A Prospective, Comparative Evaluation of Single-Use Versus Reusable Flexible Cystoscopes for Diagnostic Cystoscopy: Operator and Patient Perspectives

Abstract

Cystoscopy is a cornerstone diagnostic procedure in urology, especially for diagnosing and monitoring various bladder pathologies, including urothelial tumours and haematuria of unknown origin. Recently, advancements in endoscopic technology have introduced single-use flexible cystoscopies (SU-FC) as an alternative to traditional reusable flexible cystoscopies (R-FC), potentially simplifying workflow and reducing infection risk compared with reusable scopes. This prospective study aims to compare patient- and operator-reported outcomes, including comfort, pain levels, image quality and overall satisfaction when employing single-use versus reusable flexible cystoscopes. From October to December 2023, a single-centre study was conducted, enrolling 200 patients undergoing diagnostic flexible cystoscopy, 10 urologists and 10 urologic scrub nurses. Standardized questionnaires, adapted from validated instruments, were used to collect data on perceived pain (Visual Analogue Scale), device performance, image quality and operator satisfaction. Statistical analyses (Wilcoxon rank-sum, Fisher's exact) tested for significant differences between SU-FC and R-FC. Of the 200 patients, 100 underwent cystoscopy using SU-FC and 100 with R-FC. Patients in the single-use group reported significantly lower or milder pain (p = 0.0112) and higher satisfaction distributions (p < 0.0001). Operator assessments (physicians and nurses) indicated higher satisfaction with single-use devices in terms of image clarity, navigation and instrument performance (p < 0.0001). SU-FC confer notable benefits for both patients and healthcare professionals, including reduced pain, superior image quality and enhanced workflow. These findings support the broader investigation of disposable cystoscopy in routine practice while urging cost-effectiveness and sustainability evaluations.