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Pulsed fluoroscopy in retrograde urethrograms.

Hazem Elmansy1, Waleed Shabana2, Radu Rozenberg3

  • 1Department of Urology, Northern Ontario School of Medicine, Thunder Bay, ON. hazem.mansy@rocketmail.com.

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Pulsed fluoroscopy significantly reduces radiation exposure during retrograde urethrogram (RUG) procedures without compromising diagnostic accuracy. This method offers a safer approach for both patients and medical staff undergoing RUG examinations.

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Area of Science:

  • Urology
  • Medical Imaging
  • Radiation Safety

Background:

  • Retrograde urethrogram (RUG) is a cornerstone diagnostic tool for urologists, particularly in reconstructive surgery.
  • High-volume RUG procedures raise concerns regarding radiation exposure for patients and healthcare professionals.

Purpose of the Study:

  • To evaluate the efficacy of pulsed fluoroscopy in reducing radiation exposure during RUG.
  • To assess if pulsed fluoroscopy impacts the diagnostic capability of RUG.

Main Methods:

  • A study involving 185 RUG procedures performed between March 2016 and March 2019.
  • Utilized pulsed fluoroscopy set at 4 pulses per second for all RUG examinations.
  • Recorded patient demographics, diagnoses, intraoperative findings, and fluoroscopy times.

Main Results:

  • Median fluoroscopy time was 2.43 seconds, with a range of 0.5 to 6.5 seconds.
  • RUG accurately identified pathology in 77 patients, with 98.7% intraoperative confirmation.
  • No reduction in diagnostic capacity was observed with pulsed fluoroscopy.

Conclusions:

  • Pulsed fluoroscopy is an effective method to decrease radiation exposure during RUG.
  • This technique maintains diagnostic integrity, aligning with the ALARA principle for radiation safety.
  • Further randomized controlled trials are recommended to solidify these findings.