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ORLANDO, FL USA ( - Exposure to ionizing radiation during endourological procedures is a significant hazard in the career of a urologist.

In addition to routine personal protective equipment such as lead vests, various practices have been established to reduce the quantity of radiation exposed to patients and medical professionals alike. In this study, Kasprenski and colleagues evaluate the impact of safety, minimization, and awareness radiation training (SMART) on fluoroscopy time during routine ureteroscopy for urolithiasis performed by first-year urology residents.

auaThe training consists of radiation safety training, lectures on minimizing fluoroscopy use during ureteroscopy, and enrollment in a monitoring program. Comparisons were made before and after the intervention (SMART) as well as between residents who underwent SMART and previous residents who only received radiation training.

Overall, 202 ureteroscopic cases were reviewed. They found that mean fluoroscopic time was significantly lower among those residents who underwent SMART compared to before receiving SMART (62.7 versus 92.2 seconds, p < 0.001) as well as earlier residents who only received radiation training (62.7 versus 91.2 seconds, p=0.005).

This study presents clear evidence of the efficacy of SMART on fluoroscopy time during routine ureteroscopy performed by first-year urology residents for urolithiasis. It will be interesting to see if this impact is sustained as the residents mature in their training, and to what extent this intervention has an effect. Regardless, reducing the exposure, even if significantly reduced through SMART in these early trainees, is a worthwhile goal.

Presented by Matthew Kasprenski, MD at the American Urological Association (AUA) Annual Meeting - May 16 - 21, 2014 - Orlando, Florida USA

Department of Urology, San Antonio Military Medical Center, Fort Sam Houston, TX USA

Written by Martin Hofmann, MD, University of California (Irvine), and medical writer for


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