One of the barriers to a more widespread dissemination of flexible ureteroscopy is the costs associated with the ureteroscope itself. The initial purchase price of the ureteroscope can be high, and the lifespan of the ureteroscope can be distressingly short. An important challenge inherent in the use of reusable flexible ureteroscopes is the oftentimes-involved process of cleaning the ureteroscope from a previous case and readying it for the next case. These processes are complex, and involve multiple personnel throughout many positions within the hospital (nurses, technologists, technicians, etc.). A complete accounting of the costs associated with flexible ureteroscopy must necessarily take all of these steps into consideration. The authors have performed a very nice study that takes the first step toward such an accounting. As the economic pressures associated with medical care become ever more intense, a better understanding of the true costs of surgical procedures is most welcome. For flexible ureteroscopy, a procedure wherein the margin between profitability and loss is quite thin, such information is particularly important.
