British Association of Urological Surgeons standards for management of acute ureteric colic

Tsiotras, A.; Smith, Daron; Pearce, Ian; O’Flynn, Kieran; Wiseman, Oliver

doi:10.1177/2051415817740492

Cited by 23 publications

(23 citation statements)

References 17 publications

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“…Guidelines for urolithiasis management were available from the American Urological Association (AUA), British Association of Urological Surgeons (BAUS), Canadian Urological Association (CUA), European association of Urology (EAU) and NICE [1][2][3][4][5][6]. Their recommendations are summarised in the table (Table 1).…”

Section: Guidelines and Position Statements: Stone Managementmentioning

confidence: 99%

Consensus of multiple national guidelines: agreed strategies for initial stone management during COVID-19

et al. 2020

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Purpose To review the existing available information regarding urolithiasis management and the impact of COVID-19 on this, and propose recommendations for management of emergency urolithiasis presentations in the COVID-19 era. Methods Review of published guidelines produced by Urological Governing Bodies, followed by the literature review regarding urolithiasis management during the COVID-19 pandemic. Results Consistent recommendations across guidelines and literature were that urolithiasis with concurrent sepsis or renal failure remains a urological emergency warranting urgent intervention within the pandemic environment. Ureteric stenting and percutaneous nephrostomy are considered equivalent for decompression in this setting, with both ideally to be performed under local anaesthesia where possible to spare ventilators and reduce aerosol-generating procedures. Greater utilization of medical expulsive therapy and dissolution chemolysis may occur during the pandemic, and longer indwelling stent times may be accepted while definite stone clearance is deferred. Conclusions Urolithiasis will continue to be a source of emergency presentations requiring urgent intervention during the COVID-19 pandemic. However, it is possible to limit these interventions to decompression of the collecting system in the setting of concurrent obstruction or infection, performed under local anaesthesia to limit use of resources and minimise aerosol-generating procedures, with deferral of definitive management.

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Section: Guidelines and Position Statements: Stone Managementmentioning

confidence: 99%

Consensus of multiple national guidelines: agreed strategies for initial stone management during COVID-19

et al. 2020

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“…It is recommended as the initial investigation by both the British Association of Urological Surgeons and the European Association of Urology. 2, 4 CT is the most accurate way to diagnose renal tract calculi and it can also detect conditions that may mimic renal colic clinically. Given its widespread use, it is important the urologist has an understanding of CT techniques and image interpretation.…”

Section: Introductionmentioning

confidence: 99%

A radiologist’s approach to CT KUB for the urologist

Coates

Wilkinson

2019

Journal of Clinical Urology

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In this article we review the computed tomography imaging features of renal and ureteric calculi, the secondary signs of renal tract calculi and their possible complications. Most calculi appear as high-density foci due to their composition, whereas other signs that may be appreciated include the soft-tissue rim sign in the ureter, upstream renal tract dilation and peri-ureteric or peri-renal stranding. The most accurate means of measuring a calculus is in the coronal plane on bone windows. We also provide a systematic approach to interrogating computed tomography of the kidneys, ureter and bladder for the urologist, with examples of other conditions that may present as renal colic and are apparent on computed tomography. Level of evidence: Not applicable as no original research is being proffered.

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“…The number of hospital attendances and acute admissions to UK hospitals due to urolithiasis is increasing with over 87,000 stone related acute care admissions in the year 2017-2018. 1 The British Association of Urological Surgeons (BAUS) have published guidelines for the management of patients presenting with ureteric colic 2 . Patients with a nonobstructing ureteric stone and no evidence of sepsis or renal compromise can be managed expectantly as an outpatient, negating the need for inpatient care.…”

mentioning

confidence: 99%

“…Patients with a nonobstructing ureteric stone and no evidence of sepsis or renal compromise can be managed expectantly as an outpatient, negating the need for inpatient care. 2 The recommendation is that this subgroup of patients should subsequently be followed up in the outpatient setting within 4 weeks with some form of imaging. Trying to achieve this recommendation can be timely, resource-intensive and not always feasible within the timeframe specified.…”

mentioning

confidence: 99%

“…Many consensus groups also advocate stone analysis in those presenting with urolithiasis to try and combat the health and economic burden associated with patients forming multiple stones. [2][3][4][5] Stone analysis is relatively inexpensive and can lead to the identification of an easily treatable condition. This will allow clinicians to provide patients with bespoke dietary and lifestyle advise to try and prevent further stone formation.…”

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confidence: 99%

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The Importance of Stone Retrieval in the Modern Management of Urolithiasis

Khela¹,

Ravindraanandan

Jones³

et al. 2020

Journal of Endoluminal Endourology

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Background and ObjectivesWorld urolithiasis is increasing with a 70% increase in hospital admissions between 2000 and 2015. Stone analysis can allow for the identification of metabolic conditions and stone retrieval may decrease the need for follow-up imaging, reducing costs and patient radiation.This study aimed to see if introducing the UroPro© Stone catcher into our practise would increase stone retrieval thus increasing stone analysis rates and reducing the need for follow-up imaging. MethodsBetween November 2018 and July 2019 patients receiving ESWL or being conservatively managed for a ureteric stone were discharged with a Paramount Medical solutions UroPro© Stone Catcher. Both groups of patients were asked to complete a patient survey regarding the product. ResultsThere were 27 patients recruited. 14 from SWL and 13 from acute admissions. 22 responses were received in total: 10 from acute admissions and 12 from ESWL. 5 patients were uncontactable. 30% (n=3) of the acute patients passed and caught a stone negating the need for further imaging. 30% (n=3) did not pass their stone and required either emergency or elective intervention. 1 patient passed his stone into the toilet whilst another had the stone in their bladder when they were taken to theatre. 20% (n=2) patients but did not catch their stone requiring follow-up imaging which revealed the stone had passed. In the ESWL group 16% (n=2) caught a fragment, the rest found they only passed dust. Stone analysis was performed in all 5 patients who returned a fragment. A total of 73% (n=16) of patients reported over 75% compliance with the stone catcher. 59% (n=13) reported that the stone catcher was easy to use whilst 27% (n=6) found it hard. When given a choice of sieving methods. Only 6 patients (27%) would opt to use the stone catcher with over half, 64% (n=14), preferring more traditional methods of sieving urine over the stone catcher. the patient 0.5 to 2.8 mSv of radiation from follow-up imaging, the NHS circa £100 per unnecessary follow-up computed tomography (CT) scan and aids metabolic analysis. Over time both factors may be substantial. Therefore, emphasizing the benefits and importance to patients to sieve their urine regardless of the techniques is paramount in the modern management of urolithiasis.ConclusionThe UroPro© stone catcher did increase the number of stones caught and sent for analysis. However, many patients preferred the older ‘sieving’ methods. Stone catchers retail at £5.50, therefore ‘sieving’ remains more cost-effective. Stone retrieval in any form remains advantageous as confirming stone passage saves

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British Association of Urological Surgeons standards for management of acute ureteric colic

Cited by 23 publications

References 17 publications

Consensus of multiple national guidelines: agreed strategies for initial stone management during COVID-19

Consensus of multiple national guidelines: agreed strategies for initial stone management during COVID-19

A radiologist’s approach to CT KUB for the urologist

The Importance of Stone Retrieval in the Modern Management of Urolithiasis

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