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A randomised single‐blind comparison of the effectiveness of T ristel F use (chlorine dioxide) as an office‐based fluid soak, with C idex OPA ( ortho ‐phthaldehyde) using an automated endoscopic reprocessor ( AER ) as high‐level disinfection for flexible cystoscopes
Author(s) -
Gilling Peter J.,
Reuther Rana M.,
Addidle Michael,
Lockhart Michelle M.,
Frampton Christopher M.,
Fraundorfer Mark R.
Publication year - 2013
Publication title -
bju international
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.773
H-Index - 148
eISSN - 1464-410X
pISSN - 1464-4096
DOI - 10.1111/bju.12208
Subject(s) - chlorine dioxide , computer network , chemistry , computer science , inorganic chemistry
Objective To compare the effectiveness, safety and cost of T ristel F use (chlorine dioxide) with C idex OPA ( ortho ‐phthaldehyde; 1,2–benzenedicarboxaldehyde) in an automated endoscopic reprocessor ( AER ) for high‐level disinfection of flexible cystoscopes.Patients and Methods A randomised single‐blind study comparing the high‐level disinfectants T ristel F use as a simple office‐based soak and C idex OPA using an AER was performed. Participants were ‘blinded’ to the agent used for disinfection of the flexible cystoscopes. All patients had negative mid‐stream urine at baseline, (MSU) no symptoms suggestive of urinary tract infection ( UTI ) on the day of investigation, no recent antibiotic use or current indwelling urinary catheter. Patients who underwent cystoscopic biopsy during the procedure were excluded. A urine analysis was done before and 3–5 days after cystoscopy and multiple equipment cultures were performed. The U rogenital D istress I nventory ( UDI ‐6 + two questions from the ‘long‐form’), symptom and quality‐of‐life scores were assessed before and after cystoscopy as were ease‐of‐use assessments and a full cost analysis.Results In all, 180 of 465 screened participants were randomised 1:1 and the mean age was 72.1 years, 17% were females and 57% of procedures were performed for bladder tumour surveillance. The urine analysis was positive in 5.4% of patients in each group and 29% ( T ristel) vs 20% (Cidex) of patients had urinary leukocyturia (p = ns) after cystoscopy. The turnover (minutes per cycle) was 7.5 ( T ristel) vs 26.7 ( C idex). The per‐procedure costs were $11.67 ( A merican dollars) for T ristel F use and $21.82 for C idex OPA with fixed costs of $4788 for T ristel F use and $60 514 for C idex OPA .Conclusions Tristel Fuse appears to be as effective and more cost‐effective than C idex OPA for high‐level disinfection of flexible cystoscopes. This has significant cost implications for the office urologist.