Cost analysis of flexible ureterorenoscopy.
OBJECTIVE
To assess the costs of flexible ureterorenoscopy.


METHODS
Data were collected prospectively for 100 cases using a new flexible ureteroscope (DUR8, Circon ACMI, Stamford, USA), including the indications for flexible ureterorenoscopy, use of laser probes, disposable instrumentation, and the cost and timing of ureteroscope repair.


RESULTS
Of the 100 procedures 68 were for stone disease, 21 for known or suspected transitional cell carcinoma (TCC), six were diagnostic only and five were for pelvi-ureteric junction obstruction. The ureteroscope was repaired after the 29th and 88th cases. The ability of the ureteroscope to deflect was maintained throughout. At the time of purchase the ureteroscope was listed at pound 15 000 and each repair/exchange currently costs pound 4200, thus the total expenditure on the ureteroscope was pound 23 400. Total expenditure on ancillary equipment was pound 28 727, of which pound 22 927 was on disposables and pound 5800 on 10 laser probes.


CONCLUSIONS
In this series the costs of the ancillary equipment exceeded the purchase and maintenance of the ureteroscope, and we expect this trend to continue in the long term. The advent of more durable ureteroscopes may ultimately reduce the frequency of costly repairs. The cost of disposables should be considered in planning the budget.
Collins
J W
JW
Bristol Urological Institute, Southmead Hospital, Bristol, UK.
Keeley
F X
FX
Timoney
A
A
D002295:Carcinoma, Transitional Cell / Q000175:diagnosis / Q000191:economics; D003362:Cost-Benefit Analysis; D004209:Disposable Equipment / Q000191:economics; D006801:Humans; D007680:Kidney Neoplasms / Q000175:diagnosis; D011446:Prospective Studies; D014514:Ureteral Calculi / Q000175:diagnosis / Q000191:economics*; D014516:Ureteral Neoplasms / Q000175:diagnosis / Q000191:economics; D018666:Ureteroscopy / Q000191:economics*