Surgical management of urolithiasis - a systematic analysis of available guidelines.

Zumstein, Valentin; Betschart, Patrick; Abt, Dominik; Schmid, Hans-Peter; Panje, Cedric Michael; Putora, Paul Martin (2018). Surgical management of urolithiasis - a systematic analysis of available guidelines. BMC urology, 18(1), p. 25. BMC 10.1186/s12894-018-0332-9

[img]
Preview
Text
s12894-018-0332-9.pdf - Published Version
Available under License Creative Commons: Attribution (CC-BY).

Download (1MB) | Preview

BACKGROUND

Several societies around the world issue guidelines incorporating the latest evidence. However, even the most commonly cited guidelines of the European Association of Urology (EAU) and the American Urological Association (AUA) leave the clinician with several treatment options and differ on specific points. We aimed to identify discrepancies and areas of consensus between guidelines to give novel insights into areas where low consensus between the guideline panels exists, and therefore where more evidence might increase consensus.

METHODS

The webpages of the 61 members of the Societé Internationale d'Urologie were analysed to identify all listed or linked guidelines. Decision trees for the surgical management of urolithiasis were derived, and a comparative analysis was performed to determine consensus and discrepancies.

RESULTS

Five national and one international guideline (EAU) on surgical stone treatment were available for analysis. While 7 national urological societies refer to the AUA guidelines and 11 to the EAU guidelines, 43 neither publish their own guidelines nor refer to others. Comparative analysis revealed a high degree of consensus for most renal and ureteral stone scenarios. Nevertheless, we also identified a variety of discrepancies between the different guidelines, the largest being the approach to the treatment of proximal ureteral calculi and larger renal calculi.

CONCLUSIONS

Six guidelines with recommendations for the surgical treatment of urolithiasis to support urologists in decision-making were available for inclusion in our analysis. While there is a high grade of consensus for most stone scenarios, we also detected some discrepancies between different guidelines. These are, however, controversial situations where adequate evidence to assist with decision-making has yet to be elicited by further research.

Item Type:

Journal Article (Original Article)

Division/Institute:

04 Faculty of Medicine > Department of Haematology, Oncology, Infectious Diseases, Laboratory Medicine and Hospital Pharmacy (DOLS) > Clinic of Radiation Oncology

UniBE Contributor:

Putora, Paul Martin

Subjects:

600 Technology > 610 Medicine & health

ISSN:

1471-2490

Publisher:

BMC

Language:

English

Submitter:

Beatrice Scheidegger

Date Deposited:

21 Jun 2018 15:30

Last Modified:

19 May 2021 18:43

Publisher DOI:

10.1186/s12894-018-0332-9

PubMed ID:

29636048

Uncontrolled Keywords:

Consensus Decision tree Guidelines Management Surgical Urolithiasis

BORIS DOI:

10.7892/boris.116290

URI:

https://boris.unibe.ch/id/eprint/116290

Actions (login required)

Edit item Edit item
Provide Feedback