Low Dose Fluoroscopy During Ureteroscopy Does Not Compromise Surgical Outcomes.

Objective: To evaluate whether reducing the dose of fluoroscopy to ¼ of standard dose during unilateral ureteroscopy for ureteral stone treatment would impact in a reduction of total radiation emitted and whether this strategy would impact operation time, stone-free rate, and complication rate. Methods: From August 2016 to August 2017, patients over 18 years submitted to ureteroscopy for ureteral stone between 5 and 20 mm were prospectively randomized for ¼ dose reduction or standard dose fluoroscopy. Patients with abnormal urinary anatomy such as horseshoe kidney, pelvic kidney, or duplex system were excluded from the study. Results: Ninety-four patients were enrolled. The fluoroscopic dose reduction strategy to ¼ of the standard dose was able to significantly reduce the cumulative radiation emitted by C-arm fluoroscopy and the dose area product (3.6 ± 4.5 mGy vs 16.2 ± 19.3 mGy, p = 0.0001 and 0.23 ± 0.52 mcGycm2vs 1.15 ± 2.74 mcGycm2, p = 0.02, respectively). Fluoroscopy time was similar between groups (74.5 ± 84.8 seconds vs 88.3 ± 90 seconds, p = 0.44). There was no need to increase the fluoroscopy dose during any of the procedures. Surgical outcomes were not affected by fluoroscopic dose reduction strategy. Conclusion: Low dose fluoroscopy reduces the emitted radiation during ureteroscopy without compromising surgical outcomes.

Duke Scholars

Author Michael Eric Lipkin Urology