Guidelines

Non-neurogenic Female LUTS

2. METHODS

2.1. Introduction

For the 2021 Non-neurogenic Female Lower Urinary Tract Symptoms Guidelines, the existing text of the 2018 Urinary Incontinence Guidelines was restructured and expanded. The Patient/Population, Intervention, Comparison and Outcome (PICO) question-based format of the text was modified to improve readability, although the underlying PICO structure still informs search strategies.

For the 2022 Non-neurogenic Female Lower Urinary Tract Symproms Guidelines, databases searched included Medline, Embase, and the Cochrane Libraries, covering a time frame between 12 June 2020 and 07 September 2021 with a focus on high-level evidence only (systematic reviews and meta-analyses). A total of 187 unique records were identified, retrieved and screened for relevance. Detailed search strategies are available online:

https://uroweb.org/guidelines/non-neurogenic-female-luts/publications-appendices.

For the 2022 edition of the guidelines a de novo systematic review (SR) was undertaken by the Panel on the subject of overactive bladder syndrome [11]. Full publication of the SR results are pending; however, the preliminary results have informed the corresponding sections of this guidelines update.


For each recommendation within the guidelines there is an accompanying online strength rating form, the basis of which is a modified Grading of Recommendations Assessment, Development and Evaluation (GRADE) methodology [12,13]. Each strength rating form addresses a number of key elements, namely:

  1. overall quality of the evidence which exists for the recommendation; references used in this text are graded according to a classification system modified from the Oxford Centre for Evidence-Based Medicine Levels of Evidence [14];
  2. magnitude of the effect (individual or combined effects);
  3. certainty of the results (precision, consistency, heterogeneity and other statistical or study-related factors);
  4. balance between desirable and undesirable outcomes;
  5. impact of patient values and preferences on the intervention;
  6. certainty of those patient values and preferences.

These key elements are the basis that panels use to define the strength rating of each recommendation. The strength of each recommendation is represented by the words strong or weak [15]. The strength rating forms will be available online.

Additional information can be found in the general Methodology section of this print, and online at the EAU website: https://uroweb.org/guidelines/policies-and-methodological-documents/.

A list of Associations endorsing the EAU Guidelines can also be viewed online at the above address.

2.2. Review

The guidelines were extensively peer reviewed prior to publication in 2021.

2.3. Future goals

  • Systematic review of pelvic organ prolapse;
  • Systematic review of synthetic/mesh-related mid-urethral sling complications;
  • Systematic review of the diagnosis and treatment of UAB in women.