1625 DECREASE IN RADIATION EXPOSURE DURING FLUORO URODYNAMICS (FUDS)

You have accessJournal of UrologyUrodynamics/Incontinence/Female Urology: Urodynamic Testing1 Apr 20101625 DECREASE IN RADIATION EXPOSURE DURING FLUORO URODYNAMICS (FUDS) Courtney Lee, Wunderle Kevin, Sandip Vasavada, Rackley Raymond, Moore Courtenay, and Howard B. Goldman Courtney LeeCourtney Lee More articles by this author , Wunderle KevinWunderle Kevin More articles by this author , Sandip VasavadaSandip Vasavada More articles by this author , Rackley RaymondRackley Raymond More articles by this author , Moore CourtenayMoore Courtenay More articles by this author , and Howard B. GoldmanHoward B. Goldman More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2010.02.1405AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail INTRODUCTION AND OBJECTIVES In accordance with the As Low As Reasonably Achievable (ALARA) principle for radiation, our institution initiated a quality assurance protocol to decrease the amount of fluoroscopy during FUDS. We compare the radiation emitted from the fluoroscopic unit before and after the protocol to evaluate whether the decrease in fluoroscopic images translates into a significant reduction in radiation. METHODS The quality assurance protocol defined 5 points for fluoroscopic images: a scout image prior to the exam, during the filling phase, during a valsalva maneuver or cough, during voiding, and an optional image while voiding without catheter(if patient was unable to void with catheter). Additional imaging was allowed according to the discretion of the physician performing the FUDS. All fluoroscopic images were performed using the Seimens Arcadis Avantic fluoroscopic unit with the patient seated in the anterior-posterior position. The number of spot films, fluoroscopy time, cumulative dose area product (DAP), and cumulative air kerma (AK) from FUDS performed by our division during the 3 months prior to the conceptualization of the quality assurance protocol were compared to FUDS performed by our division after the initiation of the protocol. RESULTS Fifty- four FUDS performed in the 3 months prior to the conceptualization of the protocol were compared to 24 FUDS that were performed after the initiation of the protocol. There was no significant difference in age, sex, body mass index, and diagnosis. The mean number of spot films recorded before and after the quality assurance protocol was 11.19 and 4.92 respectively (p<0.001). The mean fluoroscopy time decreased from 40.94 seconds to 9.21 seconds per procedure (p<0.001). The mean DAP decreased from 518.90 mGycm2 to 105.60 mGycm2, and the mean AK decreased from 15.48 mGy to 2.95 mGy (p=0.001 and p = 0.001 respectively). CONCLUSIONS Our quality assurance protocol significantly decreased the amount of fluoroscopy time, DAP, and AK during each FUDS. This may be secondary to adherence to the protocol or staff awareness of radiation exposure during FUDS. Further study using a phantom will be required to determine the decrease in actual radiation exposure using our protocol. Cleveland, OH© 2010 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 183Issue 4SApril 2010Page: e627-e628 Advertisement Copyright & Permissions© 2010 by American Urological Association Education and Research, Inc.Metrics Author Information Courtney Lee More articles by this author Wunderle Kevin More articles by this author Sandip Vasavada More articles by this author Rackley Raymond More articles by this author Moore Courtenay More articles by this author Howard B. Goldman More articles by this author Expand All Advertisement Advertisement PDF downloadLoading ...