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For the 2018 edition of the EAU Neuro-Urology Guidelines the Guidelines Office have transitioned to a modified GRADE methodology. For each recommendation within the guidelines there is an accompanying online strength rating form which addresses a number of key elements namely:
- the overall quality of the evidence which exists for the recommendation;
- the magnitude of the effect (individual or combined effects);
- the certainty of the results (precision, consistency, heterogeneity and other statistical or study related factors);
- the balance between desirable and undesirable outcomes;
- the impact of patient values and preferences on the intervention;
- the certainty of those patient values and preferences.
These key elements are the basis which panels use to define the strength rating of each recommendation. The strength of each recommendation is determined by the balance between desirable and undesirable consequences of alternative management strategies, the quality of the evidence, and nature and variability of patient values and preferences. The strength of each recommendation is represented by the words ‘strong’ or ‘weak’.
In addition, new and relevant evidence has been identified, collated and appraised through a structured assessment of the literature. A broad and comprehensive literature search, covering all sections of the Neuro-Urology Guidelines was performed. Twenty one dditional references and text updates have been incorporated throughout the text as a result of this search. Furthermore, all recommendations have been rephrased throughout the current document to aid in their implementation.
For the 2017 Neuro-Urology Guidelines, new and relevant evidence has been identified, collated and appraised through a structured assessment of the literature. A broad and comprehensive literature search, covering all sections of the Neuro-Urology Guidelines was performed. Additional references and text updates have been incorporated throughout the text as a result of this search. Furthermore, all recommendations have been rephrased throughout the current document to aid in their implementation.
Systematic review results included in the 2017 Urological Trauma Guidelines include:
- Continent catheterisable tubes/stomas in neuro-urological patients: A systematic review.
- What is the long-term effectiveness and complication rate for bladder augmentation in
patients with neurogenic bladder dysfunction?
All chapters of the 2016 Neuro-urology Guidelines have been updated, based on the 2015 version of the guideline. Conclusions and recommendations have been rephrased and added to, throughout the current document.
Key changes for the 2016 publication:
Section 3.1: The summary table on epidemiology of neuro-urological disorders has been revised. (Table 1);
- Section 3.2: The Definitions useful in clinical practice table has been updated (Table 2), as well as Table 3
- Definitions useful when interpreting urodynamic studies;
- Section 3.3: Diagnostic evaluation, new figures have been included, as well as a new table (Table 4) presenting an overview of available patient questionnaires;
- Section 3.4: Non-invasive conservative treatment – inclusion of the systematic review results (Tibial nerve stimulation for treating neuro-urological patients: a systematic review and meta-analysis).
For the 2015 Guidelines, the text has been significantly reduced so that only key information is included and re-formatted according to the EAU non-oncology template so that all Guidelines follow a similar format.
For this 2015 print, specifically updates were made to:
- Chapter 3A: A new table summarising epidemiology of neuro-urological disorders has been added (Table 1) and text in this chapter has consequently been replaced.
- Chapter 3D: The sections on botulinum toxin sphincter injection (3D.2.5.4) and surgical treatment (3D.2.6) have been revised and updated.
- Chapter 3F: Sexual (dys)function and fertility has been revised and updated.
For this 2014 update the following changes should be noted:
Non-invasive treatment: This chapter has been revised and the literature was updated for the sections on drug treatment and surgical treatment.
Urinary tract infection: This chapter has been completely revised.
Sexual (dys)function and fertility: This chapter has been completely revised.
Follow-up: This chapter has been revised.