Urolithiasis

Full Text Guidelines Summary of Changes Scientific Publications & Appendices Pocket Guidelines Archive Panel

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C. Türk (Chair), T. Knoll (Vice-chair), A. Petrik, K. Sarica, A. Skolarikos, M. Straub, C. Seitz
Guidelines Associates: S. Dabestani, T. Drake, N. Grivas, Y. Ruhayel, A.K. Tepeler

1.INTRODUCTION

1.1.Aims and scope

The European Association of Urology (EAU) Urolithiasis Guidelines Panel have prepared these guidelines to help urologists assess evidence-based management of stones/calculi and incorporate recommendations into clinical practice. The document covers most aspects of the disease, which is still a cause of significant morbidity despite technological and scientific advances. The Panel is aware of the geographical variations in healthcare provision.

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 patients into account.

1.2.Panel composition

The EAU Urolithiasis 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 Uroweb: http://uroweb.org/guideline/urolithiasis/.

1.3.Available publications

A quick reference document (Pocket guidelines) is available, both in print and in a number of versions for mobile devices. These are abridged versions which may require consultation together with the full text versions. Also a number of translated versions and scientific publications are available [1-6]. All documents can be accessed through the EAU website: http://uroweb.org/guideline/urolithiasis/.

1.4.Publication history and summary of changes

1.4.1.Publication history

The EAU Urolithiasis Guidelines were first published in 2000. This 2016 document presents a limited update of the 2015 publication of the EAU Urolithiasis Guidelines.

1.4.2.Summary of changes

Key changes for the 2016 publication:

The literature for the entire document has been assessed and updated, whenever relevant (see Methods section below).

  • Limited changes were made to the Section 3.4.1.1 - Renal colic
  • The findings of the systematic review performed by the Panel (What are the benefit and harms of URS compared with SWL in the treatment of upper ureteral stones in children and adults? [305]) have been included in Section 3.4.3.3 - Selection of procedure for active removal of ureteral stones.
  • Section 3.4.1.3.2 - Antithrombotic therapy and stone treatment - has been expanded with new data. New table 3.4.1 - Risk stratification for bleeding and table 3.4.2 - Suggested therapies for antithrombotic therapy in stone removal have been added.
  • Figure 3.4.1 - Treatment algorithm for renal calculi has been amended; priority of treatment modalities has changed to shockwave lithotripsy and ureterorenoscopy as first choice of treatment modalities for small upper urinary stones.
  • Recent data has been included in Section 3.4.3.1.2 - Pharmacological treatment, Medical expulsive therapy (MET), which resulted in a lower recommendation (2015 recommendation was GR A).

Recommendation for MET

LE

GR

Offer α-blockers as MET as one of the treatment options.

1a

C

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