{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,28]],"date-time":"2026-03-28T04:57:00Z","timestamp":1774673820335,"version":"3.50.1"},"reference-count":18,"publisher":"Wiley","issue":"3","license":[{"start":{"date-parts":[[2024,2,6]],"date-time":"2024-02-06T00:00:00Z","timestamp":1707177600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Neurourology and Urodynamics"],"published-print":{"date-parts":[[2024,3]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Objectives<\/jats:title><jats:p>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.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>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.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>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\u2009min. 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 \u201clow volume\u201d implanters. In a multivariate analysis, bilateral finder needle testing, surgical indication, surgeon volume, and institution significantly predicted increased fluoroscopy time and radiation dose (<jats:italic>p<\/jats:italic>\u2009&lt;\u20090.05).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>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.<\/jats:p><\/jats:sec>","DOI":"10.1002\/nau.25408","type":"journal-article","created":{"date-parts":[[2024,2,7]],"date-time":"2024-02-07T09:25:02Z","timestamp":1707297902000},"page":"595-603","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":2,"title":["Radiation exposure during sacral neuromodulation lead placement: Multi\u2010institutional descriptive study"],"prefix":"10.1002","volume":"43","author":[{"ORCID":"https:\/\/orcid.org\/0009-0005-6610-4560","authenticated-orcid":false,"given":"Ramzy T.","family":"Burns","sequence":"first","affiliation":[{"name":"Department of Urology Indiana University Indianapolis Indiana USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Joanna","family":"Orzel","sequence":"additional","affiliation":[{"name":"Department of Urology University of Iowa Hospitals and Clinics Iowa City Iowa USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Paul","family":"Wadensweiler","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology Dartmouth\u2010Hitchcock Medical Center Lebanon New Hampshire USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kimberly","family":"Kenne","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology University of Iowa Hospitals and Clinics Iowa City Iowa USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Hannah","family":"Nakastuka","sequence":"additional","affiliation":[{"name":"Carver College of Medicine Iowa City Iowa USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Natalija","family":"Kovacevic","sequence":"additional","affiliation":[{"name":"Department of Urology Beaumont Health Royal Oak Michigan USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yashant","family":"Aswani","sequence":"additional","affiliation":[{"name":"Department of Radiology University of Iowa Hospitals and Clinics Iowa City Iowa USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"E.","family":"Ann Gormley","sequence":"additional","affiliation":[{"name":"Department of Urology Dartmouth\u2010Hitchcock Medical Center Lebanon New Hampshire USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Priya","family":"Padamanabhan","sequence":"additional","affiliation":[{"name":"Department of Urology Beaumont Health Royal Oak Michigan USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2667-6706","authenticated-orcid":false,"given":"Charles R.","family":"Powell","sequence":"additional","affiliation":[{"name":"Department of Urology Indiana University Indianapolis Indiana USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1819-4275","authenticated-orcid":false,"given":"Annah","family":"Vollstedt","sequence":"additional","affiliation":[{"name":"Department of Urology University of Iowa Hospitals and Clinics Iowa City Iowa USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2378-7806","authenticated-orcid":false,"given":"Elizabeth","family":"Takacs","sequence":"additional","affiliation":[{"name":"Department of Urology University of Iowa Hospitals and Clinics Iowa City Iowa 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