Radiation exposure during sacral neuromodulation lead placement: Multi-institutional descriptive study

Ramzy T Burns; Joanna Orzel; Paul Wadensweiler; Kimberly Kenne; Hannah Nakastuka; Natalija Kovacevic; Yashant Aswani; E Ann Gormley; Priya Padamanabhan; Charles R Powell; Annah Vollstedt; Elizabeth Takacs

doi:10.1002/nau.25408

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Radiation exposure during sacral neuromodulation lead placement: Multi-institutional descriptive study

Journal article

Open access

Peer reviewed

Radiation exposure during sacral neuromodulation lead placement: Multi-institutional descriptive study

Ramzy T Burns, Joanna Orzel, Paul Wadensweiler, Kimberly Kenne, Hannah Nakastuka, Natalija Kovacevic, Yashant Aswani, E Ann Gormley, Priya Padamanabhan, Charles R Powell, …

Neurourology and urodynamics, Vol.43(3), pp.595-603

03/2024

DOI: 10.1002/nau.25408

PMID: 38318969

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Abstract

Fluoroscopy has significantly improved lead placement and decreased surgical time for implantable sacral neuromodulation (SNM). There is a paucity of data regarding radiation and safety of fluoroscopy during SNM procedures. Our study aims to characterize fluoroscopy time and dose used during SNM surgery across multiple institutions and assess for predictors of increased fluoroscopy time and radiation dose. Electronic medical records were queried for SNM procedures (Stage 1 and full implant) from 2016 to 2021 at four academic institutions. Demographic, clinical, and intraoperative data were collected, including fluoroscopy time and radiation dose in milligray (mGy). The data were entered into a centralized REDCap database. Univariate and multivariate analysis were performed to assess for predictive factors using STATA/BE 17.0. A total of 664 procedures were performed across four institutions. Of these, 363 (54.6%) procedures had complete fluoroscopy details recorded. Mean surgical time was 58.8 min. Of all procedures, 79.6% were performed by Female Pelvic Medicine and Reconstructive Surgery specialists. There was significant variability in fluoroscopy time and dose based on surgical specialty and institution. Most surgeons (76.4%) were considered "low volume" implanters. In a multivariate analysis, bilateral finder needle testing, surgical indication, surgeon volume, and institution significantly predicted increased fluoroscopy time and radiation dose (p < 0.05). There is significant variability in fluoroscopy time and radiation dose utilized during SNM procedures, with differences across institutions, surgeons, and subspecialties. Increased radiation exposure can have harmful impacts on the surgical team and patient. These findings demonstrate the need for standardized fluoroscopy use during SNM procedures.

Radiology

Urology

overactive

radiation

surgeons

urinary bladder

electric stimulation therapy

fluoroscopy

ionizing

Details

Title: Subtitle: Radiation exposure during sacral neuromodulation lead placement: Multi-institutional descriptive study
Creators: Ramzy T Burns - Indiana University – Purdue University Indianapolis
Joanna Orzel - University of Iowa
Paul Wadensweiler - Dartmouth–Hitchcock Medical Center
Kimberly Kenne - University of Iowa
Hannah Nakastuka - Carver College of Medicine, Iowa City, Iowa, USA
Natalija Kovacevic - Beaumont Health
Yashant Aswani - University of Iowa Hospitals and Clinics
E Ann Gormley - Dartmouth–Hitchcock Medical Center
Priya Padamanabhan - Beaumont Health
Charles R Powell - Indiana University – Purdue University Indianapolis
Annah Vollstedt - University of Iowa
Elizabeth Takacs - University of Iowa Hospitals and Clinics
Resource Type: Journal article
Publication Details: Neurourology and urodynamics, Vol.43(3), pp.595-603
DOI: 10.1002/nau.25408
PMID: 38318969
NLM abbreviation: Neurourol Urodyn
eISSN: 1520-6777
Language: English
Electronic publication date: 02/06/2024
Date published: 03/2024
Academic Unit: Radiology; Obstetrics and Gynecology; Urology
Record Identifier: 9984557841402771

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