Radiation Exposure to the Urologist Using an Over-Couch Radiation Source Compared to an Under-Couch Radiation Source in Contemporary Urology Practice

To compare radiation dosage to the Urologist using an over-couch system, X-ray tube over table, and an under-couch system, X-ray tube under table. Urologist continue to perform more endoscopic surgery requiring fluoroscopy.

Fluoroscopy, or electromagnetic radiation, can cause cellular damage when passing through tissue. These systems are compared with respect to radiation dosage to the urologist.

A single urologic surgeon utilized a dosimeter badge while using an over-couch system. The dosimeter exposure was higher than expected and an under-couch system was then employed. Dosimeter exposure levels between the over-couch and under-couch systems were examined and compared.

Over the 4 months reviewed for the over-couch system, radiation doses to the body averaged 3.63 mSv, to the eye averaged 3.73 mSv, to the extremities averaged 3.72 mSv. The 3 month averages for the under-couch system exposure to the body, eye, and extremities were 0.31 mSv, 0.35 mSv, and 0.35 mSv respectively. The difference in radiation exposure between the two systems was significant, p=<0.001. The average number of radiation cases between the two systems was not significantly different, P=0.37. Average fluoroscopy time for the procedures between the two systems was not significantly different, p=0.24.

Over-couch fluoroscopy systems expose the urologist to significantly higher, potentially dangerous, levels of radiation. Urologist using an over-couch system should strongly consider ALARA precautions and proper utilization of lead aprons, thyroid shields, and lead glasses. Radiation safety training should be considered.

Urology. 2018 Jan 02 [Epub ahead of print]

Andrew M Harris

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University of Kentucky Medical Center, 800 Rose St, MS 237, Lexington, KY 40536-0298, Office: (859) 323-8039. Electronic address: .

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