Healthcare Utilization and Complications Associated With Single-Use Versus Reusable Flexible Cystoscopy in Hospital Outpatient Settings

Purpose Cystoscopy is one of the most commonly performed urologic procedures in the United States, yet comparative outcome data for single-use versus reusable flexible cystoscopes in hospital outpatient settings are limited. This study compared 30‑day healthcare utilization and complications after single-use versus reusable flexible cystoscopy performed in hospital outpatient settings. Methods We performed a retrospective cohort study using the Premier PINC AI Healthcare Database to identify adults who underwent diagnostic cystoscopy in a hospital outpatient setting between January 1, 2022, and August 31, 2024. We compared outcomes of patients who underwent single-use versus reusable flexible cystoscopy. Primary outcomes were 30-day healthcare utilization and complications. Propensity score matching was used to control for demographics, comorbidities, clinical history, and prior healthcare utilization. A predefined subgroup analysis was performed for patients aged 65 years or older. Results Of 62,965 eligible encounters, 1,473 (2.3%) used single-use cystoscopes and 61,492 (97.7%) used reusable cystoscopes. After matching (1:5), 1,473 single-use procedures were compared with 7,365 reusable procedures. Thirty-day healthcare utilization was significantly lower with single-use devices (5.2% vs. 13.0%; hazard ratio (HR)=0.39; 95% confidence interval (95% CI): 0.31, 0.49; p<0.001). The results favored single-use cystoscopes for acute care events (p<0.001), emergency department visits (p=0.03), same-day surgeries (p=0.01), and clinic visits (p<0.001). Complication rates were significantly lower with single-use cystoscopes (1.8% vs. 4.3%; HR=0.40; 95% CI: 0.27, 0.60; p<0.001), as were serious complications (HR=0.63, 95% CI: 0.50, 0.81; p<0.001). The findings were similar in patients aged ≥65 years. Conclusion In hospital outpatient settings, single-use flexible cystoscopes were associated with substantially lower healthcare utilization and complication rates than reusable devices. These results support considering single-use cystoscopes when planning care pathways in hospital-based outpatient care.