1449 DOCUMENTATION OF FLUOROSCOPY TIMES DURING URETEROSCOPY MAY LEAD TO SIGNIFICANT REDUCTION IN RADIATION EXPOSURE

Abstract

You have accessJournal of UrologyStone Disease: SWL, Ureteroscopic or Percutaneous Stone Removal I1 Apr 20101449 DOCUMENTATION OF FLUOROSCOPY TIMES DURING URETEROSCOPY MAY LEAD TO SIGNIFICANT REDUCTION IN RADIATION EXPOSURE Philippe Violette, Konrad Szymanski, Maurice Anidjar, and Sero Andonian Philippe ViolettePhilippe Violette More articles by this author , Konrad SzymanskiKonrad Szymanski More articles by this author , Maurice AnidjarMaurice Anidjar More articles by this author , and Sero AndonianSero Andonian More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2010.02.1163AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail INTRODUCTION AND OBJECTIVES Ureteroscopy is associated with significant radiation exposure to patients, urologists and operating room personnel. The most effective method of reducing occupational radiation exposure is to shorten the fluoroscopy time. The aim of the present study was to assess prospectively the impact of recording fluoroscopy time in the operative report on the use of fluoroscopy during ureteroscopy. METHODS Sixty-four ureteroscopies for consecutive patients presenting for stone disease at the McGill University Health Center were included in the study. These patients were divided into two groups based on the attending endourologist. Group I did not have fluoroscopy times recorded, whereas in group II, the attending endourologist recorded intra-operative fluoroscopy times in the operative report. Seven procedures were excluded (3 ureteroscopies did not have fluoroscopy time documented by either the radiologist or the urologist and 4 ureteroscopies were for staghorn calculi). Therefore, there were 33 ureteroscopies in group I and 24 ureteroscopies in group II. Patient and stone characteristics were obtained from hospital and office charts and both groups were compared using the Mann–Whitney–Wilcoxon test. Kruskal-Willis tests were used to compare fluoroscopy times between the two groups after correcting for stone size, location, and sidedness. RESULTS There were no significant differences between group I and group II in terms of average age (53 vs. 55 years, p>0.4), percentage female (24% vs. 42%, p>0.1), and percentage renal stones (63% vs. 58%, p>0.6). Similarly, there were no significant differences between the two groups in terms of mean stone size (9 vs. 11 mm, p>0.1), and mean stone volume (648 vs. 1039 mm3, p>0.2). Intra-operative average fluoroscopy time was significantly higher in group I when compared with group II (277 vs. 169 seconds, p<0.01). This statistical significance remained even when both groups were corrected for stone size (p<0.02), stone location (p<0.02), and sidedness (p<0.03). CONCLUSIONS Documentation of fluoroscopy times in ureteroscopy reports makes the urologist cognizant of radiation exposure and may lead to significant reductions in the use of fluoroscopy during ureteroscopy. Although these differences may be due to different intra-operative practices of urologists, surgeon behaviour remains the most significant modifiable factor in fluoroscopy use during ureteroscopy. Montreal, Canada© 2010 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 183Issue 4SApril 2010Page: e558-e559 Advertisement Copyright & Permissions© 2010 by American Urological Association Education and Research, Inc.MetricsAuthor Information Philippe Violette More articles by this author Konrad Szymanski More articles by this author Maurice Anidjar More articles by this author Sero Andonian More articles by this author Expand All Advertisement Advertisement PDF downloadLoading ...