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Verfasst von:Türk, Christian [VerfasserIn]   i
 Knoll, Thomas [VerfasserIn]   i
Titel:EAU guidelines on diagnosis and conservative management of urolithiasis
Verf.angabe:Christian Türk, Aleš Petřík, Kemal Sarica, Christian Seitz, Andreas Skolarikos, Michael Straub, Thomas Knoll
E-Jahr:2016
Jahr:March 2016
Umfang:7 S.
Fussnoten:Gesehen am 30.10.2019
Titel Quelle:Enthalten in: European urology
Ort Quelle:Amsterdam [u.a.] : Elsevier Science, 1976
Jahr Quelle:2016
Band/Heft Quelle:69(2016), 3, Seite 468-474
ISSN Quelle:1873-7560
 1421-993X
Abstract: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.
DOI:doi:10.1016/j.eururo.2015.07.040
URL:Bitte beachten Sie: Dies ist ein Bibliographieeintrag. Ein Volltextzugriff für Mitglieder der Universität besteht hier nur, falls für die entsprechende Zeitschrift/den entsprechenden Sammelband ein Abonnement besteht oder es sich um einen OpenAccess-Titel handelt.

Volltext: https://doi.org/10.1016/j.eururo.2015.07.040
 Volltext: http://www.sciencedirect.com/science/article/pii/S0302283815006995
 DOI: https://doi.org/10.1016/j.eururo.2015.07.040
Datenträger:Online-Ressource
Sprache:eng
Sach-SW:Chemolitholysis
 Computed tomography
 EAU guidelines
 Medical expulsive therapy
 Percutaneous nephrolithotomy
 Shock wave lithotripsy
 Stone surgery
 Ureteroscopy
 Urinary calculi
K10plus-PPN:1680708368
Verknüpfungen:→ Zeitschrift

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