Comparative study between radiation exposure in common urological procedures

Abstract

BackgroundFluoroscopy has become essential to urological surgery since advancement of endourology. Fluoroscopy use has increased, placing urologists as well as staff members at risk for occupational radiation exposure and related dangers. This study compared radiation exposure for staff personnel in percutaneous nephrolithotomy (PCNL), ureteroscopy (URS) and extracorporeal shock wave lithotripsy (ESWL). Then, study determined the maximum number of PCNL, URS and ESWL cases that staff members can handle safely each year.ResultsRadiation exposure in PCNL group was higher than URS and ESWL especially for surgeon. Dose of radiation exposure in ESWL for surgeon, assistant and nurse was 2.4 microsievert (μSv), 0.9 μSv and 0.8 μSv, respectively. Dose of radiation exposure in URS for surgeon, assistant and nurse was 18.5 μSv, 14.3 μSv and 13.1 μSv, respectively. Dose of radiation exposure in PCNL for surgeon, assistant and nurse was 73 μSv, 51.3 μSv and 47.6 μSv, respectively.ConclusionIncreased stone size and increased fluoroscopy time were associated with high radiation exposure. PCNL procedure was 8.8 times more likely to exhibit high-dose exposure than other procedures. Urologists can perform: 274 PCNL case, 1081 URS case and 8333 ESWL case per year within safe radiation exposure limits advised by International Commission on Radiation Protection (ICRP).