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欧洲肾绞痛的当前管理及其对欧洲泌尿外科学会尿石症指南的依从性:来自欧洲泌尿外科技术分会、欧洲尿石症分会、青年学术泌尿外科医生研究小组的一项调查

Current management of renal colic across Europe and its compliance to the European Association of Urology Guidelines on Urolithiasis: a survey from the European Section of Uro-technology, European Section of Urolithiasis, Young Academic Urologists study groups.

作者信息

Güven Selçuk, Sönmez Mehmet Giray, Somani Bhaskar Kumar, Gözen Ali Serdar, Sarica Kemal, Rivas Juan Gómez, Nagele Udo, Tokas Theodoros

机构信息

Urology Department, Meram School of Medicine, Necmettin Erbakan University, Konya, Turkey.

University Hospital Southampton NHS Trust, Department of Urology, Southampton, United Kingdom.

出版信息

Cent European J Urol. 2022;75(2):182-190. doi: 10.5173/ceju.2022.0046. Epub 2022 May 5.

Abstract

INTRODUCTION

Renal colic due to ureteral stones represents the primary acute condition in urology. Although guideline recommendations are available the institution, urologist, and patient preferences in diagnosis and treatment may differ. We aimed to evaluate the adherence of different European countries to the European Association of Urology (EAU) guidelines of urolithiasis and demonstrate trends in diagnostic and treatment approaches.

MATERIAL AND METHODS

We used a survey including 33 questions clustered in four sections. The survey was circulated to the representatives of the main urological centers in Europe using the European Section of Uro-technology (ESUT), the European Section of Urolithiasis (EULIS), the Young Academic Urologists (YAU), and the European Urology Residents Education Programme (EUREP) mailing lists. The first section included participant and institution demographics, the second assessed the common diagnostic and treatment pathways, the third discussed the advantages and disadvantages of treatment strategies and the fourth investigated treatment preferences in different clinical scenarios. A descriptive analysis was performed.

RESULTS

Of all participants, 84.21% stated that their departments follow specific guidelines, with no significant differences between institutions (p = 0.18). Preferred treatment practice difference in the case scenarios was significantly influenced by the Department bed capacities (p = 0.01), and complications varied between institutions (p = 0.02). Interestingly, 37-45% of participants were unaware of the different treatment costs.

CONCLUSIONS

Although urologists generally decide according to local or international guidelines when approaching renal colic patients, there are deviations in clinical practice due to 'doctor preference' and 'bed availability'. Many urologists are unaware of treatment costs.

摘要

引言

输尿管结石所致肾绞痛是泌尿外科的主要急症。尽管有指南推荐,但不同机构、泌尿外科医生以及患者在诊断和治疗方面的偏好可能存在差异。我们旨在评估欧洲不同国家对欧洲泌尿外科学会(EAU)尿石症指南的遵循情况,并展示诊断和治疗方法的趋势。

材料与方法

我们使用了一项包含33个问题的调查问卷,这些问题分为四个部分。该调查问卷通过泌尿技术欧洲分会(ESUT)、尿石症欧洲分会(EULIS)、青年学术泌尿外科医生(YAU)以及欧洲泌尿外科住院医师教育项目(EUREP)的邮件列表,分发给欧洲主要泌尿外科中心的代表。第一部分包括参与者和机构的人口统计学信息,第二部分评估常见的诊断和治疗途径,第三部分讨论治疗策略的优缺点,第四部分调查不同临床场景下的治疗偏好。进行了描述性分析。

结果

在所有参与者中,84.21%表示他们所在的科室遵循特定指南,各机构之间无显著差异(p = 0.18)。病例场景中的首选治疗方法差异受科室病床数量的显著影响(p = 0.01),并发症在不同机构之间也有所不同(p = 0.02)。有趣的是,37 - 45%的参与者不知道不同治疗方法的费用。

结论

尽管泌尿外科医生在诊治肾绞痛患者时通常会根据当地或国际指南做出决定,但由于“医生偏好”和“病床可用性”,临床实践中存在偏差。许多泌尿外科医生不知道治疗费用。

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