title: Radiation Exposure During Videourodynamics: Establishing Risk Factors.
abstract: OBJECTIVE
  The use of fluoroscopy during urodynamics can be helpful in the evaluation of patients with lower urinary tract dysfunction. However, fluoroscopy introduces the potential hazards of ionizing radiation, including malignancy. In this study we analyzed the data for radiation exposure during videourodynamic study (VUDS) at our center; we have also tried to establish the factors associated with increased exposure to radiation during VUDS.
  
  
  METHODS
  We reviewed all VUDS from August 2010 to May 2011. Patients were included if they were ≥18 years old and had data recorded on total radiation exposure (radcm2). Age, sex, body mass index, fluoroscopy time, diagnosis, and urodynamic findings were recorded. Multivariate linear regression analysis was used to identify independent risk factors that influenced increased radiation exposure.
  
  
  RESULTS
  A total of 203 videourodynamic studies were assessed in 106 female and 97 male patients with a mean age of 64.3 and body mass index of 26.8. The average fluoroscopy time was 100.2 sec and exposure was 560.9 radcm2. The most common indication for videourodynamics was incontinence, 40.9%. On multivariate linear regression analysis body mass index, vesico-ureteral reflux, sex, number of fill cycles, and larger capacity were independent predictors of increased radiation exposure.
  
  
  CONCLUSIONS
  We have shown that increased radiation exposure as measure with Dose Area Product during VUDS was significantly associated with larger BMI, female gender, larger bladder capacity, presence of VUR, junior operator, and higher number of fill cycles. Further studies are now underway to attempt to reduce exposure based on these findings.
authors.affiliation: Department of Urology, New York University Langone Medical Center, New York, New York, USA.
authors.forename: Benjamin M
authors.initials: BM
authors.lastname: Brucker
authors.affiliation: Department of Urology, McGill University, Montreal, Quebec, Canada.
authors.forename: Lysanne
authors.initials: L
authors.lastname: Campeau
authors.affiliation: Department of Urology, New York University Langone Medical Center, New York, New York, USA.
authors.forename: Eva
authors.initials: E
authors.lastname: Fong
authors.affiliation: Department of Urology, New York University Langone Medical Center, New York, New York, USA.
authors.forename: Sidhartha
authors.initials: S
authors.lastname: Kalra
authors.affiliation: Department of Urology, New York University Langone Medical Center, New York, New York, USA.
authors.forename: Nirit
authors.initials: N
authors.lastname: Rosenblum
authors.affiliation: Department of Urology, New York University Langone Medical Center, New York, New York, USA.
authors.forename: Victor W
authors.initials: VW
authors.lastname: Nitti
mesh_terms: D015992:Body Mass Index; D005260:Female; D052776:Female Urogenital Diseases / Q000503:physiopathology; D005471:Fluoroscopy / Q000009:adverse effects; D006801:Humans; D008297:Male; D052801:Male Urogenital Diseases / Q000503:physiopathology; D008875:Middle Aged; D011829:Radiation Dosage; D000069079:Radiation Exposure; D012189:Retrospective Studies; D012307:Risk Factors; D014563:Urodynamics / Q000502:physiology*; D014741:Video Recording
keywords: lower urinary tract  symptoms; radiation; risk; urinary bladder; urodynamics