Avoiding radiation exposure during retrograde intrarenal surgery; a RIRSearch score for predicting longer fluoroscopy times

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dc.authorid0000-0002-0926-3005
dc.authorid0000-0001-7577-7955
dc.contributor.authorOzman, Oktay
dc.contributor.authorSimsekoglu, Fatih
dc.contributor.authorSahin, Mehmet Fatih
dc.contributor.authorBasatac, Cem
dc.contributor.authorAkgul, Murat
dc.contributor.authorCakir, Hakan
dc.contributor.authorCinar, Onder
dc.date.accessioned2026-02-03T12:03:07Z
dc.date.available2026-02-03T12:03:07Z
dc.date.issued2025
dc.departmentÇanakkale Onsekiz Mart Üniversitesi
dc.description.abstractThe aim of this study was to identify preoperative and perioperative predictors of radiation exposure during retrograde intrarenal surgery and to develop a scoring system to estimate intraoperative fluoroscopy time. Data from 753 patients who underwent retrograde intrarenal surgery for renal stones were obtained from a multicenter database. All procedures were performed under general anesthesia using fluoroscopy. Fluoroscopy time, recorded in seconds, was the primary outcome. Ordinal regression analysis was applied to evaluate the association between clinical variables and fluoroscopy duration. A predictive score was developed based on statistically significant factors. The performance of the score was tested using receiver operating characteristic curve analysis and a calibration plot.The mean fluoroscopy time was 58 seconds, while the median was 5 seconds. In 140 procedures, fluoroscopy time exceeded 120 seconds. Six parameters were independently associated with longer fluoroscopy use: absence of preoperative ureteral stenting, low stone density (<1000 Hounsfield units), small stone burden (<250 cubic millimeters), multiple stone localizations, failure of ureteral access sheath insertion, and use of large-caliber sheaths (>= 10-12 French). Each parameter was assigned a weighted value, generating a score ranging from 0 to 15. The scoring system demonstrated excellent discriminatory ability (area under the curve: 0.901). A score of 10 or more predicted fluoroscopy duration above 120 seconds with 87.5% sensitivity and 86.2% specificity.The RIRSearch Score is a practical tool for anticipating prolonged radiation exposure before retrograde intrarenal surgery. Surgeons may use this model to minimize unnecessary fluoroscopy and enhance occupational safety.
dc.identifier.doi10.1007/s00240-025-01901-2
dc.identifier.issn2194-7228
dc.identifier.issn2194-7236
dc.identifier.issue1
dc.identifier.pmid41342913
dc.identifier.scopus2-s2.0-105023753361
dc.identifier.scopusqualityQ2
dc.identifier.urihttps://doi.org/10.1007/s00240-025-01901-2
dc.identifier.urihttps://hdl.handle.net/20.500.12428/34976
dc.identifier.volume54
dc.identifier.wosWOS:001631599200001
dc.identifier.wosqualityQ2
dc.indekslendigikaynakWeb of Science
dc.indekslendigikaynakScopus
dc.indekslendigikaynakPubMed
dc.language.isoen
dc.publisherSpringer
dc.relation.ispartofUrolithiasis
dc.relation.publicationcategoryMakale - Uluslararası Hakemli Dergi - Kurum Öğretim Elemanı
dc.rightsinfo:eu-repo/semantics/closedAccess
dc.snmzKA_WOS_20260130
dc.subjectKidney stone
dc.subjectRetrograde intrarenal surgery
dc.subjectFluoroscopy time
dc.subjectScoring system
dc.titleAvoiding radiation exposure during retrograde intrarenal surgery; a RIRSearch score for predicting longer fluoroscopy times
dc.typeArticle

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