[Guidelines on urolithiasis: update of diagnosis and treatment]

Abstract

The Japanese urolithiasis clinical guideline was established in 2002. Since that time, the American Urological Associstion (AUA) and European Association of Urology (EAU) nephrolithiasis guideline panel has developed several guidelines on the management of urolithiasis. Recently, the joint AUA/EAU panel published a 2007 update of the original 1997 report on the management of ureteral calculi. The EAU panel yields the publication of guidelines on urolithiasis, with updates almost annually. These guidelines provide useful recommendations on the management of urolithiasis. Based on their findings, the most significant update of guideline concluded that both extracorporeal shockwave lithotripsy and ureteroscopy (URS) are acceptable first-line treatments for patients requiring ureteral stone removal. With the development of smaller caliber ureteroscopes and the introduction of improved instrumentation, including the holmium : yttrium aluminum garnet laser, URS has evolved into a safer and more efficacious modality for treatment of stones in all locations in the ureter during the last decade. The other change is the establishment of effective medical expulsive therapy to facilitate spontaneous stone passage.