PMID- 29073769 OWN - NLM STAT- MEDLINE DCOM- 20180703 LR - 20181202 IS - 1557-900X (Electronic) IS - 0892-7790 (Linking) VI - 31 IP - 12 DP - 2017 Dec TI - Retrospective Cost Analysis of a Single-Center Reusable Flexible Ureterorenoscopy Program: A Comparative Cost Simulation of Disposable fURS as an Alternative. PG - 1226-1230 LID - 10.1089/end.2017.0427 [doi] AB - OBJECTIVE: The increasing number of flexible ureterorenoscopy (fURS) procedures, the fragility of devices, and their growing maintenance and repair costs represent a substantial burden for urologic departments. Disposable single-use fURS devices offer many advantages over reusable fURS. Among them, the LithoVue model shows the best clinical utility. In our study, we assessed the economic aspects of reusable fURS application compared with the potential costs and benefits of single-use fURS (LithoVue). Indications for single-use fURS were proposed based on potential risk factors of reusable fURS damage. MATERIALS AND METHODS: This single-center retrospective analysis compared the actual cost of reusable fURS procedures with the potential costs of LithoVue based on the price offered by the manufacturer. Consecutive case analysis of damaged fURS was performed to determine potential risk factors associated with fURS damage. RESULTS: The study group consisted of 423 reusable fURS procedures conducted between January 2013 and December 2016. During this period, 102 (24.11%) diagnostic fURS and 321 (75.89%) fURS for kidney stone therapy were performed. In 32 of 423 (7.57%) fURS cases, devices were postoperatively deemed defective, 9 of which were used for diagnostic procedures (9/102; 8.82%), 7 for stone removal (7/148; 4.73%), and 16 for stone removal and laser (Ho:YAG) application (16/173; 9.25%). The average cost per reusable fURS procedure was found to be euro503.26. CONCLUSIONS: Disposable fURS is a more expensive option for high-volume centers. Based on our case analysis, laser disintegration treatment of multiple, large stones in the lower kidney pole of recurrent stone formers, as well as a steep infundibulopelvic angle (IPA