The Urological Association of Asia clinical guideline for urinary stone disease

Abstract

The Urological Association of Asia, consisting of 25 member associations and one affiliated member since its foundation in 1990, has planned to develop Asian guidelines for all urological fields. The field of stone diseases is the third of its guideline projects. Because of the different climates, and social, economic and ethnic environments, the clinical practice for urinary stone diseases widely varies among the Asian countries. The committee members of the Urological Association of Asia on the clinical guidelines for urinary stone disease carried out a surveillance study to better understand the diversity of the treatment strategy among different regions and subsequent systematic literature review through PubMed and MEDLINE database between 1966 and 2017. Levels of evidence and grades of recommendation for each management were decided according to the relevant strategy. Each clinical question and answer were thoroughly reviewed and discussed by all committee members and their colleagues, with suggestions from expert representatives of the American Urological Association and European Association of Urology. However, we focused on the pragmatic care of patients and our own evidence throughout Asia, which included recent surgical trends, such as miniaturized percutaneous nephrolithotomy and endoscopic combined intrarenal surgery. This guideline covers all fields of stone diseases, from etiology to recurrence prevention. Here, we present a short summary of the first version of the guideline – consisting 43 clinical questions – and overview its key practical issues.

Formation of a calcium oxalate urethral stone in a 3‐year‐old boy due to hypocitraturia

“…Instead, citrate does not have adverse effects if administered in an adequate dose. Oral citrate is a widely recognized prevention against urinary stones in adults in many countries . Oral citrate is also recommended for children in the USA .…”

STone Episode Prediction: Development and validation of the prediction nomogram for urolithiasis

“…In 2015, the estimated annual incidence of a first‐episode upper urinary tract stone was 137.9 (191.9 in men and 86.9 in women) per 100 000 . With the increase in the prevalence of urolithiasis, there is a need for an accurate tool by which the risk of a first episode can be predicted to optimize patient screening and treatment strategies . Several studies have identified predictors for the recurrence of a stone after the first episode, the ureteral calculi‐related urosepsis and the stone‐free rate after intervention .…”

Editorial Comment to The Urological Association of Asia clinical guideline for urinary stone disease

“…Therefore, sharing clinical trends and experience among urologists in UAA should hold the potential to improve the level of daily practice. In this respect, the current article, written by Taguchi et al ., could be “a big first step” towards uniting urologists who specialize in urolithiasis among UAA countries …”