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Trends in the Use of Radiation Protection and Radiation Exposure of European Endourologists: A Prospective Trial from the EULIS-YAU Endourology Group - Beyond the Abstract

To minimize the effects of ionizing radiation during surgical practice, the International Commission on Radiation Protection (ICRP) recommends the use of 0.35mm lead aprons and thyroid shields. It has also been set to a maximum cumulative radiation exposure of 20 mSv/year for the eye lens and 500mSv/year for the extremities to avoid deterministic effects. Even though that limit is estimated by ICRP, the “ALARA” concept (meaning As Low As Reasonably Achievable) goes further to reduce the total dose because the stochastic effect can cause tissue damage independent of the cumulative dose.

We performed a prospective multicenter study where first the EAU-YAU Endourology Group developed a 36-question form. After that, the survey was delivered to both EAU-YAU endourology Group and EULIS (European Society of Urology urolithiasis group) which represent urologists of high-volume academic centers (Table 1).



Those members who filled out the survey, which were 10 from eight different countries, were followed up for 4 years. The number and surgical approach of surgeries were recorded. In addition, the cumulative radiation exposure detected by a dosimetry control was registered yearly (Table 2).

cumulative radiation exposure detected by a dosimetry control was registered yearly

The two endourologists who use ALARA in their daily practice achieved the lowest dose/procedure in the chest. Regarding eye lenses, using lead glasses was statistically significant to reduce cumulative dose radiation. Finally, we searched for previous surveys similar to ours and evaluated the daily practice use of radiation shields in endourology worldwide (Table 3).

survey_results_about_rad_shields_and_use_in_endourology.png

Written by: Sofia Fontanet Soler, Department of Urology, Fundació Puigvert (IUNA), Autonoma University of Barcelona, Barcelona, Spain

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