Extracorporeal shock waves lithotripsy versus retrograde ureteroscopy: is radiation exposure a criterion when we choose which modern treatment to apply for ureteric stones?

  • Catalin Pricop University of Medicine and Pharmacy of Iasi
  • Adrian Maier University of Medicine and Pharmacy of Targu Mures
  • Dragos Negru University of Medicine and Pharmacy of Iasi
  • Ovidiu Malau County Hospital of Targu Mures
  • Martha Orsolya University of Medicine and Pharmacy of Targu Mures
  • Daniel Radavoi University of Medicine and Pharmacy Bucharest
  • Dragomir R Serban University of Medicine and Pharmacy Iași
Keywords: extracorporeal shock waves lithotripsy, retrograde ureteroscopy, radiation

Abstract

The aim of this study is to compare two major urological procedures in terms of patient exposure to radiation. We evaluated 175 patients, that were subjected to retrograde ureteroscopy (URS) and extracorporeal shock waves lithotripsy (ESWL) for lumbar or pelvic ureteral lithiasis, at two urological departments. The C-arm Siemens (produced in 2010 by Siemens AG, Germany) was used for ureteroscopy. The radiological devices of the lithotripters used in this study in the two clinical centers had similar characteristics. We evaluated patient exposure to ionizing radiation by using a relevant parameter, the air kerma-area product (PKA; all values in cGy cm2), calculated from the radiation dose values recorded by the fluoroscopy device. PKA depends on technical parameters that change due to anatomical characteristics of each case examined, such as body mass index (BMI), waist circumference, and stone location. For the patients subjected to ESWL for lumbar ureteral lithiasis the mean of PKA (cGy cm2) was 509 (SD=180), while for those treated for pelvic ureteral lithiasis the mean of PKA was 342 (SD=201). In the URS group for lumbar ureteral lithiasis, the mean of PKA (cGy cm2) was 892 (SD=436), while for patients with pelvic ureteral lithiasis, the mean of PKA was 601 (SD=429). The patients treated by URS had higher exposure to ionizing radiation dose than patients treated by ESWL. The risk factors of higher radiation doses were obesity, exposure time, and localization of the stones.

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Author Biographies

Catalin Pricop, University of Medicine and Pharmacy of Iasi
Urology, MD, assistant professor
Adrian Maier, University of Medicine and Pharmacy of Targu Mures
Urology, PHD
Dragos Negru, University of Medicine and Pharmacy of Iasi
Radiology, MD
Ovidiu Malau, County Hospital of Targu Mures
Urology, MD
Martha Orsolya, University of Medicine and Pharmacy of Targu Mures
Urology, MD, assistant professor
Daniel Radavoi, University of Medicine and Pharmacy Bucharest
Urology, MD
Dragomir R Serban, University of Medicine and Pharmacy Iași
Physiology, MD
Published
2014-10-18
How to Cite
1.
Pricop C, Maier A, Negru D, Malau O, Orsolya M, Radavoi D, Serban DR. Extracorporeal shock waves lithotripsy versus retrograde ureteroscopy: is radiation exposure a criterion when we choose which modern treatment to apply for ureteric stones?. Bosn J of Basic Med Sci [Internet]. 2014Oct.18 [cited 2019Aug.18];14(4):254-8. Available from: https://www.bjbms.org/ojs/index.php/bjbms/article/view/254
Section
Translational and Clinical Research