Reusable vs. single use cystoscope: economic & environmental assessment.

Purpose: To introduce a scalable methodology for assessing the economic and environmental impacts of reusable versus single-use devices, with a novel approach of processing reusable devices through low-temperature sterilization (LTS) (STERRAD®).

Methods: The economic analysis used micro-costing techniques while carbon footprint was calculated with two different methods: "UO Sté method" derived from Deschavannes et al. (2021) and an ISO 14040/14044 Life Cycle Assessment (LCA) of the sterilization of the reusable device performed with OPENLCA v2.4.0 software and ELCD v3.2 free database. The uncertainty analysis was performed with a Monte Carlo analysis. These methods were applied to a case study from cystoscopes procedures performed (2023).

Results: Our LCA study indicates an annual reduction of 582.4 kg CO₂ equivalent (-14.5%) in favor of reusable devices. Regarding the economic impact, more specific to our case study, the findings suggest an annual cost savings of €108,484, (-29%). It is important to note that the analysis is based on an "in-house" LCA model. Additionally, this study provides an objective comparison without considering logistical challenges, personnel requirements, or implementation costs of reusable devices. It does not substitute the collaborative medical and paramedical judgment of a urology department.

Conclusions: LTS of reusable cystoscopes seems to have a significant decrease of the environmental footprint and economic impact.