Low Dose Fluoroscopy During Ureteroscopy Does Not Compromise Surgical Outcomes.

Area of Science:

• Urology
• Medical Imaging
• Radiation Safety

Background:

• Ureteroscopy is a common procedure for treating ureteral stones.
• Fluoroscopy is frequently used during ureteroscopy, leading to radiation exposure for patients and staff.
• Minimizing radiation dose is crucial for patient safety and adherence to radiation protection principles.

Purpose of the Study:

• To assess the impact of reducing fluoroscopy dose to one-quarter of the standard on total radiation emitted during unilateral ureteroscopy.
• To evaluate the effect of this dose reduction strategy on operation time, stone-free rate, and complication rate.

Main Methods:

• Prospective randomized study involving 94 patients undergoing ureteroscopy for ureteral stones (5-20 mm).
• Patients were randomized to receive either standard dose or one-quarter dose fluoroscopy.
• Exclusion criteria included abnormal urinary anatomy.

Main Results:

• The quarter-dose fluoroscopy strategy significantly reduced cumulative radiation emitted (mGy) and dose area product (mcGycm²).
• Fluoroscopy time and surgical outcomes, including stone-free rates and complications, were similar between the low-dose and standard-dose groups.
• No increase in fluoroscopy dose was required during procedures using the reduced-dose strategy.

Conclusions:

• Reducing fluoroscopy dose to one-quarter of the standard during ureteroscopy is effective in lowering radiation exposure.
• This low-dose approach does not compromise key surgical outcomes such as operation time, stone-free rate, or complication rate.
• Low-dose fluoroscopy represents a safe and effective method for radiation dose reduction in ureteroscopy for ureteral stones.