Guidelines

Urolithiasis

1. INTRODUCTION

1.1. Aims and scope

The European Association of Urology (EAU) Urolithiasis Guidelines Panel has prepared these guidelines to help urologists assess evidence-based management of stones/calculi in the urinary tract and incorporate recommendations into clinical practice. This 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. Originally available as a separate document, information on the management of bladder stones is now also included in these guidelines.

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. Guidelines are not mandates and do not purport to be a legal standard of care.

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 as an app for iOS and Android devices. These are abridged versions, which may require consultation together with the full text versions. Several scientific publications are also available [1-3]. 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 2022 document presents a limited update of the 2021 version.

1.4.2. Summary of changes

The literature for the entire document has been checked and, wherever relevant, updated (see Methods section 2.1). References and supporting text have also been refreshed.

For 2022, several new sections have been added to these guidelines. These include chapter 3.5. Radiation exposure and protection during endourology and chapter 5. Follow-up of urinary stones. Throughout the text passages on best clinical practice for the use of different interventions have been added to the relevant sections. In addition, chapter 3.4.3 Medical expulsive therapy has been thoroughly revised and the Bladder Stones guidelines, previously a separate document, have been integrated into this text. Four new algorithms have also been added:

  • Figure 4.2: Diagnostic algorithm for calcium vxalate stones
  • Figure 4.6: Diagnostic algorithm for uric acid stones
  • Figure 5.1: Follow-up duration of urinary stone patients after treatments
  • Figure 5.2: Consensus on follow-up frequency and imaging modality to use after treatment