1. INTRODUCTION
1.1. Aim
The European Association of Urology (EAU) Paediatric Urology Guidelines Panel has prepared these Guidelines with the aim of increasing the quality of care for children with urological conditions. This Guideline document is limited to a number of common clinical pathologies in paediatric urological practice, as covering the entire field of paediatric urology in a single guideline document is unattainable.
The majority of urological clinical problems in children are specialised and in many ways differ to those in adults. This publication intends to outline a practical and preliminary approach to paediatric urological conditions. Complex and rare conditions that require special care with experienced doctors should be referred to designated centres where paediatric urology practice has been fully established and a multidisciplinary team is available.
Over time, paediatric urology has developed and matured, establishing its diverse body of knowledge and expertise and may now be ready to distinguish itself from its parent specialties. Thus, paediatric urology has recently emerged in many European countries as a distinct subspecialty of both urology and paediatric surgery and presents a unique challenge in the sense that it covers a large area with many different schools of thought and a huge diversity in management.
Knowledge gained by increasing experience, new technological advances and non-invasive diagnostic screening modalities has had a profound influence on treatment modalities in paediatric urology, a trend that is likely to continue in the years to come.
It must be emphasised that clinical guidelines present the best evidence available to the experts but following guideline recommendations will not necessarily result in the best outcome. Guidelines can never replace clinical expertise when making treatment decisions for individual patients, but rather help to focus decisions - also taking personal values and preferences/individual circumstances of children and their caregivers into account. Guidelines are not mandates and do not purport to be a legal standard of care.
1.2. Panel composition
The EAU Paediatric Urology Guidelines Panel consists of an international group of clinicians with particular expertise in this area. All experts involved in the production of this document have submitted potential conflict of interest statements, which can be viewed on the EAU Website: http://uroweb.org/guideline/paediatric-urology/.
1.3. Available publications
A quick reference document, the Pocket Guidelines, is available in print. This is an abridged version which may require consultation together with the full-text version. A number of translated versions, alongside several scientific publications are also available [1-13]. All documents are accessible through the EAU website Uroweb: http://uroweb.org/guideline/paediatric-urology/.
A EAU Guidelines App for iOS and Android devices is also available containing the Pocket Guidelines, interactive algorithms and calculators, clinical decision support tools, guidelines cheat sheets and links to the extended guidelines.
1.4. Publication history
The Paediatric Urology Guidelines were first published in 2001 [14]. This 2024 publication includes a number of updated chapters and sections as detailed below.
1.5. Summary of changes
The literature for the complete document has been assessed and updated, wherever relevant. Key changes in the 2024 publication:
- Section 3.2 Management of undescended testes
- Section 3.3 Testicular Tumours in prepubertal boys
- Section 3.6 Acute scrotum
- Section 3.7 Hypospadias
- Section 3.8 Congenital penile curvature
- Section 3.10 Urinary tract infections in children
- Section 3.11 Day-time lower urinary tract conditions
- Section 3.13 Spinal dysraphism in children and adolescents (a new Guideline to replace the section on neurogenic bladder)
- Section 3.20.1 Rare Conditions in Childhood: Urachal remnants
- Section 3.25 Transitional urology (new section)