[Evaluation of the operating results and costs associated with the implementation of a flexible ureteroscopy activity within a university hospital center]

Introduction: The increasing use of flexible ureteroscopy (USSR) sets the cost problems inevitably associated with the fragility of these endoscopes. The aim of this work is to clear from a recent example (universitary hospital) results, costs during the implementation of this technique.

Material and methods: This is a retrospective study conducted from December 2012 (date of introduction of the activity) in March 2015 concerning the USSR made in a French universitary hospital for stone disease. In this analysis, the cost of consumables was not evaluated, nor the costs of the operating theater or hospitalization.

Results: One hundred forty-one hundred and thirteen patients USSR were conducted by seven surgeons. Seventeen breakages and failures have been identified and have led to the sending of the endoscope for repair. Breakage rate and failure was 12%. All failures were treated with a standard exchange of the device (including 4 standard exchanges made under warranty). The estimated average cost of outages was 3600 euros. This represents an average cost per procedure of about 625 euros (acquisition plus cost of failures) without counting the costs of sterilization or high-level disinfection. The impossibility of relocating the lower calyx stones is associated with an excess risk of breakage (odd ratio: 2.92 CI95: [1.02; 8.37]).

Conclusion: This study is novel because it focuses on the cost of implementing a technique in a French university hospital. The use of flexible ureteroscope to unique uses might be an interesting source of savings in the implementation of this technique. This remains to be evaluated.

Level of evidence: 5.