Prospective trial of single-use, flexible cystoscope for ureteric double-J stent removal: cost and utility analysis

Objective: The objective of this study is to evaluate the costs and benefits of Isiris (Coloplast, Denmark), a mobile, single-use, flexible cystoscope with a built-in stent grasper. Methods: A prospectively collected database was reviewed to define procedural outcomes for Isiris ureteric stent removal. Variables assessed included stent duration and location of removal. A cost assessment was performed evaluating the impact on costs, funding and facility use. Results: Seventy-five procedures were performed using Isiris between April and September 2017. There were no complications. Two procedures failed because of encrustation and poor visibility secondary to haematuria. The mean (SD), median (interquartile range) and range of delay were 2.1 (0–5.3), 0 (0–2) and 0–40 days, respectively. Only one patient was delayed more than two weeks; this occurred because he was placed on a theatre waiting list, which resulted in the 40-day delay. Overall, the cost benefit for our department with the introduction of the Isiris system has been a surplus of $104,434, with an extra 65 elective spaces free for diagnostic flexible cystoscopy cases. Conclusion: Isiris flexible stent removal offers our patients a rapid stent-removal service with low rates of removal delay. Savings have been made in scope repair costs, sterilisation and scope maintenance, as well as optimisation of theatre and procedure room space. Level of evidence: 1c