Effect of leaded gloves on patient and surgeon radiation exposure in percutaneous nephrolithotomy: A prospective pilot study.
- 1Washington University in St. Louis School of Medicine, St. Louis, Missouri, United States of America.
Abstract
Introduction
Ionizing radiation exposure is a significant occupational hazard for urologists performing percutaneous nephrolithotomy (PCNL). Surgeon hands are particularly vulnerable during fluoroscopic access. Leaded gloves are a proposed mitigation strategy. This prospective pilot study evaluated surgeon hand and patient collar radiation exposure during PCNL with standard vs leaded gloves.Material and methods
Twenty patients were prospectively allocated to standard or leaded glove groups in sequential fashion. All cases were performed by a single high-volume endourologist with patients in the prone position. Clinical variables including BMI, operative time, stone size, and fluoroscopy dose were recorded. Surgeon hand exposure was measured using ring dosimeters. Patient exposure was measured with clip-on dosimeters at the collar, reported as deep dose equivalent (DDE), lens dose equivalent (LDE), and shallow dose equivalent (SDE).Results
At baseline, patient BMI (p = 0.005) and fluoroscopy radiation dose (p <0.001) were greater in the standard glove group. There was no significant difference in surgeon hand exposure at the right (p = 0.143) or left hand (p = 0.608). Leaded gloves were associated with a significant increase in patient collar radiation at DDE (p = 0.002), LDE (p = 0.009), and SDE (p = 0.009).Conclusions
In this pilot study, leaded glove use was associated with a significant and consistent increase in patient collar radiation across all measurement depths. The non-significant reduction in surgeon hand exposure should be interpreted cautiously given limited statistical power. These findings do not support routine leaded glove use during PCNL, and adequately powered studies are needed to confirm these findings and identify optimal radiation protection strategies.
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BibTeX
@article{brawer2026effect,
title = {{Effect of leaded gloves on patient and surgeon radiation exposure in percutaneous nephrolithotomy: A prospective pilot study.}},
author = {Luke A Brawer and Johnny Wang and Matthew Skalak and Joel Vetter and Ethan Vargo},
journal = {Central European journal of urology},
year = {2026},
month = jul,
doi = {10.5173/ceju.2026.0068},
url = {https://europepmc.org/article/MED/42903919},
note = {CC BY-NC-SA},
}
RIS
TY - JOUR
TI - Effect of leaded gloves on patient and surgeon radiation exposure in percutaneous nephrolithotomy: A prospective pilot study.
AU - Luke A Brawer
AU - Johnny Wang
AU - Matthew Skalak
AU - Joel Vetter
AU - Ethan Vargo
PY - 2026
DA - 2026/07/21
JO - Central European journal of urology
DO - 10.5173/ceju.2026.0068
UR - https://europepmc.org/article/MED/42903919
AB - Introduction Ionizing radiation exposure is a significant occupational hazard for urologists performing percutaneous nephrolithotomy (PCNL). Surgeon hands are particularly vulnerable during fluoroscopic access. Leaded gloves are a proposed mitigation strategy. This prospective pilot study evaluated surgeon hand and patient collar radiation exposure during PCNL with standard vs leaded gloves.Material and methods Twenty patients were prospectively allocated to standard or leaded glove groups in sequential fashion. All cases were performed by a single high-volume endourologist with patients in the prone position. Clinical variables including BMI, operative time, stone size, and fluoroscopy dose were recorded. Surgeon hand exposure was measured using ring dosimeters. Patient exposure was measured with clip-on dosimeters at the collar, reported as deep dose equivalent (DDE), lens dose equivalent (LDE), and shallow dose equivalent (SDE).Results At baseline, patient BMI (p = 0.005) and fluoroscopy radiation dose (p <0.001) were greater in the standard glove group. There was no significant difference in surgeon hand exposure at the right (p = 0.143) or left hand (p = 0.608). Leaded gloves were associated with a significant increase in patient collar radiation at DDE (p = 0.002), LDE (p = 0.009), and SDE (p = 0.009).Conclusions In this pilot study, leaded glove use was associated with a significant and consistent increase in patient collar radiation across all measurement depths. The non-significant reduction in surgeon hand exposure should be interpreted cautiously given limited statistical power. These findings do not support routine leaded glove use during PCNL, and adequately powered studies are needed to confirm these findings and identify optimal radiation protection strategies.
SN - 2080-4806
SN - 2080-4873
ER -