Adherence to guidelines in the management of urolithiasis: are there differences among distinct patient care settings?

Eismann, Lennert; Kretschmer, Alexander; Bader, Markus; Kess, Sabine; Stief, Christian G.; Strittmatter, Frank

doi:10.1007/s00345-020-03562-9

Cited by 3 publications

(3 citation statements)

References 27 publications

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“…The role of the EAU Urolithiasis Guideline Panel is to provide such a tool on an annual basis [ 12 ]. Nonetheless, there are different approaches in diagnosis, follow-up, and treatment decisions in the everyday clinical practice [ 8 – 11 ]. The survey demonstrated that more than 80% of urologists depend on local or international guidelines when approaching renal colic patients.…”

Section: Discussionmentioning

confidence: 99%

“…Surveys from different European countries have demonstrated significant differences regarding diagnostic and treatment strategies. Urologists working in university hospitals are more inclined to adopt guidelines compared to those who practice in non-academic centers [ 9 , 10 , 11 ]. The aim of this study is to control the adherence of European countries to the EAU guidelines of urolithiasis and demonstrate different trends in diagnostic and treatment approach in a European level.…”

Section: Introductionmentioning

confidence: 99%

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Current management of renal colic across Europe and its compliance to the European Association of Urology Guidelines on Urolithiasis: a survey from the European Section of Uro-technology, European Section of Urolithiasis, Young Academic Urologists study groups

Güven

Sönmez

Somani

et al. 2022

Cent european J Urol

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Introduction Renal colic due to ureteral stones represents the primary acute condition in urology. Although guideline recommendations are available the institution, urologist, and patient preferences in diagnosis and treatment may differ. We aimed to evaluate the adherence of different European countries to the European Association of Urology (EAU) guidelines of urolithiasis and demonstrate trends in diagnostic and treatment approaches. Material and methods We used a survey including 33 questions clustered in four sections. The survey was circulated to the representatives of the main urological centers in Europe using the European Section of Uro-technology (ESUT), the European Section of Urolithiasis (EULIS), the Young Academic Urologists (YAU), and the European Urology Residents Education Programme (EUREP) mailing lists. The first section included participant and institution demographics, the second assessed the common diagnostic and treatment pathways, the third discussed the advantages and disadvantages of treatment strategies and the fourth investigated treatment preferences in different clinical scenarios. A descriptive analysis was performed. Results Of all participants, 84.21% stated that their departments follow specific guidelines, with no significant differences between institutions (p = 0.18). Preferred treatment practice difference in the case scenarios was significantly influenced by the Department bed capacities (p = 0.01), and complications varied between institutions (p = 0.02). Interestingly, 37–45% of participants were unaware of the different treatment costs. Conclusions Although urologists generally decide according to local or international guidelines when approaching renal colic patients, there are deviations in clinical practice due to ‘doctor preference’ and ‘bed availability’. Many urologists are unaware of treatment costs.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Current management of renal colic across Europe and its compliance to the European Association of Urology Guidelines on Urolithiasis: a survey from the European Section of Uro-technology, European Section of Urolithiasis, Young Academic Urologists study groups

Güven

Sönmez

Somani

et al. 2022

Cent european J Urol

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“…Due to the lack of outpatient urological care for the patients, they are cared for by general practitioners during this period. Depending on the health care system, uniform guidelines are not always applied in further outpatient urological care [3].…”

Section: Introductionmentioning

confidence: 99%

Impact of Stone Localization before Emergency Ureteral Stenting on Further Stone Treatment

et al. 2022

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Introduction: Ureter stones leading to severe pain and urosepsis are usually treated by emergency primary ureteral stenting. However, this intervention can significantly change the location of the stone, potentially also changing the preferred method and/or technical aspects of definitive treatment. We analyzed stone location changes and consequences after emergency ureteral stent insertion prior to secondary ureterorenoscopy. Methods: We performed a retrospective analysis of stone locations in 649 patients with a mean age of 52 ± 16 years who were treated with ureterorenoscopy for symptomatic stones from May 2016 to December 2019. All patients with single unilateral ureterolithiasis undergoing definitive stone treatment by secondary ureterorenoscopy were included. In 469 patients, ureteral stone localization before emergency ureteral stenting and at subsequent ureterorenoscopy was evaluated. Additionally, the use of flexible ureterorenoscopy for complete stone removal was also recorded. Results: Inadvertent repositioning of ureteral stones with a mean diameter of 6.9 (±3.1) mm after ureteral stenting was observed in 45.6%. 119 (25.4%) ureteral stones were displaced back into the kidney. Proximal stones showed a particularly high incidence of repositioning into the renal pelvis (42%, p < 0.05). The majority of cases required the use of flexible ureterorenoscopy showed a primary proximal ureteral localization (60 of 85 patients, 70.5%). Discussion/Conclusion: Emergency ureteral stenting for ureterolithiasis may change the location of a stone, potentially affecting therapy planning, particularly in the case of proximal stones. Imaging control prior to definitive stone treatment is thus especially advisable for proximal ureteral stones.

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Endoscopic Combined Intrarenal Surgery vs Percutaneous Nephrolithotomy for Large and Complex Renal Stone: A Systematic Review and Meta-Analysis

Widyokirono

Kloping

Hidayatullah

et al. 2022

Journal of Endourology

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Adherence to guidelines in the management of urolithiasis: are there differences among distinct patient care settings?

Cited by 3 publications

References 27 publications

Current management of renal colic across Europe and its compliance to the European Association of Urology Guidelines on Urolithiasis: a survey from the European Section of Uro-technology, European Section of Urolithiasis, Young Academic Urologists study groups

Current management of renal colic across Europe and its compliance to the European Association of Urology Guidelines on Urolithiasis: a survey from the European Section of Uro-technology, European Section of Urolithiasis, Young Academic Urologists study groups

Impact of Stone Localization before Emergency Ureteral Stenting on Further Stone Treatment

Endoscopic Combined Intrarenal Surgery vs Percutaneous Nephrolithotomy for Large and Complex Renal Stone: A Systematic Review and Meta-Analysis

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