Follow-up of urolithiasis patients after treatment: an algorithm from the EAU Urolithiasis Panel

Kód výsledku v IS VaVaI

<a href="https://www.isvavai.cz/riv?ss=detail&h=RIV%2F00216208%3A11110%2F24%3A10482051" target="_blank" >RIV/00216208:11110/24:10482051 - isvavai.cz</a>

Výsledek na webu

<a href="https://verso.is.cuni.cz/pub/verso.fpl?fname=obd_publikace_handle&handle=RECLKrceqx" target="_blank" >https://verso.is.cuni.cz/pub/verso.fpl?fname=obd_publikace_handle&handle=RECLKrceqx</a>

DOI - Digital Object Identifier

<a href="http://dx.doi.org/10.1007/s00345-024-04872-y" target="_blank" >10.1007/s00345-024-04872-y</a>

Jazyk výsledku

angličtina

Název v původním jazyce

Follow-up of urolithiasis patients after treatment: an algorithm from the EAU Urolithiasis Panel

Popis výsledku v původním jazyce

Objective: To develop a follow-up algorithm for urinary stone patients after definitive treatment. Materials and methods: The panel performed a systematic review on follow-up of urinary stone patients after treatment (PROSPERO: CRD42020205739). Given the lack of comparative studies we critically evaluated the literature and reached a consensus on the follow-up scheme. Results: A total of 76 studies were included in the analysis, including 17 RCTs. In the stone-free general population group, 71–100% of patients are stone-free at 12 months while 29–94% remain stone-free at 36 months. We propose counselling these patients on imaging versus discharge after the first year. The stone-free rate in high-risk patients not receiving targeted medical therapy is &lt; 40% at 36 months, a fact that supports imaging, metabolic, and treatment monitoring follow-up once a year. Patients with residual fragments ≤ 4 mm have a spontaneous expulsion rate of 18–47% and a growth rate of 10–41% at 12 months, supporting annual imaging follow-up. Patients with residual fragments &gt; 4 mm should be considered for surgical re-intervention based on the low spontaneous expulsion rate (13% at 1 year) and high risk of recurrence. Plain film KUB and/or kidney ultrasonography based on clinicians’ preference and stone characteristics is the preferred imaging follow-up. Computed tomography should be considered if patient is symptomatic or intervention is planned. Conclusions: Based on evidence from the systematic review we propose, for the first time, a follow-up algorithm for patients after surgical stone treatment balancing the risks of stone recurrence against the burden of radiation from imaging studies.

Název v anglickém jazyce

Follow-up of urolithiasis patients after treatment: an algorithm from the EAU Urolithiasis Panel

Popis výsledku anglicky

Objective: To develop a follow-up algorithm for urinary stone patients after definitive treatment. Materials and methods: The panel performed a systematic review on follow-up of urinary stone patients after treatment (PROSPERO: CRD42020205739). Given the lack of comparative studies we critically evaluated the literature and reached a consensus on the follow-up scheme. Results: A total of 76 studies were included in the analysis, including 17 RCTs. In the stone-free general population group, 71–100% of patients are stone-free at 12 months while 29–94% remain stone-free at 36 months. We propose counselling these patients on imaging versus discharge after the first year. The stone-free rate in high-risk patients not receiving targeted medical therapy is &lt; 40% at 36 months, a fact that supports imaging, metabolic, and treatment monitoring follow-up once a year. Patients with residual fragments ≤ 4 mm have a spontaneous expulsion rate of 18–47% and a growth rate of 10–41% at 12 months, supporting annual imaging follow-up. Patients with residual fragments &gt; 4 mm should be considered for surgical re-intervention based on the low spontaneous expulsion rate (13% at 1 year) and high risk of recurrence. Plain film KUB and/or kidney ultrasonography based on clinicians’ preference and stone characteristics is the preferred imaging follow-up. Computed tomography should be considered if patient is symptomatic or intervention is planned. Conclusions: Based on evidence from the systematic review we propose, for the first time, a follow-up algorithm for patients after surgical stone treatment balancing the risks of stone recurrence against the burden of radiation from imaging studies.

Druh

J_imp - Článek v periodiku v databázi Web of Science

CEP obor

—

OECD FORD obor

30217 - Urology and nephrology

Projekt

—

Návaznosti

V - Vyzkumna aktivita podporovana z jinych verejnych zdroju

Rok uplatnění

2024

Kód důvěrnosti údajů

S - Úplné a pravdivé údaje o projektu nepodléhají ochraně podle zvláštních právních předpisů

Název periodika

World Journal of Urology

ISSN

0724-4983

e-ISSN

1433-8726

Svazek periodika

42

Číslo periodika v rámci svazku

1

Stát vydavatele periodika

US - Spojené státy americké

Počet stran výsledku

10

Strana od-do

202

Kód UT WoS článku

001195506000002

EID výsledku v databázi Scopus

2-s2.0-85189169971