Dr. Wenzel on pregnancy and radiation exposure in urology

In this interview, Jessica L. Wenzel, MD, MPH, shares the background and key findings from the study, “Occupational Radiation Exposure During Pregnancy: A Survey of Urologists on Perception, Experience, and Practice Patterns,” for which she served as the lead author. Wenzel is a fourth-year resident at Oregon Health & Science University in Portland.

Video Transcript:

Could you describe the background for this study?

There are more women than ever that are going into the urologic work force. Typically, training and early attending-hood overlap with reproductive years. So, what that means is that there are going to be more urologists than ever that are practicing while pregnant. What we found is that there are no real guidelines from any urologic societies, not from the AUA, that say how to best navigate pregnancy in regards to radiation exposure. That said, of course, there are other specialties that have radiation exposure: IR, cardiology. Several of these do have guidelines, but there's nothing urology specific.

What were the key findings from this work?

We surveyed both men and women because we wanted to best assess attitudes regarding radiation exposure for all urologists. What we found was that there were no differences between men and women in concern regarding radiation exposure. However, women were actually more likely to reduce their caseload or adjust their practices due to concern for radiation exposure, even though there was no difference in concern. Additionally, amongst our respondents, about two-thirds of the female respondents had been previously pregnant. What we found in the previously pregnant respondents–they had some further questions to answer–so what we found was that women had a very low access to either custom-fitted lead or maternity lead. Only about 20% had access to either during pregnancy. There was also really low access to any sort of policies for who to notify, policies for how to navigate radiation exposure while pregnant, and only about half of respondents had access to these while they were pregnant.

We also asked respondents about, knowing what they know now, if they would change how they approach pregnancy, if they would change the precautions they took. We found about half the women said that they would not make any changes, but actually, about half of them would take greater precautions. Also, somewhat interestingly, one thing that comes up in the literature as a necessary PPE item is the dosimeter, just so you can monitor your radiation exposure. Even though everything says, "this is really great, and really helpful and necessary," I think logistically, they can be really difficult to track on a day-to-day basis. We found that two-thirds or female respondents did not know their dosimeter doses during pregnancy. So obviously, this was an area of concern that this vital aspect of PPE isn't being used super commonly. Then one other thing that we found, in women that had subsequent pregnancies, they were actually less likely to make any adjustments to a caseload, to precautions taken, or anything like that in their subsequent pregnancies. We've theorized that maybe the things that they implemented in their first pregnancy, they just didn't revert back to when they weren't pregnant anymore, so there wasn't anything to change when they were pregnant later on.

This transcription has been edited for clarity.