Variables Affecting Radiation Exposure in Patients under Going Endo-Urological Procedures

Abstract

INTRODUCTION AND OBJECTIVES: Previously we have published data showing how clinician awareness surrounding radiation doses from common diagnostic modalities is poor. Evidence suggests that radiation exposure, from diagnostic and interventional procedures is placing patients at a small but significant increased risk of malignancy. As the usage of radiation in endourological surgery increases, urologists need to have an understanding of the variables affecting perioperative radiation exposure. Here we look at how the operating consultant, the patient triage status (elective vs. emergency admission) and the endourological procedure performed impacts upon perioperative radiation exposure. METHODS: One hundred patients, who had undergone an endourological procedure in 2012 were randomly selected. The image intensifiers were interrogated for stored data of radiation dose and screening times. Computerized patient records provided the consultant's identity (A-D), the patient's triage status and the exact endourological procedure performed. RESULTS: There was no difference in radiation exposure when comparing elective and emergency patients. Endourological procedures requiring therapeutic intervention led to higher levels of radiation exposure when compared with diagnostic endourological procedures (p value < 0.05). The operating consultant significantly varied the radiation exposure. Consultant B's radiation dosages and screening times were significantly lower compared to consultants A, C and D (p values < 0.05). CONCLUSIONS: The operating consultant causes a significant variation in the perioperative radiation dosage. This could be due to a subjective judgment about the importance of using perioperative imaging. Alternatively it could be due to the consultant's operating technique, the communication methods used with the radiographer or the consultant's own awareness about the risks of radiation exposure. With the usage of perioperative radiation increasing, further studies are warranted to better understand the variables that affect and increase its use. This will allow future surgeons to consciously reduce perioperative radiation exposure and consequently patient harm