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Level of knowledge on radiation exposure and compliance to wearing protective equipment: where do endourologists stand? An ESUT/EULIS survey

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Abstract

Purpose

Fluoroscopy is valuable in modern endourology. We present the results of a survey where compliance to radiation safety measures was tested according to surgical exposure, and level of understanding of the radiation rules and risks associated with it.

Methods

A 52-item, anonymous questionnaire, structured by 6 ESUT/EULIS experts was distributed at 3 different endourological meetings during 2017–2018. Main aim was to evaluate level of knowledge on radiation physics and the protective measures taken against radiation exposure by participants. Fisher’s exact test, Kruskal–Wallis test and ROC curve were used for statistical analysis.

Results

211 responses were evaluated. Number of correct answers (median 7.00) differed significantly according to age (p = 0.001), working position (p = 0.005), working field (p < 0.001), number of semirigid (p < 0.001)/flexible URS (p < 0.001) and PNL (p < 0.001) performed per year. Physicians aged 50–60 years, consultants, academics and those who performed more procedures achieved higher scores. In our study 51.7% of responders used shields in the operating room, 89.6% wore lead aprons, 84.4% thyroid shields, while glasses and gloves were used by 14.7% and 8.1%, respectively. Age, working field and number of correct answers did not affect significantly the use of protection in contrast with endourology fellowship training, working position and lessons on radiation. Interestingly, residents, untrained endourologists and those who were provided with lessons on radiation were more compliant.

Conclusions

Our study revealed that majority of modern urologists advocate radiation protection during endourology practice. Senior consultants and academic urologists performing a high volume of procedures seem to understand physics and rules of radiation use.

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Abbreviations

PNL:

Percutaneous nephrolithotomy

URS:

Ureteroscopy

CT:

Computed tomography

KUB:

Kidney–ureter–bladder

IVP:

Intravenous pyelography

SWL:

Shockwave lithotripsy

ALARA:

As low as reasonably achievable

mSV:

Millisievert

mA:

Milliamper

ESUT:

EAU section of uro-technology

EULIS:

EAU section of urolithiasis

ROC:

Receiver operating characteristic

CI:

Confidence interval

y/o:

Years old

BMI:

Body mass index

RIRS:

Retrograde intrarenal surgery

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Author information

Authors and Affiliations

  1. 2nd Department of Urology, Sismanoglio Hospital, National and Kapodistrian University of Athens, Athens, Greece

    Lazaros Tzelves & Andreas Skolarikos

  2. University Hospital Southampton NHS Trust, Southampton, UK

    Bhaskar Somani

  3. Department of Urology Sindelfingen-Boeblingen Medical, Center Teaching Hospital University, Tuebingen, Germany

    Thomas Knoll

  4. Department of Urology, AMC Amsterdam, Amsterdam, The Netherlands

    Guido Kamphuis

  5. Department of Urology, Kafkas University Medical School, Kars, Turkey

    Kemal Sarica

  6. Department of Urology, Medical University of Vienna, Währinger Gurtel 18-20, 1090, Vienna, Austria

    C. Seitz

  7. Department of Urology, University of Patras, Patras, Greece

    E. Liatsikos

Authors
  1. Lazaros Tzelves
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  2. Bhaskar Somani
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  3. Thomas Knoll
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  4. Guido Kamphuis
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  5. Kemal Sarica
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  6. C. Seitz
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  7. E. Liatsikos
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  8. Andreas Skolarikos
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Contributions

LT: protocol/project development, data collection/management, data analysis, and manuscript writing. BS: protocol/project development, data collection/management, data analysis, and manuscript writing. TK: protocol/project development, data collection/management, data analysis, and manuscript writing. GK: protocol/project development, data collection/management, data analysis, and manuscript writing. KS: protocol/project development, data collection/management, data analysis, and manuscript writing. CS: protocol/project development, data collection/management, data analysis, and manuscript writing. EL: protocol/project development, data collection/management, data analysis, and manuscript writing. SA: protocol/project development, data collection/management, data analysis, and manuscript writing.

Corresponding author

Correspondence to Lazaros Tzelves.

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All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional research committee and with the 1964 Helsinki declaration and its later amendments.

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Informed consent was obtained from all individual participants included in the study.

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Tzelves, L., Somani, B., Knoll, T. et al. Level of knowledge on radiation exposure and compliance to wearing protective equipment: where do endourologists stand? An ESUT/EULIS survey. World J Urol 38, 761–768 (2020). https://doi.org/10.1007/s00345-019-02807-6

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  • DOI: https://doi.org/10.1007/s00345-019-02807-6

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