You have accessJournal of UrologyUrodynamics/Incontinence/Female Urology: Incontinence - Evaluation & Therapy III1 Apr 20121354 RADIATION EXPOSURE TO THE PATIENT AND PHYSICIAN DURING SACRAL NEUROMODULATION Alana Murphy, Courtney Lee, Kevin Wunderle, Howard Goldman, and Sandip Vasavada Alana MurphyAlana Murphy Cleveland, OH More articles by this author , Courtney LeeCourtney Lee Cleveland, OH More articles by this author , Kevin WunderleKevin Wunderle Cleveland, OH More articles by this author , Howard GoldmanHoward Goldman Cleveland, OH More articles by this author , and Sandip VasavadaSandip Vasavada Cleveland, OH More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2012.02.1737AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail INTRODUCTION AND OBJECTIVES In 2010, the FDA launched an initiative to reduce radiation exposure during medical diagnostics and medical procedures. Radiation exposure to the patient and physician during sacral neuromodulation has not been reported in the literature. This study aims to calculate the radiation exposure to both the patient and physician during sacral neuromodulation with the InterStim® device. METHODS We conducted a prospective IRB approved study to determine the radiation exposure to both the patient and physician during sacral neuromodulation. The study population included patients undergoing initial lead placement (stage 1), peripheral nerve evaluation (PNE) or lead revision for urinary frequency, urge incontinence or non-obstructive urinary retention. Each procedure was performed by one of four fellowship trained urologists. The physician's radiation exposure was measured using an electronic radiation dosimeter placed on the outside of their lead apron and the patient's radiation exposure was measured using a radiation sensitive film placed on the lateral hip facing the x-ray source. RESULTS A total of 34 patients have been enrolled. Four patient dose readings were excluded based on improper handling of the radiation sensitive film. The patients were predominantly female (91.2%) with a mean age of 60.7 years old (23.2-90.5) and a mean BMI of 30.2 kg/m2 (17.7-45.7). Indication for sacral neuromodulation included urinary frequency in 9 patients (26.5%), urge incontinence in 14 patients (41.2%) and non-obstructive urinary retention in 11 patients (32.3%). Details of the procedures and radiation exposure for the patient and physician are characterized in table 1. Radiation exposure to both the patient and physician is lowest during a PNE procedure and greatest during the initial lead placement. Procedure Patients No. Leads Procedure Time⁎ Fluoro Time⁎ Physican Dose⁎ Patient Dose⁎ PNE 8 1 n=1; 2 n=7 23min(20-32) 8.3sec(6-16) 0.3mrem(0-1.2) 3.8mGy(0.1-10.5) Stage I 17 1 n=9; 2 n=8 51min(26-79) 29.5sec(6-60) 1.7mrem(0-8.1) 37.2mGy(14.1-64.2) Lead Revision 9 1 n=9 51min(42-74) 13.1sec(6-30) 0.5mrem(0-2.4) 14.0mGy(9.8-21.5) ⁎ values are presented as means. CONCLUSIONS Although our results indicate that radiation exposure is minimal during sacral neuromodulation, the cumulative dose for physicians should not be ignored. With a mean exposure of 1.7 mrem during an initial lead placement, a physician is exposed to the equivalent of one chest x-ray with every 4.7 procedures. © 2012 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 187Issue 4SApril 2012Page: e549 Advertisement Copyright & Permissions© 2012 by American Urological Association Education and Research, Inc.MetricsAuthor Information Alana Murphy Cleveland, OH More articles by this author Courtney Lee Cleveland, OH More articles by this author Kevin Wunderle Cleveland, OH More articles by this author Howard Goldman Cleveland, OH More articles by this author Sandip Vasavada Cleveland, OH More articles by this author Expand All Advertisement Advertisement PDF downloadLoading ...