Effect of Protective Lead Curtains on Scattered Radiation Exposure to the Operator During Ureteroscopy for Stone Disease: A Controlled Trial

Abstract

To evaluate a reduction in the total radiation dose to the operator during ureteroscopy (URS) for stone disease by using protective lead curtains. Two studies were planned to compare scattered radiation doses without (nonprotective lead curtain [n-LC] group) and with protective lead curtains (lead curtain [LC] group). In study 1, we measured the spatial distribution of the scattered radiation dose using a human phantom simulating URS for stone management for both groups. In study 2, we prospectively randomized patients undergoing treatment for stone disease with URS into n-LC (n = 62) and LC (n = 61) groups. Scattered radiation doses to the operator during URS were recorded. The primary end point was a reduction in the effective dose to the operator. In study 1, there was an 80% reduction in dose at the operator area between the n-LC and the LC groups. In study 2, the mean effective doses to the operator in the n-LC and the LC groups were 0.33 ± 0.85 and 0.08 ± 0.08 µSv (P = .003). The mean doses measured at the neck and waist outside of the lead apron and at the chest inside the lead apron in the n-LC and the LC groups were 2.22 ± 4.56 vs 0.84 ± 0.7 µSv (P = .008), 5.48 ± 12.4 vs 0.76 ± 0.89 µSv (P = .001), and 0.10 ± 0.47 vs 0.00 ± 0.00 µSv (P = .001), respectively. These curtains are useful for protecting the operator from scattered radiation, resulting in a reduction of the total radiation exposure for surgeons performing URS.