Joint AUA/SUNA white paper on reprocessing of flexible cystoscopes

J. Quentin Clemens, Robert Dowling, Frances Foley, Howard B. Goldman, Chris M. Gonzalez, Christopher Tessier, Mary Anne Wasner, Eileen Young

Research output: Contribution to journalArticle

21 Citations (Scopus)

Abstract

Purpose Numerous federal bodies and professional societies have produced guidelines and standards for the reprocessing of endoscopes, but few specifically address the reprocessing of cystoscopes. Materials and Methods This document presents a summary of the current recommendations for reprocessing flexible cystoscopes, and highlights particular aspects of instrument reprocessing that are unique to cystoscopy. Results Cystoscopes are classified as "semi-critical" devices. Such devices require high-level disinfection or sterilization between patients. High-level disinfection differs from sterilization in that high-level disinfection does not kill large numbers of bacterial spores, while sterilization involves the complete destruction of all microbial life. In the office setting, high-level disinfection (using glutaraldehyde or another chemical disinfectant) is commonly employed for the reprocessing of flexible cystoscopes. During high-level disinfection, standard reprocessing steps should be followed to prevent contamination of the cystoscope between uses. These include precleaning, leak testing, cleaning, disinfection, rinsing, and drying. Recommended "soak times" for glutaraldehyde vary from 20 to 45 minutes, depending upon the degree to which these steps are followed. If no precleaning is performed, a 45-minute glutaraldehyde soak is required to achieve high-level disinfection. Conversely, a 20-minute soak is adequate to achieve high-level disinfection if recommended reprocessing steps are followed prior to immersion in the glutaraldehyde. One chemical disinfectant (ortho-phthalaldehyde) has been associated with anaphylaxis in bladder cancer patients, and should be avoided in these patients. Conclusions This white paper provides a concise reference document for the reprocessing of flexible cystoscopes. In addition, references and links to more comprehensive resources are provided. This document may be useful for clinicians and others who are in search of guidance in this area.

Original languageEnglish (US)
Pages (from-to)2241-2245
Number of pages5
JournalJournal of Urology
Volume184
Issue number6
DOIs
StatePublished - Dec 2010
Externally publishedYes

Fingerprint

Cystoscopes
Disinfection
Joints
Glutaral
Disinfectants
Bacterial Spores
o-Phthalaldehyde
Equipment and Supplies
Cystoscopy
Endoscopes
Anaphylaxis
Immersion
Urinary Bladder Neoplasms
Guidelines

Keywords

  • Cystoscopes
  • Disinfection
  • Guideline
  • Sterilization

ASJC Scopus subject areas

  • Urology

Cite this

Clemens, J. Q., Dowling, R., Foley, F., Goldman, H. B., Gonzalez, C. M., Tessier, C., ... Young, E. (2010). Joint AUA/SUNA white paper on reprocessing of flexible cystoscopes. Journal of Urology, 184(6), 2241-2245. https://doi.org/10.1016/j.juro.2010.08.001

Joint AUA/SUNA white paper on reprocessing of flexible cystoscopes. / Clemens, J. Quentin; Dowling, Robert; Foley, Frances; Goldman, Howard B.; Gonzalez, Chris M.; Tessier, Christopher; Wasner, Mary Anne; Young, Eileen.

In: Journal of Urology, Vol. 184, No. 6, 12.2010, p. 2241-2245.

Research output: Contribution to journalArticle

Clemens, JQ, Dowling, R, Foley, F, Goldman, HB, Gonzalez, CM, Tessier, C, Wasner, MA & Young, E 2010, 'Joint AUA/SUNA white paper on reprocessing of flexible cystoscopes', Journal of Urology, vol. 184, no. 6, pp. 2241-2245. https://doi.org/10.1016/j.juro.2010.08.001
Clemens JQ, Dowling R, Foley F, Goldman HB, Gonzalez CM, Tessier C et al. Joint AUA/SUNA white paper on reprocessing of flexible cystoscopes. Journal of Urology. 2010 Dec;184(6):2241-2245. https://doi.org/10.1016/j.juro.2010.08.001
Clemens, J. Quentin ; Dowling, Robert ; Foley, Frances ; Goldman, Howard B. ; Gonzalez, Chris M. ; Tessier, Christopher ; Wasner, Mary Anne ; Young, Eileen. / Joint AUA/SUNA white paper on reprocessing of flexible cystoscopes. In: Journal of Urology. 2010 ; Vol. 184, No. 6. pp. 2241-2245.
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abstract = "Purpose Numerous federal bodies and professional societies have produced guidelines and standards for the reprocessing of endoscopes, but few specifically address the reprocessing of cystoscopes. Materials and Methods This document presents a summary of the current recommendations for reprocessing flexible cystoscopes, and highlights particular aspects of instrument reprocessing that are unique to cystoscopy. Results Cystoscopes are classified as {"}semi-critical{"} devices. Such devices require high-level disinfection or sterilization between patients. High-level disinfection differs from sterilization in that high-level disinfection does not kill large numbers of bacterial spores, while sterilization involves the complete destruction of all microbial life. In the office setting, high-level disinfection (using glutaraldehyde or another chemical disinfectant) is commonly employed for the reprocessing of flexible cystoscopes. During high-level disinfection, standard reprocessing steps should be followed to prevent contamination of the cystoscope between uses. These include precleaning, leak testing, cleaning, disinfection, rinsing, and drying. Recommended {"}soak times{"} for glutaraldehyde vary from 20 to 45 minutes, depending upon the degree to which these steps are followed. If no precleaning is performed, a 45-minute glutaraldehyde soak is required to achieve high-level disinfection. Conversely, a 20-minute soak is adequate to achieve high-level disinfection if recommended reprocessing steps are followed prior to immersion in the glutaraldehyde. One chemical disinfectant (ortho-phthalaldehyde) has been associated with anaphylaxis in bladder cancer patients, and should be avoided in these patients. Conclusions This white paper provides a concise reference document for the reprocessing of flexible cystoscopes. In addition, references and links to more comprehensive resources are provided. This document may be useful for clinicians and others who are in search of guidance in this area.",
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