MP17-02 REPAIR RATE AND ASSOCIATED COST OF REUSABLE FLEXIBLE URETEROSCOPES: A SYSTEMATIC REVIEW AND META-ANALYSIS

Abstract

You have accessJournal of UrologyHealth Services Research: Value of Care: Cost and Outcomes Measures I (MP17)1 Sep 2021MP17-02 REPAIR RATE AND ASSOCIATED COST OF REUSABLE FLEXIBLE URETEROSCOPES: A SYSTEMATIC REVIEW AND META-ANALYSIS Dinah Rindorf, Bhaskar Somani, Olivier Traxer, Guido Kamphuis, Thomas Tailly, Sara Larsen, Lotte Ockert, and Kevin Koo Dinah RindorfDinah Rindorf More articles by this author , Bhaskar SomaniBhaskar Somani More articles by this author , Olivier TraxerOlivier Traxer More articles by this author , Guido KamphuisGuido Kamphuis More articles by this author , Thomas TaillyThomas Tailly More articles by this author , Sara LarsenSara Larsen More articles by this author , Lotte OckertLotte Ockert More articles by this author , and Kevin KooKevin Koo More articles by this author View All Author Informationhttps://doi.org/10.1097/JU.0000000000002002.02AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: The refined mechanics of the flexible ureteroscope (fURS) is known to be vulnerable to damage necessitating routine repair. Repair of fURS is costly and makes the device unavailable for clinical use. With the introduction of single-use ureteroscopes, accurate assessment of the resources required for fURS maintenance and repair is especially relevant. The aim of this study was to systematically review available literature and estimate 1) the total weighted repair rate of reusable fURS and 2) the average repair cost per ureteroscopy using meta-analysis. METHODS: A systematic review was conducted by searching the databases MEDLINE, EMBASE, Web of Science and Cochrane library for studies estimating the repair rate of fURS used for ureteroscopy procedures. Study eligibility and data extraction was evaluated by two reviewers independently. Data on average repair cost of all repairs identified in the included studies was extracted if reported. A random-effects model was used to calculate the pooled total repair rate of fURS. The total weighted repair rate and the average cost per repair were multiplied to provide an average cost of repair per ureteroscopy procedure. RESULTS: We identified 15 studies that fulfilled the inclusion criteria, which included 219 repairs from 3,642 investigated ureteroscopy procedures. The calculated weighted repair rate was 5.96%±0.646 (95% confidence interval [Cl]: 4.70% - 7.23%; I2=60.8%), equivalent to 17 ureteroscopy procedures before repair. The average cost per repair was 5,746 USD and according to the weighted repair rate of 5.96%, this corresponds to an average repair cost of 357 USD per procedure. Egger’s regression test did not indicate significant publication bias (Egger’s test p>0.05). A subgroup analysis of the repair rate of major repairs showed a weighted repair rate of 4.52%±2.571 (95% Cl: 2.00% - 7.04%; I2=76.0%). CONCLUSIONS: This is the first meta-analysis to estimate the repair rate of fURS used for ureteroscopy. Our analysis demonstrates a repair rate of 5.96%. This indicates an average of 17 ureteroscopy procedures in between fURS repairs and a repair cost of 357 USD per procedure. High-volume ureteroscopy practices should consider fURS breakage rates and repairs costs to optimize the use of reusable versus disposable devices. Source of Funding: None © 2021 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 206Issue Supplement 3September 2021Page: e308-e308 Advertisement Copyright & Permissions© 2021 by American Urological Association Education and Research, Inc.MetricsAuthor Information Dinah Rindorf More articles by this author Bhaskar Somani More articles by this author Olivier Traxer More articles by this author Guido Kamphuis More articles by this author Thomas Tailly More articles by this author Sara Larsen More articles by this author Lotte Ockert More articles by this author Kevin Koo More articles by this author Expand All Advertisement Loading ...