Pulsed fluoroscopy in ureteroscopy and percutaneous nephrolithotomy

Area of Science:

• Urology
• Medical Imaging
• Radiation Safety

Background:

• Fluoroscopy is essential for guiding ureteroscopy (URS) and percutaneous nephrolithotomy (PCNL).
• Minimizing radiation exposure during these procedures is a critical safety concern for both patients and healthcare professionals.

Purpose of the Study:

• To evaluate the impact of pulsed fluoroscopy (PF) at 4 frames per second (fps) on total fluoroscopy time.
• To compare PF with standard fluoroscopy (SF) at 30 fps in URS and PCNL procedures.

Main Methods:

• Retrospective review of prospectively collected data from URS and PCNL procedures performed by a single surgeon.
• Comparison of patient and stone characteristics, operative data, and fluoroscopy times between SF and PF groups.
• Statistical analysis using univariate and multivariate methods.

Main Results:

• No significant differences in patient demographics, stone characteristics, operative duration, or stone-free rates between SF and PF groups for URS and PCNL.
• Significantly lower mean fluoroscopy times in PF groups compared to SF groups for both URS (44.1s vs. 109.1s) and PCNL (121.5s vs. 341.1s).
• These findings remained significant in multivariate analyses.

Conclusions:

• Pulsed fluoroscopy (PF) at 4 fps is associated with substantially reduced fluoroscopy time during URS and PCNL.
• The adoption of PF leads to decreased radiation exposure for patients and medical personnel.
• PF offers a viable strategy for enhancing safety in endourological procedures.