The Carbon Footprint of Single-Use Flexible Cystoscopes Compared with Reusable Cystoscopes.

Single-use devices for endourologic procedures are becoming more popular. The environmental impact of single-use instruments is relatively unknown. This study aimed to compare the carbon footprint of single-use reusable flexible cystoscopes based on waste production and estimated carbon emissions. An analysis of the solid waste produced when using the aScope™ 4 Cysto (Ambu) single-use flexible cystoscope compared with the reusable Cysto-Nephro Videoscope CYF-VA2 (Olympus) was performed. The solid waste generated was measured (grams) and recorded as either recyclable, landfill, or contaminated, and carbon dioxide (CO) produced by disposal, manufacture, and cleaning was calculated. A total of 40 flexible cystoscopies (20 single-use and 20 reusable) were analyzed. Median total weight of waste produced was 622 g (interquartile range [IQR] 621-651) for the single-use cystoscope compared with 671.5 g (IQR 659-677.5) for the reusable cystoscope ( < 0.0001). More waste was disposed of by incineration after single-use than reusable cystoscopy (496 g [IQR 495-525] 415 g [IQR 403-421.5],  < 0.0001). However, more waste went to landfill after reusable cystoscopy (256 g ± 0 126 g ± 0,  < 0.0001). There was no difference in weight of waste produced based on the indication for cystoscopy ( = 0.1570). A total of 2.41 kg of CO (IQR 2.40-2.44) was produced per case for the single-use flexible cystoscope compared with 4.23 kg of CO (IQR 4.22-4.24) for the reusable cystoscope ( < 0.0001). Environmental accountability is essential in modern health care. This study highlights that disposable flexible cystoscopes have a significantly lower impact on the environment in terms of carbon footprint and landfill. We propose that environmental impact studies should be a routine part of device development for a sustainable future.