Abstracts from the Mid-Atlantic Section of the AUA 2020

MA AUA 2020 Abstracts RPE-04 Radiation Exposure in the Operating Room. A Hidden Killer? J. Thatcher; K. Klimowich; A. Sridhar; T. Mueller Rowan University School of Osteopathic Medicine, Stratford, NJ, USA Introduction: Fluoroscopy is an important tool in endourology. Residents spend a significant amount of time performing fluoroscopic procedures. However, the actual amount of radiation to vulnerable parts of the body has not been well elucidated. Residents may be exposed to harmful amounts of radiation. The aim of this study is to investigate the amount of radiation exposure to different areas of the body, to evaluate the current compliance of radiation dosage guidelines and to evaluate the appropriateness of radiation standards in the Operating Room. Materials &Methods: Radex One Quarta Geiger Dosimeters were used tomeasure radiation exposure to the inner chest, thyroid/eyes, backside, and groin of the pri- mary surgeon during various fluoroscopic procedures, (Figure 1). The amount of radiation was normalized using the total radiation emitted from the C-Arm X-ray. Results: Radiation exposure to various body parts during eighty-one endourologic procedures over a six month period was tabulated. The normalized average was then compared. The highest amount of radiation received was to the thyroid/ eyes - 8.42 µ Gy, followed by groin - 1.76 µ Gy, backside - 1.53 µ Gy, and inner chest - 1.07 µ Gy per procedure as shown in table one. Protective equipment is variable and compliance is low in the OR. Conclusions: Residents are unknowingly exposed to high amounts of radiation during fluoroscopic procedures, which can be harmful. Dose exposure varies by body region. Further investigation is warranted to improve occupational safety in the operating room, increase compliance by practitioners, and better protect body parts that are predisposed to higher radiation levels. Testis-Sparing Surgery: A Single Institution Experience J. Egan 1 ; J. Cheaib 2 ; M. Biles 2 ; M. Metcalf 2 ; M. Huang 2 ; P. Pierorazio 2a 1 MedStar Georgetown University Hospital, Washington, DC, USA; 2 Johns Hopkins Medicine, Baltimore, MD, USA Introduction: Previous studies demonstrate small, non-palpable testis masses have high likelihood of being benign. Radical orchiectomy in these instances represents over treatment. In the setting of bilateral germ cell tumors (GCT) or tumor in solitary testis, orchiectomy results in infertility and lifelong testosterone replacement therapy. We aim to show that testis sparing surgery (TSS) is safe and effective in these populations. Materials &Methods: The IRB-approved testicular cancer registry was reviewed for men who underwent inguinal exploration with intent for TSS (2013-2020). In patients with bilateral tumors, clinical stage was based on the radical orchiectomy specimen while size of the tumor was based on the spared, non-malignant testis. Attempted and completed TSS groups were evaluated for differences using Student’s t-test for normally-distributed variables, chi-squared and Fisher’s exact tests for proportions, and Wilcoxon rank-sum test for non-parametric variables. Results: TSS was attempted in 30 patients and completed in 15. TSS was completed only if intraoperative frozen section demonstrated benign disease, except for one patient with stage I seminoma and solitary testicle. Final pathology was concordant in all cases. There were no differences in demographics between attempted vs. completed TSS cohorts. Tumor size ranged from 0.3 to 5.5 cm. Median tumor size was significantly smaller in the completed TSS cohort (1.0 cm vs. 1.7 cm, p = 0.03). In patients with unilateral masses without history of testis cancer, the testis was successfully spared in 10/24 (42%) cases. In patients with bilateral disease or GCT in solitary testis, the testis was spared in 5/6 (83%) cases. At a mean follow up of 20.5 months, all patients were alive, and 29/30 (97%) had no evidence of disease. Conclusions: TSS is safe and effective in appropriately selected patients. RPE-03 Resident Prize Essay Podium Session 3