aScope 4 Cysto Supporting Evidence
There are many reasons why choosing a single-use cystoscope is beneficial — to the clinician, to the practice and, ultimately, to the patient. Our aScope™ 4 Cysto Evidence Dossier explores the many health outcomes such as improved workflow, health economics, sustainability, and more. Open one of the sections below to review full text and abstracts with links to their initial publication and research.
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Improved Workflow
The Impact of Single-Use Cystoscopes on Clinical Time Workflow in an Outpatient Setting
Medairos et al.
This single-center prospective study in an outpatient urolgoy clinic compared clinical workflow time when utilizing reusable flexible cystoscopes versus single-use cystoscopes. By eliminating cystoscope precleaning, transportation and reprocessing tasks, the average total encounter time dropped 22 minutes (34%). The facility was able to increase the number of patients they could see in a given day from 12, to 21.
2024
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Prospective Randomized Trial of Single-Use vs Reusable Cystoscope for Ureteral Stent Removal
Johnson et al.
The Ambu aScope 4 Cysto was comparable in procedural success versus standard resuable flexible cystoscopes and physician satisfaction, but with signficant time savings per procedure.
2023
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Direct to cystoscopy: A prospective quality assessment of patient preferences
Assmus et al.
Single-use cystoscopes enable a facility to perform cystoscopies in office and clinic setting without requiring OR time. Patients prefer to go directly to a cystoscopy procedure rather than conudcting a consultation beforehand.
2020
Comparison of ureteric stent removal procedures using reusable and single-use flexible cystoscopes following ureteroscopy and lasertripsy: a micro-cost analysis
Pietropaolo et al.
Shifting stent removal procedures to the outpatient clinic with single-use cystoscopes saved time and improved patient outcomes compared to stent removal procedures in the endoscopy room with reusable cystoscopes. This workflow shift results in decreased procedure time compared to reusable cystoscopy, reduced stent dwell time, and improved the rate of stent encrustation. Reusable cystoscope stent removal saw 14% of patient develop stent encrustation, compared to no stent encrustation in the single-use stent removal.
2020
Cost-effectiveness analysis of a single-use digital flexible cystoscope for double J removal
Oderda et al.
Shifting stent removal procedures to consultation rooms or the clinic environment through the introduction of single-use cystoscopes has time and financial advantages. Following 127 consecutive double-J stent removals, investigators found a signficant cost-savings per procedure by shifting to consultation rooms, and saved 64 hours of OR room time.
2019
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Prospective trial of single-use, flexible cystoscope for ureteric double-J stent removal: Cost and utility analysis
Donato et al.
Single-use cystoscopes were introduced to this facility in order to shift procedures to consultation rooms and away from the OR. In doing so, the facility was able to reduced reusable cystoscope repair rates and costs, while freeing up 65 elective surgery spaces in the OR.
2019
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Office-based ureteric stent removal is achievable, improves clinical flexibility and quality of care, whilst also keeping surgeons close to their patients
Baston et al.
Single-use cystoscopes enabled the investigators to transfer cystoscopic stent removals to the office and clinic environment. In doing so, the excess dwell time was significantly reduced for patients by performing removals in the new setting, which subsequently lead to a reduction in patient complications.
2018
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Efficiency and User Satisfaction of Single-Use vs Reusable Cystoscopes in a High-Volume Urology Clinic
Butaney et al.
A high-volume urology clinic evaluated the differences in workflow efficiency and user satisfaction between single-use and reusable cystoscopes. Single-use cystoscopes saved 7:40 min. of staff time per procedure compared to reusable cystoscopes, and received an excellent rating across all quality measures by providers.
2023
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Workflow Efficiencies for Flexible Cystoscopy: Comparing Single-Use vs Reusable Cystoscopes
Haislip et al.
Single-use cystoscopy reduced the time required for preparation, set up, and breakdown compared to reusables. The total time saved by utilizing single-use was 2' 31" per cystoscope.
2023
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Time Efficiency and Performance of Disposable versus Reusable Cystoscopes: A Prospective, Randomized Benchtop Comparison
Baas et al.
Disposable cystoscopes were faster to assemble and disassemble for procedures, and had better image quality and greater deflection compared to reusable cystoscopes.
2022
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Single-Use Disposable Flexible Cystoscopes: Implementation in a Mobile Bedside Portable Cystoscopy Service
Yeap et al.
The introduction of portable single-use cystoscopes enabled this facility to bring cystoscopies to the bedside for high-risk patients, reducing the need for patient transfer, inpatient stay, and OR usage.
2022
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Impact of Double-J Stent Removal With a Single Use Cystoscope Dedicated to this Procedure: A cost Analysis
Doizi et al.
By introducing single-use cystoscopes for double-J stent removal, procedures were moved from the OR to consultation rooms. Reducing OR usage saved time and and reduced costs for this institution.
2018
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Health Economics
The Cost of Reusable Cystoscopy: A Microcosting Evaluation at a U.S. Academic Medical Center
Hassig et al.
This single-center microcosting evaluation at a U.S. academic hospital reviewed retrospective purchasing and repair data, while following reusable scopes through reprocessing over a two-week period in 2019. The total cost to perform cystoscopy with reusable scopes amounted to $144.73 in 2019 USD. When considering inflation and additional overhead costs in 2024, the total cost amounted to $173.67.
2024
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Cost-Effectiveness of 90-day Single-use Flexible Cystoscope Trial: Single Center Micro-Costing Analysis and User Satisfaction
Assmus et al.
A 90-day trial of single-use flexible cystoscopes identified a per use cost of $272.41 for reusable flexible cystoscopes compared to $185.00 for single-use, resulting in $39,142 in annual cost-savings.
2022
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Micro-cost analysis of single-use vs. reusable cystoscopy in a single-payer healthcare system
Kim et al.
The cost-effectiveness of single-use cystoscopes was found to be dependent on cystoscopy annual volume. Single-use cystoscopes are more cost-effective if the total number of cases performed is less than 1,265 per year.
2022
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A micro-costing analysis of outpatient flexible cystoscopy: implications for adoption of single-use flexible cystoscopes
Su et al.
To evaluate the total cost of reusable flexible cystoscopy, cost data pertaining to capital purchases, repairs and maintenance, and reprocessing were collected. To estimate the cost per procedure across different facilities, the investigators modeled costs across a range of annual cystoscopy volumes and cystoscope fleet sizes to determine total cost per use.
2021
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Disposable versus Reusable Cystoscopes: A Micro-Costing value Analysis in High-Volume and Low-Volume Urology Practices
Young et al.
A micro-costing approach was used to determine the cost per cystoscopy with reusable flexible cystoscopes at high- and low-volume clinics. Cost data included original purchasing price of reusable cystoscopes, accessory equipment costs, sterilization supplies, repairs costs, and personnel labor.
2021
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Outcomes and Cost Evaluation Related to a Single-Use, Disposable Ureteric Stent Removal System: a Systematic Review of the Literature
Hughes et al.
Disposable single-use cystoscopes provide a cost benefit when performing procedures in the clinic or outpatient based setting. Disposable cystoscopes offer greater flexibility compared to reusable cystoscopes, and are at their most useful in low-volume centers or high-volume centers where there is a significant demand on endoscopy resources.
2021
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The Economics of Cystoscopy: A Microcost Analysis
Kenigsberg et al.
Reusable cystoscopy requires a considerable investment in capital equipment, maintenance, labor, and supplies. The cost to perform cystoscopy is highly dependent on the annual procedure volume of cystoscopies performed for each reusable cystoscope and the method of reprocessing at the given site.
2021
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Single-Use Grasper Integrated Flexible Cystoscope for Stent Removal: A Micro-Costing Analysis-Based Comparison
Beebe et al.
The total cost per use to perform stent removal is highly dependent upon annual procedure volumes. Lower volume stent removal centers may find single-use cystoscopes more cost beneficial than a reusable system.
2020
Micro-Costing Analysis Demonstrates Comparable Costs for LithoVue Compared to Reusable Flexible Fiberoptic Ureteroscopes
Taguchi et al.
Sterilizing reusable urological endoscopes can be costly and time consuming. Sterilization of urological endoscopes amounted to $107.27 per cycle, for labor and consumables during each cycle.
2018
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The Cost of Reusable Cystoscopy in the US: A Systematic Review
Haislip et al.
The cost to perform cystoscopy in the U.S. varies signifcantly by facility and setting. This systematic review aimed to capture the most recent cystoscopy cost-analyses performed in the U.S., and identified a total cost per use of $185.53 for reusable cystoscopes.
2023
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Outcomes, Contamination and Infection
High-level Disinfection Evaluation in the Ambulatory Setting
Montero et al.
An investigation was performed on the HLD process performed at an outpatient urology practice after expired chemical test strips were identified in use. Various breaches in protocol were identified in the reprocessing of reusable flexible cystoscopes including lack of staff training and documentation, availability of appropriate supplies, and inappropriate hand hygiene and use of PPE.
2023
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The Utility of Lighted Magnification and Borescopes for Visual Inspection of Flexible Endoscopes
Ofstead et al.
New endoscope reprocessing standards and guidelines state that reusable endoscopes should be visually inspected after every use. Visual inspection with lighted magnification and borescopes identified visible damage and residue or debris in 100% of the reusable endoscopes examined. Of these reusable endoscopes, 76% required repair.
2023
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Post-cystoscopy infections and device malfunctions in reprocessed flexible cystoscopes in a national database
Lee et al.
The FDA Manufacturer and User Facility Device Experience (MAUDE) database houses reports for adverse events and malfunctions related to medical devices. A query of the MAUDE database for reports related to reusable flexible cystoscopes between January 2015 and December 2020 identified 335 adverse events. Included in the adverse events were patient harm caused by infection, mechanical malfunction, and allergic reaction.
2022
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Comparison of ureteric stent removal procedures using reusable and single-use flexible cystoscopes following ureteroscopy and lasertripsy: a micro-cost analysis
Pietropaolo et al.
Shifting stent removal procedures to the outpatient clinic with single-use cystoscopes saved time and improved patient outcomes compared to stent removal procedures in the endoscopy room with reusable cystoscopes. This workflow shift results in decreased procedure time compared to reusable cystoscopy, reduced stent dwell time, and improved the rate of stent encrustation. Reusable cystoscope stent removal saw 14% of patient develop stent encrustation, compared to no stent encrustation in the single-use stent removal.
2020
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An outbreak of Pseudomonas aeruginosa urinary tract infections following outpatient flexible cystoscopy
Sorbets et al.
An outbreak of Pseudomonas aeruginosa UTIs was identified in a group of patients following cystoscopies. The investigation identified a damaged cystoscope with contamination by P. aeruginosa.
2019
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Conversion to Disposable Cystoscopes Decreased Post-Procedure Encounters and Infections Compared to Reusable Cystoscopes
Geldmaker, L.
Challenges with reprocessing or sterilizing reusable endoscopes and surgical equipment is well documented. This investigation looked into post-procedure encounters and infections after fully converting to single-use cystoscopes and compared to the previous annual rate of encounters and infections with the reusable cystoscopes. Single-use cystoscopes reduced the number of encounters, urine cultures, and positive urine cultures compared to reusable cystoscopy.
2023
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Outbreak of urinary tract infections by Salmonella spp. After cystoscopic manipulation
Jimeno et al.
Performing urine cultures before procedures or administering prophylaxis is determined by the risk factors for UTI. An unusual aggregation of Salmonella spp. isolates were identified in urine cultures within a short period of time. All of the identified patients had undergone cystoscopy.
2016
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Sustainability
Environmental Impact of Flexible Cystoscopy: A Comparative Analysis Between Carbon Footprint of Isiris Single-use Cystoscope and Reusable Flexible Cystoscope and a Systematic Review of Literature
Jahrreiss et al.
This systematic review was conducted in conjunction with a direct comparison of the Isiris® single-use cystoscope and reusables, and found that total carbon emissions for single-use cystoscopes ranged between 2.06-2.41kg of carbon dioxide per use. Conversely, the total carbon emissions for reusable cystsocopes ranged from 0.53-4.23kg of carbon dioxide per use, noting that published research tend toward a lower environmental impact of single-use, despite noting the disparate results across publications.
2024
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Carbon Footprinting and Sustainability Impact Assessment in Urological Surgical Practice - A Systematic Review
Wani et al.
This systematic review was performed following PRISMA guidelines covering publications from 1971 to 2023. Single-use cystopscopes were noted to be non-inferior environmentally to reusable cystoscopes due to the carbon footprint of reusable scope decontamination and repackaging.
2024
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Environmental Impact of Current Endoscopic Technology in Urological Procedures: A Systematic Review on Reusable vs. Disposable Scopes
Peyrottes et al.
A review of relevant publications through January 2024 found that single-use cystoscopy resulted in decreased waste mass and water consumption compared to reusable scopes, with the primary discrepancy noted in regards to reprocessing methods. Life-cycle assessments did not conclusively highlight superiority for single-use cystoscopes, but found more comparable results between the two types of scopes.
2024
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Institutional Micro-Cost Comparative Analysis of Reusable vs Single-use Cystoscopes with Assessment of Environmental Footprint
Bertolo et al.
This single-center investigation compared the costs to perform cystsoscopy and total amount of water use and waste generation, for both reusable and single-use cystoscopes. The invesitagation found that reusable cystoscopes consumed 60L of water and generated 6Kg of waste, per procedure. Single-use cystoscopes consumed no water per procedure and generated only 3.5Kg of waste, per procedure.
2024
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Life Cycle Assessment of Reusable and Disposable Cystoscopes: A Path to Greener Urological Procedures
Baboudjian, M., Pradere, B., Martin, N., et al.
The environmental impact of reusable flexible cystoscopes and disposable cystoscopes was examined through life cycle assessments of both devices. The use of disposable cystoscopes would allow for a reduction of the environmental footprint compared to reprocessing reusable cystoscopes alone.
2022
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Environmental Impact of Single-use and Reusable Flexible Cystoscopes
Kemble, JP., Winoker, J., Patel, S., et al.
Evaluation of the carbon footprint and environmental impact of single-use and reusable flexible cystoscopes at a high-volume center. This life cycle analysis found a greater environmental impact for single-use cystoscopes compared to reusable flexible cystoscopes.
2022
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The Carbon Footprint of Single-Use Flexible Cystoscopes Compared with Reusable Cystoscopes
Hogan, D., Rauf, H., Kinnear, N., Hennessey, DB.
A comparison of the carbon footprint of single-use cystoscopes versus reusable flexible cystoscopes based on waste production and carbon emissions. Disposable flexible cystoscopes had a significantly lower impact on the environment in terms of carbon emissions and landfill waste compared to reusable cystoscopes.
2022
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Cost and Environmental Impact of Disposable Flexible Cystoscopes Compared to Reusable Devices
Boucheron, T., Lechevallier, E., Gondran-Tellier, B., et al.
The environmental impact and costs associated with cystoscopy was examined with particular focus on disposable and reusable cystoscopes. Upon implementing disposable cystoscopes for 100% of procedures, this facility was able to reduce waste generation and water consumption compared to use of reusable flexible cystoscopes.
2022
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Product Performance
Clinical Utility of a Single-Use Flexible Cystoscope Compared with a Standard Reusable Device: A Randomized Noninferiority Study
Holmes et al.
The Ambu aScope 4 Cysto is noninferior to standard reusable flexible cystoscopes in terms of procedure completion, light quality, image quality and maneuverability.
2023
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Evolution of Single-Use Urologic Endoscopy: Benchtop and Initial Clinical Assessment of a New Single-Use Flexible Cystoscope
Whelan, P., Kim, C., Tabib, C., et al.
Single-use cystoscope benchtop and initial clinical assessment in an academic office setting. The Ambu aScope 4 Cysto demonstrated good flexibility across instruments with comparable optics to reusable cystoscopes. Inpatient bedside cystoscopy with aScope 4 and monitor system compared favorably to reusable cystoscopes.
2021
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The First UK Experience with Single-use Disposable Flexible Cystoscopes: An in-depth Cost Analysis, Service Delivery and Patient Satisfaction Rate with Ambu aScope 4 Cysto
Wong, A., Phan, YC., Thursby, H., Mahmalji, W.
The first hospital in the UK trialed the Ambu aScope 4 Cysto and conducted a survey among patients to assess overall satisfaction. 95% of patients surveyed preferred to have cystoscopy performed with single-use cystoscopes.
2021
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Market Readiness for Single-Use Cystoscopes According to Urologists and Procurement Managers Worldwide
Rindorf, D., Larsen, S., Ockert, L., et al.
This study aimed to identify the readiness of urologists to utilize single-use cystoscopes. As awareness around single-use endoscopes continues to rise, urologists voiced their input on what is driving adoption and attractiveness to single-use endoscopes, including their portability, sterility, and cost-transparency.
2021
Download Evidence Dossier
See published peer-reviewed studies on health economics, organizational impact and infection control related to the aScope 4 Cysto single-use cystoscope.
