Radiation exposure and the urologist: what are the risks?

Area of Science:

• Urology
• Medical Physics
• Occupational Health

Background:

• Endourology commonly utilizes fluoroscopic guidance in urological practice.
• While direct radiation exposure is minimal for medical staff, scatter radiation poses a secondary risk.
• Limited data exists on scatter radiation exposure and its associated risks for personnel during urological fluoroscopic procedures.

Purpose of the Study:

• To assess the risks of scatter radiation exposure to medical personnel during routine fluoroscopic imaging in urology.
• To quantify radiation doses received by surgeons, assistants, and nurses during endourological procedures.

Main Methods:

• Thermoluminescent dosimeters (LiF:Mg,Ti) were used to measure staff radiation exposure during ureteral endourological procedures.
• Radiation doses for percutaneous nephrolithotomy (PCNL) were extrapolated from ureteral procedure data.
• Theoretical scattered radiation dose rates were also calculated.

Main Results:

• The average fluoroscopy time for ureteral procedures was 78 seconds.
• Surgeons received the highest exposure, with lower legs and feet accumulating more dose than eyes and hands.
• Estimated annual doses for 50 ureteral cases were <0.12% of regulatory limits; for 50 PCNLs, doses were <2% of limits.

Conclusions:

• Fluoroscopic screening leads to measurable radiation exposure for medical personnel.
• Maximum estimated scatter radiation exposure for surgeons performing 50 PCNLs annually is <10 mGy, less than 2% of extremity dose limits.
• Medical personnel should maintain awareness of scatter radiation risks and implement measures to minimize exposure during fluoroscopic procedures.