Radiation Exposure During Videourodynamics: Establishing Risk Factors

Brucker, Benjamin M.; Campeau, Lysanne; Fong, Eva; Kalra, Sidhartha; Rosenblum, Nirit; Νitti, Victor W.

doi:10.1111/luts.12161

Cited by 5 publications

(4 citation statements)

References 22 publications

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“…This is likely secondary to difficulties with positioning and adequate penetration of the X-ray to capture images of appropriate quality. This is consistent with prior findings at the same institution before protocol initiation, 8 as well as with other studies in women and children undergoing VUD. 15,16 Similarly, studies looking at radiation during spinal surgery have found that patients with a BMI greater than 25 have a 30% increase in fluoroscopy time which may be explained by the lower quality of images and difficulty in image acquisition due to tissue penetration and scatter.…”

Section: Discussionsupporting

confidence: 92%

“…Interestingly, before the implementation of a standardized protocol, female sex was found to be an independent risk factor for increased radiation exposure which was previously attributed to the decreased clarity of fluoroscopic images in the seated position which may require repeat spot images or longer fluoroscopic time. 8 Additionally, while there was no prior protocol dictating that images be taken during Valsalva to assess for fluoroscopic evidence of SUI this was done by many operators and may have contributed to radiation exposure.…”

Section: Discussionmentioning

confidence: 99%

“…Authors previously described the baseline radiation exposure during VUD studies and identified independent predictors of increased radiation exposure such as body mass index (BMI), vesicoureteral reflux (VUR), sex, number of fill cycles, and larger bladder capacity . The authors aimed to implement a standardized protocol for radiation use during VUD, and to assess the impact on radiation exposure.…”

Section: Introductionmentioning

confidence: 99%

“…7 Authors previously described the baseline radiation exposure during VUD studies and identified independent predictors of increased radiation exposure such as body mass index (BMI), vesicoureteral reflux (VUR), sex, number of fill cycles, and larger bladder capacity. 8 The authors aimed to implement a standardized protocol for radiation use during VUD, and to assess the impact on radiation exposure. Secondly, the authors aimed to categorize radiation exposure by condition warranting VUD and to identify clinical variables that correlate with increased radiation exposure, all the while adhering to the principles of ALARA.…”

Section: Introductionmentioning

confidence: 99%

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Radiation exposure during videourodynamic testing: Is dose reduction possible using a standardized protocol?

Hoffman

Sussman

Pape

et al. 2019

Neurourology and Urodynamics

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Aims: To evaluate the impact of a protocol for standardized image capture during video urodynamics (VUD) on radiation exposure. Secondly, to categorize radiation exposure by condition warranting VUD and to identify clinical variables that correlate with increased radiation exposure. Methods: One hundred fifty patients underwent VUD using our standardized protocol. All images were taken using low dose and pulsed settings. Four images are captured: one scout image, one filling image, one voiding image, and one post-void image. If the patient is unable to void with the catheter in place, the catheter is removed and a second image is taken during an attempt at unintubated flow. If vesicoureteral reflux (VUR) is identified, an alternate protocol is entered to document parameters. The mean radiation exposure measured in dose area product (DAP), fluoroscopy time, and number of images were noted and compared with previously published fluoroscopy data collected at our institution before protocol implementation. Results: The mean fluoroscopy exposure after the implementation of our protocol was 273.5 mGy/cm 2 taking 5.2 images in 4.5 seconds. Protocol implementation leads to a 51.2% reduction in radiation exposure calculated by mean DAP (P < .0001) and a 96.5% reduction in fluoroscopy time (P < .0001).The presence of VUR, fluoroscopy time, and body mass index (BMI) > 25 were associated with higher radiation exposure (P < .0001).Conclusion: Implementation and adherence to a standardized protocol for fluoroscopy led to a reduction in radiation exposure fluoroscopy time. The presence of VUR, fluoroscopy time, and BMI > 25 were associated with higher radiation exposure. K E Y W O R D Squality improvement, radiation exposure, urodynamics

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Section: Discussionsupporting

confidence: 92%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Radiation exposure during videourodynamic testing: Is dose reduction possible using a standardized protocol?

Hoffman

Sussman

Pape

et al. 2019

Neurourology and Urodynamics

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Indications and added value of videourodynamics in men with spinal cord injury

Françot,

Lefevre,

Reiss

et al. 2024

BJUI Compass

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PurposeThe primary aim of this study was to evaluate the indications and additional information provided by videourodynamic study (VUDS) over urodynamic studies (UDS) in men with spinal cord injury (SCI) and neurogenic lower urinary tract dysfunction (NLUTD). The secondary aim was to determine the added value of VUDS and its impact on bladder management.Materials and MethodsSingle‐centre retrospective study of all men with SCI who underwent VUDS between 2011 and 2021. Participant characteristics, clinical data and indications for UDS and VUDS as well as bladder management were recorded. The added value of VUDS was defined as additional information not provided by standard UDS that impacted on bladder management (choice of voiding mode, surgical indication or type of surgery).ResultsEighty‐eight men with a median age of 52 years were included. In 20 men who were unable to perform self‐catheterisation, the VUDS clarified the nature and extent of the obstruction and enabled targeted surgery to achieve reflex bladder emptying in all of them. VUDS also clarified the type and level of obstruction in 28 patients, enabling targeted surgery in 24. In 11 men, VUDS was performed as part of the preoperative assessment for a Brindley procedure or after this operation if a complication occurred during follow‐up to confirm the need for further surgery or to target surgical revision. Overall, VUDS had added value in 59 patients (67%).ConclusionsVUDS had added value over UDS in specific situations; the additional information provided impacted on bladder management in men with SCI and NLUTD.

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Neuro-urologic Imaging: A Practical Guide

Stoffel

2019

Urological Care for Patients With Progressive Neurological Conditions

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Radiation Exposure During Videourodynamics: Establishing Risk Factors

Cited by 5 publications

References 22 publications

Radiation exposure during videourodynamic testing: Is dose reduction possible using a standardized protocol?

Radiation exposure during videourodynamic testing: Is dose reduction possible using a standardized protocol?

Indications and added value of videourodynamics in men with spinal cord injury

Neuro-urologic Imaging: A Practical Guide

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