To compare radiation dosage to the urologist using an overcouch system, x-ray tube over table, and an undercouch system, x-ray tube under table. Urologists continue to perform more endoscopic surgery requiring fluoroscopy. Fluoroscopy, or electromagnetic radiation, can cause cellular damage when passing through tissues. These systems are compared with respect to radiation dosage to the urologist.

A single urologic surgeon utilized a dosimeter badge while using an overcouch system. The dosimeter exposure was higher than expected and an undercouch system was then employed. Dosimeter exposure levels between the overcouch and the undercouch systems were examined and compared.

Over the 4 months reviewed for the overcouch system, radiation doses to the body averaged 3.63 mSv, those to the eye averaged 3.73 mSv, and those to the extremities averaged 3.72 mSv. The 3-month averages for the undercouch system exposure to the body, the eye, and the extremities were 0.31, 0.35, and 0.35 mSv, respectively. The difference in radiation exposure between the 2 systems was significant (P ≤.001). The average number of radiation cases between the 2 systems was not significantly different (P = .37). The average fluoroscopy time for the procedures between the 2 systems was not significantly different (P = .24).

Overcouch fluoroscopy systems expose the urologist to significantly higher, potentially dangerous levels of radiation. Urologists using an overcouch system should strongly consider as low as reasonably achievable precautions and proper utilization of lead aprons, thyroid shields, and lead glasses. Radiation safety training should be considered.