FROM THE AUA SCIENCE AND QUALITY COUNCIL: Science & Quality Update: Guidelines
By: David Penson, MD, MPH, MMHC | Posted on: 01 Feb 2022
Despite ongoing challenges due to the COVID-19 pandemic, 2021 was a strong year for the AUA Guidelines program with the release of 3 new guidelines and related educational content. The AUA membership showed continued support for the program through use of guidelines products available on the AUA website as well as programming accessed via the 2021 virtual Annual Meeting. In line with the AUA mission, such dedication highlights the commitment of the field of urology to promoting the highest standards of care through evidence-based medicine.
The Acute Ischemic Priapism Guideline, developed in partnership with the Sexual Medicine Society of North America, provides a clinical framework for the diagnosis, evaluation, and treatment (nonsurgical and surgical) of this condition.1 This guideline joins the AUA’s robust stable of guidelines focused on sexual and reproductive health, which also includes titles on erectile dysfunction, Peyronie’s disease, testosterone deficiency, male infertility, disorders of ejaculation and vasectomy.
Developed in partnership with the Society of Urodynamics, Female Pelvic Medicine & Urogenital Reconstruction, adult neurogenic lower urinary tract dysfunction is a new topic for AUA Guidelines. Focused on abnormal function of the bladder, bladder neck, and/or its sphincters due to neurologic disorder, this guideline provides discussion of available treatment options and emphasizes the importance of shared decision making in optimizing patient quality of life as it relates to bladder management.2,3
Following previous iterations of the Surgical Management of Benign Prostatic Hyperplasia Guideline, this guideline was revised in 2021 as the AUA Guideline on Management of Benign Prostatic Hyperplasia/Lower Urinary Tract Symptoms and now includes detailed discussion of medical therapy options as well as updated content related to surgical management.4,5 Additional information is also provided on initial and followup evaluation, preoperative testing and medically complicated patients.
Moving forward in 2022, the AUA will release a Guideline on Localized Prostate Cancer as well as an expansion of the Priapism Guideline. Development will also continue on early detection of prostate cancer, which will expand on the current AUA Guideline, which is largely focused on the use of prostate specific antigen in cancer detection, as well as a new topic on upper tract urothelial carcinoma. The latter is the first AUA Guideline to undergo development using the AUA’s new policy on open nominations for panel membership. This significant update to the paneling process allows for the creation of multidisciplinary panels of subject matter experts while further underscoring the AUA’s commitment to promoting diversity within the program.
As new topics are assessed for potential guideline development, AUA members are reminded that they are able to nominate topics for consideration by visiting www.auanet.org/guidelines. Members are also encouraged to visit the AUA Guidelines webpage for updates on future opportunities to engage with the Guidelines team through activities such as panel participation and peer review. The Guidelines webpage also houses all freely available, full-text guidelines and selected translations. Members will also find links to order Guidelines-at-a-Glance books and download the AUA Guidelines smartphone application, which is available for both Apple® and Android™ devices. As use of AUA Guidelines grows, the AUA will continue to review the program to ensure compliance with the most current accepted standards in guideline development to guarantee production of the quality documents that AUA members have come to expect and trust.
- Bivalacqua TJ, Allen BK, Brock G et al: Acute ischemic priapism: an AUA/SMSNA guideline. J Urol 2021; 206: 1114.
- Ginsberg DA, Boone TB, Cameron AP et al: The AUA/SUFU Guideline on adult neurogenic lower urinary tract dysfunction: diagnosis and evaluation. J Urol 2021; 206: 1097.
- Ginsberg DA, Boone TB, Cameron AP et al: The AUA/SUFU Guideline on adult neurogenic lower urinary tract dysfunction: treatment and follow-up. J Urol 2021; 206: 1106.
- Lerner LB, McVary KT, Barry MJ et al: Management of lower urinary tract symptoms attributed to benign prostatic hyperplasia: AUA Guideline part I, initial work-up and medical management. J Urol 2021; 206: 806.
- Lerner LB, McVary KT, Barry MJ et al: Management of lower urinary tract symptoms attributed to benign prostatic hyperplasia: AUA Guideline part II, surgical evaluation and treatment. J Urol 2021; 206: 818.