Vol.:(0123456789) 1 3 World Journal of Urology https://doi.org/10.1007/s00345-019-02807-6 ORIGINAL ARTICLE Level of knowledge on radiation exposure and compliance to wearing protective equipment: where do endourologists stand? An ESUT/EULIS survey Lazaros Tzelves 1  · Bhaskar Somani 2  · Thomas Knoll 3  · Guido Kamphuis 4  · Kemal Sarica 5  · C. Seitz 6  · E. Liatsikos 7  · Andreas Skolarikos 1 Received: 25 March 2019 / Accepted: 10 May 2019 © Springer-Verlag GmbH Germany, part of Springer Nature 2019 Abstract Purpose Fluoroscopy is valuable in modern endourology. We present the results of a survey where compliance to radia- tion safety measures was tested according to surgical exposure, and level of understanding of the radiation rules and risks associated with it. Methods A 52-item, anonymous questionnaire, structured by 6 ESUT/EULIS experts was distributed at 3 diferent endouro- logical meetings during 2017–2018. Main aim was to evaluate level of knowledge on radiation physics and the protective measures taken against radiation exposure by participants. Fisher’s exact test, Kruskal–Wallis test and ROC curve were used for statistical analysis. Results 211 responses were evaluated. Number of correct answers (median 7.00) difered signifcantly according to age (p = 0.001), working position (p = 0.005), working feld (p < 0.001), number of semirigid (p < 0.001)/fexible URS (p < 0.001) and PNL (p < 0.001) performed per year. Physicians aged 50–60 years, consultants, academics and those who performed more procedures achieved higher scores. In our study 51.7% of responders used shields in the operating room, 89.6% wore lead aprons, 84.4% thyroid shields, while glasses and gloves were used by 14.7% and 8.1%, respectively. Age, working feld and number of correct answers did not afect signifcantly the use of protection in contrast with endourology fellowship training, working position and lessons on radiation. Interestingly, residents, untrained endourologists and those who were provided with lessons on radiation were more compliant. Conclusions Our study revealed that majority of modern urologists advocate radiation protection during endourology prac- tice. Senior consultants and academic urologists performing a high volume of procedures seem to understand physics and rules of radiation use. Keywords Ureteroscopy · Radiation · Fluoroscopy · Protective measures · Kidney stone disease · Lithiasis Abbreviations PNL Percutaneous nephrolithotomy URS Ureteroscopy CT Computed tomography KUB Kidney–ureter–bladder Electronic supplementary material The online version of this article (https://doi.org/10.1007/s00345-019-02807-6) contains supplementary material, which is available to authorized users. * Lazaros Tzelves lazarostzelves@gmail.com 1 2nd Department of Urology, Sismanoglio Hospital, National and Kapodistrian University of Athens, Athens, Greece 2 University Hospital Southampton NHS Trust, Southampton, UK 3 Department of Urology Sindelfngen-Boeblingen Medical, Center Teaching Hospital University, Tuebingen, Germany 4 Department of Urology, AMC Amsterdam, Amsterdam, The Netherlands 5 Department of Urology, Kafkas University Medical School, Kars, Turkey 6 Department of Urology, Medical University of Vienna, Währinger Gurtel 18-20, 1090 Vienna, Austria 7 Department of Urology, University of Patras, Patras, Greece