Introduction: While reusable cystoscopes (RCs) are commonly used for urologic procedures, bulky equipment and lengthy sterilization times can impact efficiency. Disposable cystoscopes (DCs) may offer advantages including increased availability, greater portability, and faster setup times. The aim of this study is to compare procedure times, cystoscope specifications, and physician satisfaction between RCs and DCs. Methods: Ten urologists performed simulated bedside cystoscopies using a prospective, randomized, crossover study design. A 3D-printed bladder model with 22 target letters was positioned within a female mannequin pelvis. Each subject used both a new disposable Ambu aScope 4 Cysto and a reusable Olympus CYF-5 flexible cystoscope to identify the targets. Afterward, participants completed a satisfaction survey. Times required for supply-gathering, setup, cystoscopy, and cleanup were compared. Image definition, field of view, deflection angle, force required for deflection, irrigation rate, weight, and working length were also compared. Results: The DCs required less time for supply-gathering (187.5 vs 289.4 s, p<0.05), setup (203.3 vs 327.5 s, p<0.01), and cleanup (183.7 vs 356.2 s, p<0.05) while cystoscopy times were similar (230.4 vs 274.1 s, p=0.58). Optical testing showed higher image definition for the DCs (6.30 vs 2.00 line pairs/mm, p<0.01), but a smaller field of view (67° vs 108°, p<0.01) and no adjustable optical settings. The DCs had increased deflection (214° up/182° down vs 198° up/109° down, p<0.01) but required more force to deflect 180° up (6.86 vs 4.46 N, p<0.01) and 90° down (4.66 vs 3.55 N, p<0.01). The RC was heavier (325 vs 159 g), had a shorter working length (37.5 vs 39.0 cm), and a faster irrigation rate at 200 cm H2O (494.1 vs 387.4 mL/min, p<0.01). Post-testing, deflection was reduced for two DCs, but optical qualities remained unchanged. Survey results showed higher ratings in time-efficiency (9.5/10 vs 6.2/10, p <0.01) and overall satisfaction (9.3/10 vs 7.9/10, p <0.01) for the DCs. No subjective difference was found in maneuverability or image quality. Conclusions: While DCs had better image quality, greater deflection, and were faster to assemble and disassemble, RCs had greater durability, more optical settings, wider field of view, faster irrigation rates, and required less force for deflection. Knowledge of the strengths and weaknesses of each device could assist surgeons in optimizing cystoscope utilization in specific clinical scenarios. SOURCE OF Funding: None
