EAU Guidelines on Diagnosis and Conservative Management of Urolithiasis.


CONTEXT:Low-dose computed tomography (CT) has become the first choice for detection of ureteral calculi. Conservative observational management of renal stones is possible, although the availability of minimally invasive treatment often leads to active treatment. Acute renal colic due to ureteral stone obstruction is an emergency that requires immediate pain management. Medical expulsive therapy (MET) for ureteral stones can support spontaneous passage in the absence of complicating factors. These guidelines summarise current recommendations for imaging, pain management, conservative treatment, and MET for renal and ureteral stones. Oral chemolysis is an option for uric acid stones. OBJECTIVE:To evaluate the optimal measures for diagnosis and conservative and medical treatment of urolithiasis. EVIDENCE ACQUISITION:Several databases were searched for studies on imaging, pain management, observation, and MET for urolithiasis, with particular attention to the level of evidence. EVIDENCE SYNTHESIS:Most patients with urolithiasis present with typical colic symptoms, but stones in the renal calices remain asymptomatic. Routine evaluation includes ultrasound imaging as the first-line modality. In acute disease, low-dose CT is the method of choice. Ureteral stones <6mm can pass spontaneously in well-controlled patients. Sufficient pain management is mandatory in acute renal colic. MET, usually with α-receptor antagonists, facilitates stone passage and reduces the need for analgesia. Contrast imaging is advised for accurate determination of the renal anatomy. Asymptomatic calyceal stones may be observed via active surveillance. CONCLUSIONS:Diagnosis, observational management, and medical treatment of urinary calculi are routine measures. Diagnosis is rapid using low-dose CT. However, radiation exposure is a limitation. Active treatment might not be necessary, especially for stones in the lower pole. MET is recommended to support spontaneous stone expulsion. PATIENT SUMMARY:For stones in the lower pole of the kidney, treatment may be postponed if there are no complaints. Pharmacological treatment may promote spontaneous stone passage.


Eur Urol


European urology


Türk C,Petřík A,Sarica K,Seitz C,Skolarikos A,Straub M,Knoll T




Has Abstract


2016-03-01 00:00:00














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    journal_title:European urology

    pub_type: 杂志文章


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    更新日期:1984-01-01 00:00:00

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    abstract::The records of children enrolled in the National Wilms' Tumor Study-3 who had Wilms' tumor and thrombosis into the renal vein were reviewed. There were 164 patients with gross involvement of the extrarenal vein and 47 patients with microscopic involvement, an incidence of 11.3% (211 of 1,865 evaluable patients). Two-y...

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    abstract:OBJECTIVE:The dietary habits of interstitial cystitis (IC) patients compared to the average food and fluid consumption of the general population were evaluated and any spontaneous preference or avoidance of specific foodstuffs and fluids of IC patients was investigated. METHODS:A verbal interview with 16 IC patients p...

    journal_title:European urology

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    authors: Bade JJ,Peeters JM,Mensink HJ

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  • Priapism of the clitoris.

    abstract::Priapism of the clitoris is a rare entity. A case of painful priapism is reported in a patient who had previously suffered a radical cystectomy for bladder carcinoma pT3-GIII, followed by local recurrence in the pelvis. From a symptomatic point of view she showed a good response to conservative treatment (analgesics a...

    journal_title:European urology

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  • Acupuncture versus paroxetine for the treatment of premature ejaculation: a randomized, placebo-controlled clinical trial.

    abstract:BACKGROUND:Acupuncture therapy has been used by many researchers in both male and female sexual dysfunction studies. OBJECTIVE:To determine whether acupuncture is effective as a premature ejaculation (PE) treatment compared with paroxetine and placebo. DESIGN, SETTING, AND PARTICIPANTS:The study was conducted with me...

    journal_title:European urology

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  • Sexual functioning of adult patients born with meningomyelocele. A pilot study.

    abstract:OBJECTIVES:This pilot study was started to get an impression of the sexual activity and sexual difficulties of adult patients born with meningomyelocele in control at Utrecht University Hospital, and to find out whether these problems deserve more attention from the Spina Bifida Team. METHODS:Seventeen patients (9 men...

    journal_title:European urology

    pub_type: 杂志文章


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  • A preoperative prognostic model for patients treated with nephrectomy for renal cell carcinoma.

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    journal_title:European urology

    pub_type: 杂志文章,多中心研究


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    journal_title:European urology

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    更新日期:2008-11-01 00:00:00

  • Robot-assisted laparoscopic radical prostatectomy: oncologic and functional results of 184 cases.

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    journal_title:European urology

    pub_type: 杂志文章


    authors: Mottrie A,Van Migem P,De Naeyer G,Schatteman P,Carpentier P,Fonteyne E

    更新日期:2007-09-01 00:00:00

  • Trends in the use of perioperative chemotherapy for localized and locally advanced muscle-invasive bladder cancer: a sign of changing tides.

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    journal_title:European urology

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    authors: Reardon ZD,Patel SG,Zaid HB,Stimson CJ,Resnick MJ,Keegan KA,Barocas DA,Chang SS,Cookson MS

    更新日期:2015-01-01 00:00:00

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    pub_type: 共识发展会议,杂志文章,实务指引,评审


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    更新日期:2015-03-01 00:00:00

  • Spread of onabotulinumtoxinA after bladder injection. Experimental study using the distribution of cleaved SNAP-25 as the marker of the toxin action.

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    journal_title:European urology

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    authors: Coelho A,Cruz F,Cruz CD,Avelino A

    更新日期:2012-06-01 00:00:00

  • Postpubertal cryptorchism. Morphofunctional study with special reference to Leydig's cells.

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    authors: Chen WS,Aggarwal R,Zhang L,Zhao SG,Thomas GV,Beer TM,Quigley DA,Foye A,Playdle D,Huang J,Lloyd P,Lu E,Sun D,Guan X,Rettig M,Gleave M,Evans CP,Youngren J,True L,Lara P,Kothari V,Xia Z,Chi KN,Reiter RE,Maher

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    journal_title:European urology

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    authors: Cifuentes Delatte L,Santos M

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  • Androgen-deprivation therapy and diabetes control among diabetic men with prostate cancer.

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    journal_title:European urology

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    journal_title:European urology

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    journal_title:European urology

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    pub_type: 杂志文章


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    journal_title:European urology

    pub_type: 杂志文章


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    journal_title:European urology

    pub_type: 杂志文章


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    journal_title:European urology

    pub_type: 杂志文章


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  • Survival and impact of clinical prognostic factors in surgically treated metastatic renal cell carcinoma.

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    journal_title:European urology

    pub_type: 杂志文章


    authors: Tosco L,Van Poppel H,Frea B,Gregoraci G,Joniau S

    更新日期:2013-04-01 00:00:00

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    journal_title:European urology

    pub_type: 杂志文章


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    journal_title:European urology

    pub_type: 评论,社论


    authors: Miller DC,Birkmeyer JD

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