Poster Session 2: Basic Science and Pediatrics

Introduction: Retrograde urethrogram (RUG) is the standard imaging method used to evaluate the urethral stricture.The ALARA principle ("as low as reasonably achievable") emphasizes minimizing radiation exposure through strategies such as time management, distance optimization, and shielding.This study explored the diagnostic accuracy and reliability of pulsed fluoroscopy RUG (1FPS) compared to traditional RUG (4FPS) in identifying urethral strictures.Methods: The study is a prospective RCT conducted at TBRHSC institute as of September 2022 and is still ongoing; it includes a total of 45 participants.RAND function in Excel assigned 21 patients to the traditional RUG arm and 24 to pulsed fluoroscopy RUG.The demographic data, dose, and duration were obtained, as were stricture location during RUG and intraoperative procedure.Results: A total of 77 RUG procedures were performed from September 2022 to the present.The median age of patients was 68 years (range 39-88).Of these, seven patients were found to have no strictures, confirmed through cystoscopy.Another 25 patients were excluded due to the presence of complex stricture disease or the need for procedural manipulation.The preliminary results showed that average X-ray exposure time during RUG for the pulsed fluoroscopy RUG group (n=25), set at one frame per second (FPS), was 0.76 seconds, while it was 0.98 seconds for t h e traditional RUG group (n=21).The average radiation dose for the traditional RUG was 0.00411 Gy, compared to 0.00373 Gy for the pulsed RUG group.Data analysis conducted using IBM SPSS (v30.0) and Excel, yielded an F-statistic of 1.24, which was compared to the critical F-value (24,21) of 2.05 at a 95% confidence interval (=0.005).This result indicated no significant difference in radiation doses between the two groups (p=0.30).RUG results were compared with intraoperative findings, with results showing specificity of 100% and an accuracy of 100%.Urethral strictures were categorized as bulbar urethral strictures (66.66%) and penile urethral strictures (33.33%).Conclusions: Pulsed retrograde urethrography (RUG) demonstrates exceptional diagnostic accuracy (100%) while significantly reducing X-ray exposure time (ALARA principle).Although the observed reduction in radiation dose did not reach statistical significance -potentially due to the judicious use of the X-ray paddle by the physician and the variability in patients' BMI -these findings nonetheless highlight the potential of pulsed RUG to enhance patient safety.Further studies and data are warranted to establish the feasibility of pulsed RUG as an innovative and safer diagnostic modality for the evaluation of urethral stricture in male patients.