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Erschienen in: International Urogynecology Journal 9/2013

01.09.2013 | Original Article

Radiation exposure during videourodynamics in women

verfasst von: Ilias Giarenis, Jonathan Phillips, Heleni Mastoroudes, Sushma Srikrishna, Dudley Robinson, Cornelius Lewis, Linda Cardozo

Erschienen in: International Urogynecology Journal | Ausgabe 9/2013

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Abstract

Introduction and hypothesis

Our aim was to calculate the total radiation exposure and the dose absorbed by specific organs during videourodynamics (VUDS) in women.

Methods

This was a retrospective study of consecutive women attending for VUDS in a tertiary referral urodynamics unit. Tests with missing data and those that were terminated during the filling phase of the cystometry were excluded from the study. The VUDS examination was tailored according to the indication for the test and the urodynamic question to be answered. The PCXMC simulation program (version 2.0) was utilised to calculate the effective dose and the dose absorbed by individual organs.

Results

Out of 345 consecutive VUDS, 264 were included in the study. The mean effective dose was 0.34 mSv (SD: 0.15) and the mean fluoroscopic time was 63.15 s (SD: 21.81). Multivariate linear regression analysis of factors affecting the radiation dose showed that BMI (p = 0.009) and fluoroscopy time (p < 0.001) were the only statistically significant factors. The final linear regression model for the estimation of the effective dose was Eff. Dose (mSv) = −0.049 + 0.003 · BMI (kg/m2) + 0.005 · fluoroscopy time (s).

Conclusions

This study reveals that women are exposed to relatively small amounts of radiation during VUDS. The use of fluoroscopy only without additional static radiographic images minimises exposure to a level consistent with the “as low as reasonably achievable” radiological principle.
Literatur
1.
Zurück zum Zitat Bates CP, Whiteside CG, Turner-Warwick R (1970) Synchronous cine-press-flow-cysto-urethrography with special reference to stress and urge incontinence. Br J Urol 42:714–723PubMedCrossRef Bates CP, Whiteside CG, Turner-Warwick R (1970) Synchronous cine-press-flow-cysto-urethrography with special reference to stress and urge incontinence. Br J Urol 42:714–723PubMedCrossRef
2.
Zurück zum Zitat Abrams P (2006) Urodynamics, 3rd edn. Springer, London, pp 88–94 Abrams P (2006) Urodynamics, 3rd edn. Springer, London, pp 88–94
3.
Zurück zum Zitat Haylen BT, de Ridder D, Freeman RM, Swift SE, Berghmans B, Lee J et al (2010) An International Urogynecological Association (IUGA)/International Continence Society (ICS) joint report on the terminology for female pelvic floor dysfunction. Int Urogynecol J 21:5–26PubMedCrossRef Haylen BT, de Ridder D, Freeman RM, Swift SE, Berghmans B, Lee J et al (2010) An International Urogynecological Association (IUGA)/International Continence Society (ICS) joint report on the terminology for female pelvic floor dysfunction. Int Urogynecol J 21:5–26PubMedCrossRef
4.
Zurück zum Zitat Nitti VW, Tu LM, Gitlin J (1999) Diagnosing bladder outlet obstruction in women. J Urol 161:1535–1540PubMedCrossRef Nitti VW, Tu LM, Gitlin J (1999) Diagnosing bladder outlet obstruction in women. J Urol 161:1535–1540PubMedCrossRef
5.
Zurück zum Zitat Tubaro A, Artibani W, Bartram C, Delancey J, Khullar V, Vierhout M et al (2009) Imaging and other investigations. In: Abrams P, Cardozo L, Khoury S, Wein A (eds) Incontinence, 4th International Consultation on Incontinence, 4th edn. Health Publications Ltd, Paris, pp 541–630 Tubaro A, Artibani W, Bartram C, Delancey J, Khullar V, Vierhout M et al (2009) Imaging and other investigations. In: Abrams P, Cardozo L, Khoury S, Wein A (eds) Incontinence, 4th International Consultation on Incontinence, 4th edn. Health Publications Ltd, Paris, pp 541–630
6.
Zurück zum Zitat Hart D, Wall BF, Hillier MC, Shrimpton PC (2010) Frequency and collective dose for medical and dental X-ray examinations in the UK, 2008. Report HPA –CRCE-012. www.hpa.org.uk Hart D, Wall BF, Hillier MC, Shrimpton PC (2010) Frequency and collective dose for medical and dental X-ray examinations in the UK, 2008. Report HPA –CRCE-012. www.​hpa.​org.​uk
7.
Zurück zum Zitat Arbique GM, Gilleran JP, Guild JB, Harris JE, Poon CI, Zimmern PE (2006) Radiation exposure during standing voiding cystourethrography in women. Urology 67:269–274PubMedCrossRef Arbique GM, Gilleran JP, Guild JB, Harris JE, Poon CI, Zimmern PE (2006) Radiation exposure during standing voiding cystourethrography in women. Urology 67:269–274PubMedCrossRef
8.
Zurück zum Zitat International Commission on Radiological Protection (2007) Recommendations of the International Commission on Radiological Protection. Publication 103. Ann ICRP 37:2–4 International Commission on Radiological Protection (2007) Recommendations of the International Commission on Radiological Protection. Publication 103. Ann ICRP 37:2–4
9.
Zurück zum Zitat Bump RC, Mattiasson A, Bo K et al (1996) The standardization of terminology of female pelvic organ prolapse and pelvic floor dysfunction. Am J Obstet Gynecol 175:10–17PubMedCrossRef Bump RC, Mattiasson A, Bo K et al (1996) The standardization of terminology of female pelvic organ prolapse and pelvic floor dysfunction. Am J Obstet Gynecol 175:10–17PubMedCrossRef
10.
Zurück zum Zitat Schafer W, Abrams P, Liao L et al (2002) Good urodynamic practices: uroflowmetry, filling cystometry and pressure-flow studies. Neurourol Urodyn 21:261–274PubMedCrossRef Schafer W, Abrams P, Liao L et al (2002) Good urodynamic practices: uroflowmetry, filling cystometry and pressure-flow studies. Neurourol Urodyn 21:261–274PubMedCrossRef
11.
Zurück zum Zitat Servomaa A, Tapiovvara M (1998) Organ dose calculation in medical x ray examinations by the program PCXMC. Radiat Prot Dosim 80:213–219CrossRef Servomaa A, Tapiovvara M (1998) Organ dose calculation in medical x ray examinations by the program PCXMC. Radiat Prot Dosim 80:213–219CrossRef
12.
Zurück zum Zitat International Commission on Radiological Protection (1991) Recommendations of the International Commission on Radiological Protection. Publication 60. Ann ICRP 21:1–3 International Commission on Radiological Protection (1991) Recommendations of the International Commission on Radiological Protection. Publication 60. Ann ICRP 21:1–3
13.
Zurück zum Zitat Darling S, Sammer M, Chapman T, Parisi MT (2011) Physician documentation of fluoroscopy in voiding cystourethrography reports correlates with lower fluoroscopy times: a surrogate marker of patient radiation exposure. AJR Am J Roentgenol 196:W777–W780PubMedCrossRef Darling S, Sammer M, Chapman T, Parisi MT (2011) Physician documentation of fluoroscopy in voiding cystourethrography reports correlates with lower fluoroscopy times: a surrogate marker of patient radiation exposure. AJR Am J Roentgenol 196:W777–W780PubMedCrossRef
14.
Zurück zum Zitat Guild J, Takacs E, Kircher S, Arbique G, Zimmern PE (2009) The number of voiding radiographs during cystourethrography in women with stress incontinence or prolapse can be reduced to enhance safety without compromising study interpretation. Neurourol Urodyn 28:385–389PubMedCrossRef Guild J, Takacs E, Kircher S, Arbique G, Zimmern PE (2009) The number of voiding radiographs during cystourethrography in women with stress incontinence or prolapse can be reduced to enhance safety without compromising study interpretation. Neurourol Urodyn 28:385–389PubMedCrossRef
15.
Zurück zum Zitat Lee CL, Wunderle K, Vasavada SP, Goldman HB (2011) Reduction of radiation during fluoroscopic urodynamics: analysis of quality assurance protocol limiting fluoroscopic images during fluoroscopic urodynamic studies. Urology 78:540–543PubMedCrossRef Lee CL, Wunderle K, Vasavada SP, Goldman HB (2011) Reduction of radiation during fluoroscopic urodynamics: analysis of quality assurance protocol limiting fluoroscopic images during fluoroscopic urodynamic studies. Urology 78:540–543PubMedCrossRef
16.
Zurück zum Zitat Singh G, Lucas M, Dolan L, Knight S, Ramage C, Toozs-Hobson P (2010) Minimum standards for urodynamic practice in the UK. Neurourol Urodyn 29:1365–1372PubMedCrossRef Singh G, Lucas M, Dolan L, Knight S, Ramage C, Toozs-Hobson P (2010) Minimum standards for urodynamic practice in the UK. Neurourol Urodyn 29:1365–1372PubMedCrossRef
17.
Zurück zum Zitat Perisinakis K, Damilakis J, Grammatikakis J, Theocharopulos N, Gourtsoyiannis N (2003) Radiogenic risks from hysterosalpingography. Eur Radiol 13:1522–1528PubMedCrossRef Perisinakis K, Damilakis J, Grammatikakis J, Theocharopulos N, Gourtsoyiannis N (2003) Radiogenic risks from hysterosalpingography. Eur Radiol 13:1522–1528PubMedCrossRef
18.
Zurück zum Zitat Lee R, Thomas KE, Connolly BL, Falkiner M, Gordon CL (2009) Effective dose estimation for pediatric voiding cystourethrography using an anthrophomorphic phantom set and metal oxide semiconductor field-effect transistor (MOSFET) technology. Pediatr Radiol 39:608–615PubMedCrossRef Lee R, Thomas KE, Connolly BL, Falkiner M, Gordon CL (2009) Effective dose estimation for pediatric voiding cystourethrography using an anthrophomorphic phantom set and metal oxide semiconductor field-effect transistor (MOSFET) technology. Pediatr Radiol 39:608–615PubMedCrossRef
19.
Zurück zum Zitat Hart D, Hillier MC, Wall BF (2007) Doses to patients from radiographic and fluoroscopic X-ray imaging procedures in the UK, 2005. Report HPA –RPD-029. www.hpa.org.uk Hart D, Hillier MC, Wall BF (2007) Doses to patients from radiographic and fluoroscopic X-ray imaging procedures in the UK, 2005. Report HPA –RPD-029. www.​hpa.​org.​uk
Metadaten
Titel
Radiation exposure during videourodynamics in women
verfasst von
Ilias Giarenis
Jonathan Phillips
Heleni Mastoroudes
Sushma Srikrishna
Dudley Robinson
Cornelius Lewis
Linda Cardozo
Publikationsdatum
01.09.2013
Verlag
Springer London
Erschienen in
International Urogynecology Journal / Ausgabe 9/2013
Print ISSN: 0937-3462
Elektronische ISSN: 1433-3023
DOI
https://doi.org/10.1007/s00192-013-2062-6

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