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

Objectives. To assess, in patients undergoing extracorporeal shock wave lithotripsy (ESWL), if a policy of using unilateral X-rays of the kidney, ureter and bladder (hemi-KUB) whenever possible and appropriate during diagnosis and follow-up, was successful in reducing the radiation exposure associated with ESWL. Patients and methods. Two groups of patients of statistically comparable size and demography were assessed retrospectively before and after the implementation of the policy. All had undergone ESWL for radio-opaque upper urinary tract stones and all were finally rendered stone-free. The number and type of all radiological procedures from initial diagnosis of the stone to documented stone-free status were recorded and the dose calculated. Results. The appropriate use of hemi-KUB X-rags resulted in a significant mean 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 after ESWL is a simple and effective way of significantly reducing the radiation exposure of such patients.