Extracorporeal shockwave lithotripsy versus ureteroscopy: A comparison of intraoperative radiation exposure during the management of nephrolithiasis

David A. Rebuck, Sarah Coleman, Jian-Feng Chen, Jessica T. Casey, Kent T Perry Jr, Robert B Nadler*

*Corresponding author for this work

Research output: Contribution to journalArticle

14 Citations (Scopus)

Abstract

Background and Purpose: Both shockwave lithotripsy (SWL) and ureteroscopy (URS) may be used in the treatment of similar stones and both need fluoroscopic imaging to achieve this. Fluoroscopy, however, is a source of ionizing radiation. The purpose of this study is to compare the effective radiation dose (ERD) between patients undergoing SWL vs URS. Patients and Methods: The ERD was measured among consecutive patients who were undergoing either SWL or URS between January 2010 and February 2011. For SWL, ERD was calculated using fluoroscopic exposure time, current, voltage, skin-to-source distance, and field size. For URS, it was calculated from the measured dose-area product. We measured several patient and stone factors. Univariate and multivariate analyses were performed. Results: A total of 190 patients were included (87 SWL and 103 URS). In the univariate analyses, no differences were found in ERD (7.32 vs 6.00 mSv, P=0.262 and 7.23 vs 6.07 mSv, P=0.198, for renal and ureteral stones, respectively). In the multivariate analyses, among renal stones, SWL was associated with a higher ERD than URS (β=2.06, P=0.026), and body mass index and stone size were also significant predictors (β=0.212, P=0.045 and β=0.452, P=0.004, respectively). Among ureteral stones, no differences were found (β=0.425, P=0.674), and only the presence of a stent was related to ERD (β=2.53, P=0.013). Conclusions: Among patients with renal stones, SWL was associated with a modest increase in ERD compared with URS, but for ureteral stones, both modalities were associated with similar levels of radiation. This information may be relevant for frequent stone formers needing treatments for which cumulative exposures may become significant.

Original languageEnglish (US)
Pages (from-to)597-601
Number of pages5
JournalJournal of Endourology
Volume26
Issue number6
DOIs
StatePublished - Jun 1 2012

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Ureteroscopy
Nephrolithiasis
Lithotripsy
Radiation
Kidney
Multivariate Analysis
Radiation Exposure
Fluoroscopy
Ionizing Radiation
Stents
Body Mass Index
Skin

ASJC Scopus subject areas

  • Urology

Cite this

@article{61143113af1d450f8da1966cfc010903,
title = "Extracorporeal shockwave lithotripsy versus ureteroscopy: A comparison of intraoperative radiation exposure during the management of nephrolithiasis",
abstract = "Background and Purpose: Both shockwave lithotripsy (SWL) and ureteroscopy (URS) may be used in the treatment of similar stones and both need fluoroscopic imaging to achieve this. Fluoroscopy, however, is a source of ionizing radiation. The purpose of this study is to compare the effective radiation dose (ERD) between patients undergoing SWL vs URS. Patients and Methods: The ERD was measured among consecutive patients who were undergoing either SWL or URS between January 2010 and February 2011. For SWL, ERD was calculated using fluoroscopic exposure time, current, voltage, skin-to-source distance, and field size. For URS, it was calculated from the measured dose-area product. We measured several patient and stone factors. Univariate and multivariate analyses were performed. Results: A total of 190 patients were included (87 SWL and 103 URS). In the univariate analyses, no differences were found in ERD (7.32 vs 6.00 mSv, P=0.262 and 7.23 vs 6.07 mSv, P=0.198, for renal and ureteral stones, respectively). In the multivariate analyses, among renal stones, SWL was associated with a higher ERD than URS (β=2.06, P=0.026), and body mass index and stone size were also significant predictors (β=0.212, P=0.045 and β=0.452, P=0.004, respectively). Among ureteral stones, no differences were found (β=0.425, P=0.674), and only the presence of a stent was related to ERD (β=2.53, P=0.013). Conclusions: Among patients with renal stones, SWL was associated with a modest increase in ERD compared with URS, but for ureteral stones, both modalities were associated with similar levels of radiation. This information may be relevant for frequent stone formers needing treatments for which cumulative exposures may become significant.",
author = "Rebuck, {David A.} and Sarah Coleman and Jian-Feng Chen and Casey, {Jessica T.} and {Perry Jr}, {Kent T} and Nadler, {Robert B}",
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Extracorporeal shockwave lithotripsy versus ureteroscopy : A comparison of intraoperative radiation exposure during the management of nephrolithiasis. / Rebuck, David A.; Coleman, Sarah; Chen, Jian-Feng; Casey, Jessica T.; Perry Jr, Kent T; Nadler, Robert B.

In: Journal of Endourology, Vol. 26, No. 6, 01.06.2012, p. 597-601.

Research output: Contribution to journalArticle

TY - JOUR

T1 - Extracorporeal shockwave lithotripsy versus ureteroscopy

T2 - A comparison of intraoperative radiation exposure during the management of nephrolithiasis

AU - Rebuck, David A.

AU - Coleman, Sarah

AU - Chen, Jian-Feng

AU - Casey, Jessica T.

AU - Perry Jr, Kent T

AU - Nadler, Robert B

PY - 2012/6/1

Y1 - 2012/6/1

N2 - Background and Purpose: Both shockwave lithotripsy (SWL) and ureteroscopy (URS) may be used in the treatment of similar stones and both need fluoroscopic imaging to achieve this. Fluoroscopy, however, is a source of ionizing radiation. The purpose of this study is to compare the effective radiation dose (ERD) between patients undergoing SWL vs URS. Patients and Methods: The ERD was measured among consecutive patients who were undergoing either SWL or URS between January 2010 and February 2011. For SWL, ERD was calculated using fluoroscopic exposure time, current, voltage, skin-to-source distance, and field size. For URS, it was calculated from the measured dose-area product. We measured several patient and stone factors. Univariate and multivariate analyses were performed. Results: A total of 190 patients were included (87 SWL and 103 URS). In the univariate analyses, no differences were found in ERD (7.32 vs 6.00 mSv, P=0.262 and 7.23 vs 6.07 mSv, P=0.198, for renal and ureteral stones, respectively). In the multivariate analyses, among renal stones, SWL was associated with a higher ERD than URS (β=2.06, P=0.026), and body mass index and stone size were also significant predictors (β=0.212, P=0.045 and β=0.452, P=0.004, respectively). Among ureteral stones, no differences were found (β=0.425, P=0.674), and only the presence of a stent was related to ERD (β=2.53, P=0.013). Conclusions: Among patients with renal stones, SWL was associated with a modest increase in ERD compared with URS, but for ureteral stones, both modalities were associated with similar levels of radiation. This information may be relevant for frequent stone formers needing treatments for which cumulative exposures may become significant.

AB - Background and Purpose: Both shockwave lithotripsy (SWL) and ureteroscopy (URS) may be used in the treatment of similar stones and both need fluoroscopic imaging to achieve this. Fluoroscopy, however, is a source of ionizing radiation. The purpose of this study is to compare the effective radiation dose (ERD) between patients undergoing SWL vs URS. Patients and Methods: The ERD was measured among consecutive patients who were undergoing either SWL or URS between January 2010 and February 2011. For SWL, ERD was calculated using fluoroscopic exposure time, current, voltage, skin-to-source distance, and field size. For URS, it was calculated from the measured dose-area product. We measured several patient and stone factors. Univariate and multivariate analyses were performed. Results: A total of 190 patients were included (87 SWL and 103 URS). In the univariate analyses, no differences were found in ERD (7.32 vs 6.00 mSv, P=0.262 and 7.23 vs 6.07 mSv, P=0.198, for renal and ureteral stones, respectively). In the multivariate analyses, among renal stones, SWL was associated with a higher ERD than URS (β=2.06, P=0.026), and body mass index and stone size were also significant predictors (β=0.212, P=0.045 and β=0.452, P=0.004, respectively). Among ureteral stones, no differences were found (β=0.425, P=0.674), and only the presence of a stent was related to ERD (β=2.53, P=0.013). Conclusions: Among patients with renal stones, SWL was associated with a modest increase in ERD compared with URS, but for ureteral stones, both modalities were associated with similar levels of radiation. This information may be relevant for frequent stone formers needing treatments for which cumulative exposures may become significant.

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