Radiation Safety During Surgery for Urolithiasis

Abstract

With the advent of technological advancements in endoscopy and laser systems, the use of endourological surgery to treat urolithiasis has dramatically increased. Thus retrograde intrarenal surgery (RIRS) with flexible ureteroscopy has seen increased usage around the world because of its higher stone-free rate, less invasive nature, and versatile use. However, endourological procedures, including RIRS and percutaneous nephrolithotomy, usually are performed under fluoroscopic guidance. Therefore, patients, surgeons, and the medical staff involved in undergoing or performing these procedures have an increased chance of radiation exposure, and long-term low-dose exposure has become a critical issue for patients and medical personnel. Radiation doses exceeding the standard limits place the individual at risk for hair loss, erythema, chronic general fatigue, cataracts, pregnancy complications, and malignancies that include thyroid cancer, leukemia, and breast cancer. Hence, even if the risk of harmful effects of occupational radiation exposure are relatively low, patients and medical personnel must endeavor to keep radiation exposure related to imaging diagnoses and therapy as low as reasonably achievable. As the disease prevalence of urolithiasis has increased worldwide, long-term low-dose radiation exposure for patients and medical personnel should not be ignored. All urologists involved with using fluoroscopy need to acquire knowledge about radiation exposure to provide optimal treatment for patients and maintain a safe environment for themselves.