Evidence map›Paper›PMID 42604101›Full record

ReviewAsian journal of urology2026

Tips and tricks for reducing radiation exposure during retrograde intrarenal surgery: A literature review by the European Association of Urology Section of Endourology.

Otas Durutovic, Milos Petrovic, Vincent De Coninck, Laurian Dragos, Marcos Cepeda, Guido M Kamphuis, Panagiotis Kallidonis, Andreas Skolarikos, Amelia Pietropaolo, Bhaskar Somani and 2 more

Abstract readReview
In one paragraph

Review in Asian journal of urology, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

0numbers the graph read from it
0cells of the map it votes in
0citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

0 citing papers in PubMed.

No citing paper in PubMed yet.

4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

12 authors.

Otas DurutovicClinic of Urology, University Clinical Centre of Serbia, Belgrade, Serbia.
Milos PetrovicClinic of Urology, University Clinical Centre of Serbia, Belgrade, Serbia.
Vincent De ConinckDepartment of Urology, Algemeen Ziekenhuis Klina, Brasschaat, Belgium.
Laurian DragosDepartment of Urology, Cambridge University Hospitals, Cambridge, UK.
Marcos CepedaDepartment of Urology, Rio Hortega University Hospital, Valladolid, Spain.
Guido M KamphuisDepartment of Urology, Amsterdam University Medical Center, University of Amsterdam, Amsterdam, the Netherlands.
Panagiotis KallidonisDepartment of Urology, University of Patras, Patras, Greece.
Andreas SkolarikosSecond Department of Urology, Sismanogleio Hospital, National and Capodistrian University of Athens, Athens, Greece.
Amelia PietropaoloDepartment of Urology, University Hospital Southampton National Health Service Foundation Trust, Southampton, UK.
Bhaskar SomaniDepartment of Urology, University Hospital Southampton National Health Service Foundation Trust, Southampton, UK.
Vineet GauharDepartment of Urology, Ng Teng Fong General Hospital, Singapore.
Thomas TaillyDepartment of Urology, Ghent University Hospital, European Reference Network-accredited Centre, Ghent, Belgium.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

Objective: Fluoroscopy is an important component of retrograde intrarenal surgery (RIRS), as it facilitates safe and accurate access, guidance, and intraoperative navigation. Fluoroscopy during surgery exposes patients and medical personnel to the harmful effects of ionizing radiation. To reduce radiation exposure, multiple strategies have been proposed. The objective of this review is to analyze strategies for minimizing radiation exposure during RIRS and to provide recommendations for their implementation. Methods: A comprehensive literature review was performed by searching the PubMed, Cochrane Library, EMBASE, and Web of Science databases, as well as the ClinicalTrials.gov registry, for publications on strategies for reducing fluoroscopy use during RIRS, using various combinations of the following Medical Subject Headings: "fluoroscopy", "radiation safety", "radiation exposure", "urology", "endourology", "flexible ureterorenoscopy", "FURS", "retrograde intrarenal surgery", "RIRS". Results: A substantial corpus of evidence, encompassing original articles, clinical trials, and narrative and systematic reviews, was identified. Several preoperative measures, including thorough analysis of available imaging studies and the application of quality checklists to guarantee optimal patient positioning, C-arm settings, and the use of radiation protection equipment, have been associated with a significant reduction in radiation exposure. Intraoperatively, the use of fluoroless or fluoroscopy-free RIRS, along with equipment optimization techniques such as intermittent fluoroscopy, collimation, and last image hold, has been identified as a promising approach for radiation reduction. The implementation of radiation safety and simulation-based training can further decrease radiation exposure. Conclusion: Minimizing radiation exposure during RIRS necessitates a comprehensive strategy that integrates careful preoperative planning, fluoroless or fluoroscopy-free techniques, equipment optimization, and radiation safety training and education. Current evidence suggests that these approaches can be performed safely and effectively in appropriately selected patients. However, further high-quality randomized controlled trials are needed to confirm these findings and guide their broader adoption.

Indexed as

EndourologyFlexible ureteroscopyFluorolessFluoroscopyRadiationRetrograde intrarenal surgery

Identifiers

PMID42604101
PMCPMC13476964

What Socratic holds

Textmetadata
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.