You have accessJournal of UrologyCME1 May 2022MP44-01 WHAT IS THE IDEAL FOLLOW UP AFTER KIDNEY STONE TREATMENT? A SYSTEMATIC REVIEW AND FOLLOW-UP ALGORITHM FROM THE EUROPEAN ASSOCIATION OF UROLOGY UROLITHIASIS PANEL Riccardo Lombardo, Lazaros Tzelves, Robert Geraghty, Niall F. Davis, Andreas Neisius, Ales Petřík, Giovanni Gambaro, Christian Türk, Bhaskar Somani, Andreas Skolarikos, and Kay Thomas Riccardo LombardoRiccardo Lombardo More articles by this author , Lazaros TzelvesLazaros Tzelves More articles by this author , Robert GeraghtyRobert Geraghty More articles by this author , Niall F. DavisNiall F. Davis More articles by this author , Andreas NeisiusAndreas Neisius More articles by this author , Ales PetříkAles Petřík More articles by this author , Giovanni GambaroGiovanni Gambaro More articles by this author , Christian TürkChristian Türk More articles by this author , Bhaskar SomaniBhaskar Somani More articles by this author , Andreas SkolarikosAndreas Skolarikos More articles by this author , and Kay ThomasKay Thomas More articles by this author View All Author Informationhttps://doi.org/10.1097/JU.0000000000002610.01AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: Stone disease is a common and costly clinical condition, with currently no specific recommendations regarding when and how to follow-up these patients. The aim of our study was to develop a follow-up flow-chart after stone disease treatment, based on a systematic review performed by EAU Urolithiasis Guidelines Panel on urolithiasis follow-up. METHODS: The panel critically evaluated the raw data (stone free status, residual growth and spontaneous expulsion rate at different time points) and the outcome derived from a systematic review (PROSPERO: CRD42020205739) on urinary stone patients’ follow-up after definitive treatment. Given the lack of comparative studies between different follow-up modalities, a consensus statement between Panel members was made to establish the follow up of different group of patients. The final algorithm was developed using a benefit/harm principle. Every proposal of follow up was thoroughly discussed by all Panel members to finalize the algorithm. RESULTS: A total of 76 studies were included in the analysis. In the stone free general population group, 71.4-100% of patients are stone-free at 12-months and 28.6-94% remain stone-free at 36 months. The stone-free rate in high-risk patients not under targeted medical therapy is <40% at 36 months. Patients with residual fragments ≤4 mm have a spontaneous expulsion rate of 17.9-46.5% and a growth rate of 10.1-40.7% at 12-months. Patients with residual fragments >4 mm should be considered for surgical re-intervention based on the high risk of recurrence (13-50% at 1 year). Risk of bias was moderate. A follow-up algorithm pertaining to the 4 sub-categories assessed is summarized in Figure 1. To develop the diagram all panel members agreed on following patients with plain film KUB and/or KUS based on clinicians’ preference and stone characteristics. However, NCCT scan should be performed if patient is symptomatic or if intervention is planned. CONCLUSIONS: Based on the best evidence available we propose, for the first time, a possible follow-up chart for patients after stone surgical treatment. Despite existing limitations, this flow chart can improve the management of patients after stone disease treatment. Source of Funding: None © 2022 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 207Issue Supplement 5May 2022Page: e751 Advertisement Copyright & Permissions© 2022 by American Urological Association Education and Research, Inc.MetricsAuthor Information Riccardo Lombardo More articles by this author Lazaros Tzelves More articles by this author Robert Geraghty More articles by this author Niall F. Davis More articles by this author Andreas Neisius More articles by this author Ales Petřík More articles by this author Giovanni Gambaro More articles by this author Christian Türk More articles by this author Bhaskar Somani More articles by this author Andreas Skolarikos More articles by this author Kay Thomas More articles by this author Expand All Advertisement PDF DownloadLoading ...