Reduction of radiation exposure to patients in the follow-up of shockwave lithotripsy

Objectives To assess, in patients undergoing extracorporeal shock wave lith otripsy (ESWL), if a policy of using unilateral X-rays of the kidney, urete r and bladder (hemi-KUB) whenever possible and appropriate during diagnosis and follow-up, was successful in reducing the radiation exposure associate d with ESWL. Patients and methods Two groups of patients of statistically comparable siz e and demography were assessed retrospectively before and after the impleme ntation of the policy. All had undergone ESWL for radio-opaque upper urinar y tract stones and all were finally rendered stone-free. The number and typ e of all radiological procedures from initial diagnosis of the stone to doc umented stone-free status were recorded and the dose calculated. Results The appropriate use of hemi-KUB X-rays resulted in a significant me an reduction of radiation exposure after treatment of 2.28 mSv per patient (P<0.05). Furthermore, as expected, the radiation dose was clearly but not closely correlated with stone size (r=0.419) Conclusions The appropriate use of hemi-KUB X-rays during the follow-up aft er ESWL is a simple and effective way of significantly reducing the radiati on exposure of such patients.