1. INTRODUCTION
1.1. Aim
The European Association of Urology (EAU) Paediatric Urology Guidelines Panel has prepared these Guidelines with the aim of increasing the quality of care for children with urological conditions. This Guideline document is limited to a number of common clinical pathologies in paediatric urological practice, as covering the entire field of paediatric urology in a single guideline document is unattainable.
The majority of urological clinical problems in children are specialised and in many ways differ to those in adults. This publication intends to outline a practical and preliminary approach to paediatric urological conditions. Complex and rare conditions that require special care with experienced doctors should be referred to designated centres where paediatric urology practice has been fully established and a multidisciplinary team is available.
Over time, paediatric urology has developed and matured, establishing its diverse body of knowledge and expertise and may now be ready to distinguish itself from its parent specialties. Thus, paediatric urology has recently emerged in many European countries as a distinct subspecialty of both urology and paediatric surgery and presents a unique challenge in the sense that it covers a large area with many different schools of thought and a huge diversity in management.
Knowledge gained by increasing experience, new technological advances and non-invasive diagnostic screening modalities has had a profound influence on treatment modalities in paediatric urology, a trend that is likely to continue in the years to come.
It must be emphasised that clinical guidelines present the best evidence available to the experts but following guideline recommendations will not necessarily result in the best outcome. Guidelines can never replace clinical expertise when making treatment decisions for individual patients, but rather help to focus decisions - also taking personal values and preferences/individual circumstances of children and their caregivers into account. Guidelines are not mandates and do not purport to be a legal standard of care.
1.2. Panel composition
The EAU Paediatric Urology Guidelines Panel consists of an international group of clinicians with particular expertise in this area. All experts involved in the production of this document have submitted potential conflict of interest statements, which can be viewed on the EAU Website: http://uroweb.org/guideline/paediatric-urology/.
1.3. Available publications
A quick reference document (Pocket guidelines) is available this is an abridged versions which may require consultation together with the full text version. A number of translated versions, alongside several scientific publications are also available [1-7]. All documents can be viewed through the EAU website:
http://uroweb.org/guideline/paediatric-urology/.
1.4. Publication history
The Paediatric Urology Guidelines were first published in 2001 [8]. This 2023 publication includes a number of updated chapters and sections as detailed below.
1.5. Summary of changes
The literature for the complete document has been assessed and updated, wherever relevant. Key changes in the 2023 publication:
- Section 3.1 - Phimosis and other abnormalities of the penile skin: Both the literature and the text have been extensively updated.
- Section 3.8 – Varicocele: Both the literature and the text have been extensively updated.
- Section 3.14 – Vesicoureteric reflux: Both the literature and the text have been extensively updated.
- Section 3.15 – Urinary stones disease: Both the literature and the text have been extensively updated.
- Section 3.17 – Disorders/differences of sex development: Both the literature and the text have been extensively updated.