367 Flexible Cystoscopy Audit in Patients with Recurrent Urinary Tract Infections (rUTI) / Lower Urinary Tract Symptoms (LUTS): A Path to Clinical Excellence and Cost Savings

Aim To minimize unnecessary flexible cystoscopy in patients with rUTI and LUTS, thereby enhancing patient care and optimizing the utilization of resources. Method Comprehensive data collection from the outpatient cystoscopy clinic, including demographics, indications (rUTI/LUTS), red flag symptoms and outcome. Results In October 2023, our DGH outpatient clinic performed 240 flexible cystoscopy procedures, with 24.1% (58 cases) for rUTI (32) and LUTS (26). Only 37.9% of patients exhibited one or more risk factors, necessitating flexible cystoscopy according to European Urological Association (EUA) guidelines. Additionally, over 13% of patients were under 40 years old with symptoms of rUTI/LUTS. Through collaborative efforts with the consultant body, we derived local consensus criteria for flexible cystoscopy, leading to the introduction of a new referral pathway. Departmental education may further contribute to a significant reduction in unnecessary procedures. Cost analysis, based on private clinic pricing, revealed a substantial predicted monthly saving. Conclusions The complex landscape surrounding the investigations and management of rUTI/LUTS, coupled with the decision on cystoscopy, often introduces uncertainty. By establishing a local consensus and implementing new criteria within our referral pathway, we have successfully brought clarity to the utilization of this procedure, which may result in enhanced and efficient patient care. Our adherence to EUA guidelines demonstrates our commitment to best practices. The predicted substantial cost savings emphasize the financial advantages of our interventions. Our collaborative and locally driven initiatives underscore our dedication to excellence in patient care and healthcare efficiency.