Radiation Practice Patterns and Exposure in the High-volume Endourologist

Abstract

To define radiation exposure among high-volume endourologists and characterize surgeon exposure patterns as previous literature has focused primarily on patient exposure. Surveys were obtained from the Research on Calculus Kinetics Society members from 14 different institutions across North America. All surgeons practice at high-volume academic institutions as surgical stone specialists. Protective equipment, fluoroscopy variables, and practice patterns were recorded. Dosimeter readings from the past year were analyzed when available. Fifteen surveys were returned, with a response rate of 94%. Fluoroscopic procedures comprised 87% of surgeon cases. Surgeon mean experience was 12.4 years (range, 1-32 years). Lead aprons were worn in 99.3% of cases, thyroid shields in 98.7%, radiation glasses in 52.7%, and lead gloves in 9.7%. Only 33.3% of surgeons regularly wore dosimeters. Of these surgeons, average deep-dose equivalent was 816.6 mrem/y. Lens dose equivalent was 1303.4 mrem/y. Shallow-dose equivalent was 1286 mrem/y. Endourologists receive moderate radiation exposure, and dosimetry use remains low. As Low As Reasonably Achievable principles should be in place and judiciously followed. Improved monitoring and education should assist with reduction of radiation exposure to both the patient and the endourologist.