RESULTS
A total of 226 participants fully completed and returned the email survey. Of the 226 participants 78 (34.5%) were academics, 44 (19,4 %) were residents and 104 (46.1%) were experts. The data regarding the institution where the participants worked, the average number of weekly surgery days, the number of operations performed using fluoroscopy per week, and which type of surgery was used most are shown in Table 1.
The mean duration of fluoroscopy was less than 30 seconds for 112 (49.6%) respondents, while it was 31–60 seconds in 246 (20.4%) and ≥ 61 seconds in 68 (30.1%). Only 16 (6.8%) academicians, 10 (9.6%) experts and 2 (4,5%) residents reported that they determined their own dose when using fluoroscopy. The majority of both experts and academics reported that they obtained the imaging in automatic mode and were unaware of the radiation dose information. When asked how the mSv dose was determined, four of the academics and six of the experts were found to adhere to textbook data. More than 80% of the 226 surveyed urologists stated that there was no available literature about fluoroscopy doses. In addition, 210 (93%) participants reported that they always used lead aprons, while 118 (52.5%) stated that they used thyroid protectors along with lead aprons. Eight (3.5%) of the urologists used a combination of lead gowns, thyroid protectors, and goggles together; only two urologists reported using lead screens. Six respondents (2.7%) reported that they did not use any protectors, while 16 people did not take any protective measures at least some of the time. One urologist shared that he did not believe in the reliability of lead protectors but still used them (Table 2).
The twelfth question was asking about the proper method of fluoroscopy positioning, and 16 (20.5%) of the academics, 22 of the experts (21.2%) and eight of the residents (18.2%) answered this question correctly. For the 13th question regarding the position of patients to fluoroscopy for reducing the radiation dose. Thirty-eight (48.7%) of the academics, 44 (42.3%) of the experts and 22 (50%) of the residents answered this question correctly (Table 3).
The questionnaire also revealed that 156 (69%) of the participants thought that additional surgery would not be required in fluoroscopy-used surgeries for any reason, while the remaining 70 (31%) reported that additional interventions would be needed. In addition, 50% of the experts and 66.1% of the academics responded that they had not read the literature about the potential damage caused by fluoroscopy (p<0.09) (Table 3).
Approximately 35% of urologists were receiving help during fluoroscopy shooting. 80.5% of the participants did not use dosimeters (Table 2). The most common adverse effects after radiation exposure were fatigue and headache, followed by eye symptoms (red eye, etc.) and anxiety on the day of use of fluoroscopy in the participants (Figure 2).
After beginning to train in the urology, the number of urologists who had have biological children was 150, while the total number of children was 170. Of these 68 of them were boys (40%) while 102 of those were girls (60%).