The cost–efficiency of preoperative phenazopyridine use in ureteral jet visualization at time of cystoscopy following minimally invasive hysterectomy

Objective: To determine the impact of planned preoperative phenazopyridine administration on operative times and costs compared with as-needed intravenous agent use during routine cystoscopy following minimally invasive hysterectomy for benign indications. Method: This prospective cohort study exami...

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Main Authors: Caitlin H. Waters, Maame Yaa Brako, Heidi Preis, Lokesh Patil, Nicole Massad, Jennifer Blaber, Sara Kim, Xun Lian
Format: Article
Language:English
Published: KeAi Communications Co., Ltd. 2025-09-01
Series:Laparoscopic, Endoscopic and Robotic Surgery
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Online Access:http://www.sciencedirect.com/science/article/pii/S2468900925000465
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author Caitlin H. Waters
Maame Yaa Brako
Heidi Preis
Lokesh Patil
Nicole Massad
Jennifer Blaber
Sara Kim
Xun Lian
author_facet Caitlin H. Waters
Maame Yaa Brako
Heidi Preis
Lokesh Patil
Nicole Massad
Jennifer Blaber
Sara Kim
Xun Lian
author_sort Caitlin H. Waters
collection DOAJ
description Objective: To determine the impact of planned preoperative phenazopyridine administration on operative times and costs compared with as-needed intravenous agent use during routine cystoscopy following minimally invasive hysterectomy for benign indications. Method: This prospective cohort study examined patients who underwent laparoscopic or robotic-assisted total or supracervical hysterectomy for benign indications between January 27, 2023 and March 11, 2024, with one of our minimally invasive gynecologic surgeons at Stony Brook University Hospital. Patients were assigned to the non-phenazopyridine group or the phenazopyridine group. The time needed to visualize the ureteral jets during cystoscopy and the total surgery duration were recorded. A cost analysis was then performed. Results: In total, 106 patients were included, with 53 patients in each group. Compared with the non-phenazopyridine group, the phenazopyridine group had significantly shorter times from the start of cystoscopy to visualization of the first ureteral jet (31 s vs. 42 s, p < 0.05). However, there were no significant differences observed for visualization of the second jet, total jet time, or surgery duration. Two patients in the non-phenazopyridine group required the administration of intravenous agents intraoperatively. Routine phenazopyridine was found to be more cost-efficient when medication costs and operative times were examined. Conclusion: Routine phenazopyridine use does not significantly shorten overall cystoscopy times, but it is the more cost-efficient option given increased rates of costly intravenous medication use in the non-phenazopyridine group.
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spelling doaj-art-6ef90221b52043e3bfa056ee9065a23e2025-08-20T03:36:47ZengKeAi Communications Co., Ltd.Laparoscopic, Endoscopic and Robotic Surgery2468-90092025-09-018312813310.1016/j.lers.2025.07.001The cost–efficiency of preoperative phenazopyridine use in ureteral jet visualization at time of cystoscopy following minimally invasive hysterectomyCaitlin H. Waters0Maame Yaa Brako1Heidi Preis2Lokesh Patil3Nicole Massad4Jennifer Blaber5Sara Kim6Xun Lian7Department of Obstetrics, Gynecology and Reproductive Medicine, Renaissance School of Medicine, Stony Brook University, Stony Brook, USA; Corresponding author.Department of Obstetrics and Gynecology, Brigham &amp; Women’s Hospital, Boston, USADepartment of Obstetrics, Gynecology and Reproductive Medicine, Renaissance School of Medicine, Stony Brook University, Stony Brook, USA; Department of Psychology, Stony Brook University, Stony Brook, USADepartment of Obstetrics, Gynecology and Reproductive Medicine, Renaissance School of Medicine, Stony Brook University, Stony Brook, USA; Program in Public Health, Renaissance School of Medicine, Stony Brook University, Stony Brook, USADepartment of Obstetrics, Gynecology and Reproductive Medicine, Renaissance School of Medicine, Stony Brook University, Stony Brook, USADepartment of Obstetrics, Gynecology and Reproductive Medicine, Renaissance School of Medicine, Stony Brook University, Stony Brook, USADepartment of Obstetrics, Gynecology and Reproductive Medicine, Renaissance School of Medicine, Stony Brook University, Stony Brook, USADepartment of Obstetrics, Gynecology and Reproductive Medicine, Renaissance School of Medicine, Stony Brook University, Stony Brook, USAObjective: To determine the impact of planned preoperative phenazopyridine administration on operative times and costs compared with as-needed intravenous agent use during routine cystoscopy following minimally invasive hysterectomy for benign indications. Method: This prospective cohort study examined patients who underwent laparoscopic or robotic-assisted total or supracervical hysterectomy for benign indications between January 27, 2023 and March 11, 2024, with one of our minimally invasive gynecologic surgeons at Stony Brook University Hospital. Patients were assigned to the non-phenazopyridine group or the phenazopyridine group. The time needed to visualize the ureteral jets during cystoscopy and the total surgery duration were recorded. A cost analysis was then performed. Results: In total, 106 patients were included, with 53 patients in each group. Compared with the non-phenazopyridine group, the phenazopyridine group had significantly shorter times from the start of cystoscopy to visualization of the first ureteral jet (31 s vs. 42 s, p < 0.05). However, there were no significant differences observed for visualization of the second jet, total jet time, or surgery duration. Two patients in the non-phenazopyridine group required the administration of intravenous agents intraoperatively. Routine phenazopyridine was found to be more cost-efficient when medication costs and operative times were examined. Conclusion: Routine phenazopyridine use does not significantly shorten overall cystoscopy times, but it is the more cost-efficient option given increased rates of costly intravenous medication use in the non-phenazopyridine group.http://www.sciencedirect.com/science/article/pii/S2468900925000465Robotic-assisted hysterectomyLaparoscopic hysterectomyRoutine cystoscopyUreteral jet visualization
spellingShingle Caitlin H. Waters
Maame Yaa Brako
Heidi Preis
Lokesh Patil
Nicole Massad
Jennifer Blaber
Sara Kim
Xun Lian
The cost–efficiency of preoperative phenazopyridine use in ureteral jet visualization at time of cystoscopy following minimally invasive hysterectomy
Laparoscopic, Endoscopic and Robotic Surgery
Robotic-assisted hysterectomy
Laparoscopic hysterectomy
Routine cystoscopy
Ureteral jet visualization
title The cost–efficiency of preoperative phenazopyridine use in ureteral jet visualization at time of cystoscopy following minimally invasive hysterectomy
title_full The cost–efficiency of preoperative phenazopyridine use in ureteral jet visualization at time of cystoscopy following minimally invasive hysterectomy
title_fullStr The cost–efficiency of preoperative phenazopyridine use in ureteral jet visualization at time of cystoscopy following minimally invasive hysterectomy
title_full_unstemmed The cost–efficiency of preoperative phenazopyridine use in ureteral jet visualization at time of cystoscopy following minimally invasive hysterectomy
title_short The cost–efficiency of preoperative phenazopyridine use in ureteral jet visualization at time of cystoscopy following minimally invasive hysterectomy
title_sort cost efficiency of preoperative phenazopyridine use in ureteral jet visualization at time of cystoscopy following minimally invasive hysterectomy
topic Robotic-assisted hysterectomy
Laparoscopic hysterectomy
Routine cystoscopy
Ureteral jet visualization
url http://www.sciencedirect.com/science/article/pii/S2468900925000465
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