AUA releases 5 urologic guideline updates ahead of annual meeting
The guideline updates span non-metastatic upper tract urothelial carcinoma, female stress urinary incontinence, urethral stricture disease, and prostate cancer.
Ahead of their 2023 annual meeting, the American Urological Association (AUA) released 5 clinical practice guideline updates spanning non-metastatic upper tract urothelial carcinoma (UTUC), female stress urinary incontinence (SUI), urethral stricture disease, and prostate cancer. The guideline updates will be presented at the 2023 AUA Annual Meeting in Chicago, Illinois.
The new guidelines on UTUC and early detection of prostate cancer will be presented during plenary sessions at AUA.
Non-metastatic upper tract urothelial carcinoma guideline
The new guideline includes 38 recommendations for the diagnosis and management of non-metastatic UTUC. Key areas include diagnosis and evaluation, risk stratification, kidney-sparing management, surgical management, lymph node dissection, neoadjuvant/adjuvant chemotherapy and immunotherapy, post-treatment surveillance, and survivorship.
"UTUC requires a specialized approach, and there is a need for updated strategies to help this vulnerable patient population. New information and guidelines like these can help improve cancer control and survival. Clinicians will not only learn how to evaluate patients, but they will get the most up to date information on treatment, surveillance, survivorship and more said Jonathan Coleman, MD, in a news release.1 Coleman is the chair of the guideline panel and a surgeon at Memorial Sloan Kettering Cancer Center in New York, NY.
The new guideline will be presented by Coleman during a plenary session at AUA on Friday, April 28.
Update to the female stress urinary incontinence guideline
In partnership with the Society of Urodynamics, Female Pelvic Medicine, and Urogenital Reconstruction (SUFU), the AUA released a guideline update that includes 24 recommendations for the management of SUI in women. The recommendations are based on 24 studies that were reviewed since the initial guideline publication in 2017. Focal topics in the guideline include patient evaluation, cystoscopy and urodynamics testing, patient counseling, treatment, special cases, and outcomes assessment.
"The recommendations in this guideline are fundamental to the delivery of the most effective treatment for our female patients with SUI. The guidelines advocate for the importance of proper patient evaluation, as well as for careful consideration around which treatment options are best suited for a given individual. Importantly, they also focus on the crucial nature of assiduous counseling regarding the risks, benefits, and alternatives available for treatment. We believe this guideline will help practicing urologists provide comprehensive, evidence-based, and effective care for SUI,” said Kathleen C. Kobashi, MD, in a news release.2 Kobashi is a chair in the department of urology at Houston Methodist Hospital in Texas.
Update to the urethral strictures disease guideline
The urethral stricture disease guideline update includes 33 additional recommendations for the diagnosis and management of the disease. The initial guideline was published in 2016.
According to the AUA, the updated guideline now includes:
- “Research on females and female urethral stricture studies.
- “New key questions comparing sexual dysfunction outcomes in men with bulbar urethral strictures receiving non-transecting anastomotic urethroplasty procedures or transecting procedures.
- Discussion of initial management, urethroplasty, reconstruction, contracture, stenosis, special circumstances and post-operative follow-up care.”3
"It is imperative that urologists are familiar with the evaluation and diagnosis of urethral stricture as well as surgical treatments. This guideline amendment underscores those topics and provides evidence-based guidance on how to recognize symptoms, carry out testing, and recommend best treatment options including new endoscopic, open and robotic surgical approaches,” said Hunter Wessells, MD, in a news release. Wessells is the chair of the guideline amendment panel and a physician at the University of Washington School of Medicine in Seattle.
Update to the advanced prostate cancer guideline
In partnership with the Society of Urologic Oncology (SUO), the advanced prostate cancer guideline update released by the AUA includes 40 recommendations in different disease states: biochemical recurrence without metastatic disease after exhaustion of local treatment options, metastatic hormone-sensitive prostate cancer, non-metastatic castration-resistant prostate cancer, and metastatic castration-resistant prostate cancer.
"New data related to advanced prostate cancer is constantly being published, and clinicians need to keep up. This guideline not only goes over the latest evidence-based treatments, but it explains the different classes of agents for use in various prostate cancer disease states,” commented William Lowrance, MD, in a news release.4 Lowrance is a chair of the guideline panel and urologic oncologist at Bon Secours Mercy Health in Greenville, South Carolina.
Early detection of prostate cancer guideline
The new early detection of prostate cancer guideline was released by the AUA in partnership with SUO. It includes 35 recommendations on early detection of prostate cancer.
According to the AUA, notable areas covered in the update include:
- “Focus on early detection with an emphasis on PSA-based screening.
- “Considerations for initial and repeat biopsy, with the goal of identifying clinically significant prostate cancer.
- “Discussion of biopsy technique.
- “Reference figures outlining the recommended screening process and decision points.”5
"Prostate cancer is the leading cancer diagnosis and the second leading cause of cancer death among men, making early detection imperative. With this completely new AUA/SUO prostate cancer early detection guideline, clinicians will see the latest set of recommendations for individuals undergoing prostate cancer screening, or considering an initial/repeat prostate biopsy, as well as guidance regarding use of new biomarker and imaging technologies,” said John Wei, MD, in a news release. Wei is a chair of the guideline panel and a professor at the University of Michigan in Ann Arbor.
The new guideline will be presented by Wei during a plenary session at AUA on Friday, April 28.
References
1. American Urological Association releases non-metastatic upper tract urothelial carcinoma guideline. News release. American Urological Association. April 25, 2023. Accessed April 26, 2023. https://auanet.mediaroom.com/2023-04-25-American-Urological-Association-Releases-Non-Metastatic-Upper-Tract-Urothelial-Carcinoma-Guideline
2. AUA, SUFU release an amendment to the female stress urinary incontinence guideline. News release. American Urological Association. April 25, 2023. Accessed April 26, 2023. https://auanet.mediaroom.com/2023-04-25-AUA,-SUFU-Release-an-Amendment-to-the-Female-Stress-Urinary-Incontinence-Guideline
3. American Urological Association releases urethral strictures disease guideline update. News release. American Urological Association. April 25, 2023. Accessed April 26, 2023. https://auanet.mediaroom.com/2023-04-25-American-Urological-Association-Releases-Urethral-Strictures-Disease-Guideline-Update
4. AUA/SUO release an amendment to the advanced prostate cancer guideline. News release. American Urological Association. April 25, 2023. Accessed April 26, 2023. https://auanet.mediaroom.com/2023-04-25-AUA-SUO-Release-an-Amendment-to-the-Advanced-Prostate-Cancer-Guideline
5. AUA/SUO releases early detection of prostate cancer guideline. News release. American Urological Association. April 25, 2023. Accessed April 26, 2023. https://auanet.mediaroom.com/2023-04-25-AUA-SUO-Releases-Early-Detection-of-Prostate-Cancer-Guideline
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