Management of asymptomatic kidney stones is an ongoing debate with follow-up and treatment guidelines based on low-level evidence. Our aim was to evaluate current management of asymptomatic urinary stones.
A 70-question survey was designed in collaboration with European Association of Urology, Young Academic Urologists, Section of Uro-Technology and Section of Urolithiasis groups and distributed. Responders filled out hypothetical scenarios from 2 perspectives, either as treating physicians, or as patients themselves.
A total of 212 (40.01%) responses were obtained. Median responder age was 39 years. 75% of responders were interested in "urolithiasis". 82.5% had never experienced a renal colic, 89.6% had never undergone urolithiasis treatment.Overall, as the kidney stone scenarios got more complicated, the invasiveness of the treatment preference increased. As "the physician", responders preferred the conservative option in all situations more than they would choose as "the patient". For ureteral stones, conservative approach was most preferred for small stones and ureteroscopy became more preferred as the stone size increased.For smaller kidney stones, the most preferred follow-up schedule was 4-6 monthly, whereas for larger and complicated stones it was 0-3 monthly from both perspectives respectively. For all ureteral stone scenarios, 0-4 weekly follow-up was mostly preferred.Interestingly, having had a renal colic was an independent predictor of an interventional approach, whereas having had an intervention was an independent predictor of a conservative approach.
Current treatment and follow-up patterns of asymptomatic urinary stones are in agreement with international guidelines on symptomatic stones.In most of the urolithiasis situations urologists chose a conservative approach for their patients compared to what they would prefer for themselves. Conversely, urologists, in the scenarios as "the patient", would like to have a more frequent follow-up schedule for their stones compared to how they would follow-up their patients.
Turkish journal of medical sciences. 2023 Dec 07*** epublish ***
Tarık Emre Şener, Thomas Tailly, Yılören Tanidir, Etienne Xavier Keller, Amelia Pietropaolo, Juan Gomez Rivas, Zeeshan Hameed, Vincent DE Coninck, Tzevat Tefik, Kemal Sarica, Ali Serdar Gözen, Andreas Skolarikos, Olivier Traxer, Christian Seitz, Bhaskar Somani
Department of Urology, Marmara University, School of Medicine, İstanbul, Turkiye., EAU, Young Academic Urologists (YAU), Endourology & Urolithiasis Working Group, Arnhem, The Netherlands., Department of Urology, La Paz University Hospital, Madrid, Spain., Department of Urology, Istanbul Faculty of Medicine, İstanbul University, İstanbul, Turkiye., Department of Urology, Medicana Bahcelievler Hospital, Biruni University, İstanbul, Turkiye., Department of Urology, SLK-Kliniken Heilbronn, University of Heidelberg, Heilbronn, Germany., EAU, Section of Uro-Technology (ESUT), Arnhem, The Netherlands., Department of Urology, Tenon University Hospital, Sorbonne University, Paris, France., EAU, European Section of Urolithiasis (EULIS), Arnhem, The Netherlands.