ hospital follow American Urological Association guidelines.

A reusable cystoscope was always available in case the urologist performing the procedure was uncomfortable in visualizing the entire bladder, but no session required it.

The hospital has between 15 and 20 reusable flexible cystoscopes in service at a given time and the manufacturer reprocessing instructions for use (IFU) call for sterilization using low heat hydrogen peroxide gas. The IFU’s vigorous reprocessing cycle led to the cystoscope failures and service interruptions, according to the study.

The hospital initially started using the single-use grasper incorporated scopes for J-stent removal. Around this time, the urology department had seen a number of reusable cystoscopes fail, leading to cystoscopy service disruptions. The new, single-use grasper incorporated scopes were “readily available over the shelf” and “met the expectation of simplifying the procedure logistics and moving it from the OR to the office.”

“These scopes were associated with cost reduction, less stent dwell time, less morbidity, and improved patient satisfaction,” the study’s authors wrote.

They documented their findings in Nature, a weekly scientific journal.

There were 549,000 new bladder cancer cases globally in 2018 and 200,000 deaths. Excluding skin cancer, it is the 10th most common cancer worldwide and the second most common cancer of the genitourinary tract only behind prostate cancer.

More Urology Articles
Why You Don't Know What Burnout Is 'Until It Hits You in the Face'
Public Health
Medicine’s culture of perfection leaves physicians susceptible to burnout and depression, a urologic oncology surgeon and life coach says on the Speaking of Urology podcast.
Why Problems with Reprocessing Ureteroscopes ‘Haven’t Gone Away’
Prevention Challenges
In a new webinar, Cori Ofstead tallies the new medical device reports on flexible ureteroscopes filed with the FDA since last spring and suggests quality management programs worth implementing for reprocessing.
More From Single-Use Endoscopy
A survey of infection preventionists found that product IFUs are sometimes unclear

Public Health

Patient safety depends on it, infection preventionists say.

Artificial Intelligence took center stage at DDW 2024

Gastrointestinal Endoscopy Applications

One of the premier gatherings of digestive disease professionals in the world featured more than 400 educational sessions and more than 3,000 research abstracts.

The power of AAMI standards to keep healthcare facilities operating at their best

Patient Safety

So explains Sue Klacik, who has served on AAMI’s standard committees for many years, on the Process This! podcast. It’s not unusual to get 2,000 or 3,000 comments on a proposed standard.