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International Alliance of Urolithiasis (IAU) guideline on staghorn calculi management

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Abstract

Background

The stone burden based management strategy reported in the guidelines published by different associations is well known for a long time. Staghorn calculi, representing the largest burden and most complex stones, is one of the most challenging cases to practicing urologists in clinical practice. The International Alliance of Urolithiasis (IAU) has released a series of guidelines on the management of urolithiasis.

Purpose

To develop a series of recommendations for the contemporary management management of staghorn calculi and to provide a clinical framework for urologists treating patients with these complex stones.

Methods

A comprehensive literature search for articles published in English between 01/01/1976 and 31/12/2022 in the PubMed, OVID, Embase and Medline database is performed. A series of recommendations are developed and individually graded following the review of literature and panel discussion.

Results

The definition, pathogenesis, pathophysiology, preoperative evaluation, intraoperative treatment strategies and procedural advice, early postoperative management, follow up and prevention of stone recurrence are summarized in the present document.

Conclusion

A series of recommendations regarding the management of staghorn calculi, along with related commentary and supporting documentation offered in the present guideline is intended to provide a clinical framework for the practicing urologists in the management of staghorn calculi.

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Data availability

The data that support the findings of this study are available from the corresponding author upon reasonable request.

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Author information

Author notes

  1. Wen Zhong, Palle Osther and Margaret Pearle Co-first authors contribute equally to this work.

Authors and Affiliations

  1. Department of Urology and Key Laboratory of Guangdong, The First Affiliated Hospital of Guangzhou Medical University, Guangzhou, China

    Wen Zhong, Wei Zhu, Zhijian Zhao, Yongda Liu & Guohua Zeng

  2. Department of Urology, Lillebaelt Hospital, University of Southern Denmark, Vejle, Denmark

    Palle Osther

  3. Department of Urology, UT Southwestern Medical Center, Dallas, TX, USA

    Margaret Pearle

  4. Department of Urology, Westmoreland Street Hospital, University College Hospital London, London, UK

    Simon Choong & Daron Smith

  5. Department of Urology, San Bassiano Hospital, Vicenza, Italy

    Giorgio Mazzon

  6. Department of Urology, Wake Forest Baptist Health, Winston-Salem, NC, USA

    Jorge Gutierrez

  7. Department of Urology, Al Zahraa Hospital University Medical Center and Lebanese University, Beirut, Lebanon

    Mohamad Moussa

  8. Department of Urology, Holy Family Hospital, New Delhi, India

    Shashi Kiran Pal

  9. Department of Urology and Nephrology, Military Medical Academy, Sofia, Bulgaria

    Iliya Saltirov

  10. Department of Urology, Ganga Ram Hospital, Ganga Ram Hospital and Fatima Jinnah Medical University, Lahore, Punjab, Pakistan

    Mumtaz Ahmad

  11. Division of Urology, Department of Surgery, Ministry of the National Guard Health Affairs, King Saud Bin Abdulaziz University for Health Sciences, King Abdullah International Medical Research Center, Riyadh, Saudi Arabia

    Saeed Bin Hamri

  12. Department of Urologic Sciences, University of British Columbia, Vancouver, BC, Canada

    Ben Chew

  13. Department of Urology, Jose R. Reyes Memorial Medical Center, Manila, Philippines

    Albert Aquino

  14. Department of Urology, The Feinberg School of Medicine, Northwestern University, Chicago, IL, USA

    Amy Krambeck

  15. Department of Urology, Vayodha Hospital, Kathmandu, Nepal

    Sanjay khadgi

  16. Department of Urology, University of California San Diego Comprehensive Kidney Stone Center, San Diego, CA, USA

    Roger L. Sur

  17. Department of Urology, Meram School of Medicine, Necmettin Erbakan University, Konya, Turkey

    Selcuk Güven

  18. Department of Urology, Sohag University Hospital, Sohâg, Egypt

    Wael Gamal

  19. Department of Urology, Beijing Tsinghua Changgung Hospital, School of Clinical Medicine, Tsinghua University, Beijing, China

    Jianxing Li

  20. Department of Urology, Hospital, University of Parma, Parma, Italy

    Stefania Ferretti

  21. Department of Urology, King Fahad Hospital, Jeddah, Saudi Arabia

    Wissam Kamal

  22. Urology Department, Fujian Provincial Hospital, Fujian, China

    Liefu Ye

  23. Department of Urology, Hospital de Clinicas Jose de San Martin, Buenos Aires, Argentina

    Norberto Bernardo

  24. Department of Urology, Sabah Al-Ahmad Urology Centre, Kuwait City, Kuwait

    Shabir Almousawi

  25. Department of Urology, Hazm Mebaireek General Hospital (HMGH), Hamad Medical Corporation (HMC), Doha, Qatar

    Mohamed Abdelkareem

  26. Department of Urology, Clinic of Urology, University of Belgrade, Belgrade, Serbia

    Otas Durutovic

  27. Department of Urology, Amsterdam UMC Location University of Amsterdam, Amsterdam, Netherlands

    Guido Kamphuis

  28. Department of Urology, Hospital de Base of the Federal District, Brasília, Brazil

    Marcus Maroccolo

  29. Department of Urology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China

    Zhangqun Ye

  30. Department of Urology, University Clinic Mannheim, Mannheim, Germany

    Peter Alken

  31. Department of Urology, Medical School, Biruni University, Istanbul, Turkey

    Kermal Sarica

Authors
  1. Wen Zhong
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  2. Palle Osther
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  3. Margaret Pearle
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  4. Simon Choong
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  5. Giorgio Mazzon
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  6. Wei Zhu
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  7. Zhijian Zhao
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  8. Jorge Gutierrez
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  9. Daron Smith
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  10. Mohamad Moussa
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  11. Shashi Kiran Pal
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  12. Iliya Saltirov
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  13. Mumtaz Ahmad
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  14. Saeed Bin Hamri
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  15. Ben Chew
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  16. Albert Aquino
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  17. Amy Krambeck
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  18. Sanjay khadgi
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  19. Roger L. Sur
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  20. Selcuk Güven
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  21. Wael Gamal
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Contributions

WZ: data curation, formal analysis, methodology, investigation, writing—review and editing; PO, MP, SC, GM, WZ, ZZ, JG, DS, MM, SKP, IM, SBH, BC, AA, AK, SK, RLS, SG, WG, JL, YL, SF, WK, LY, NB, SA, MA, OD, GK, MM, and ZY: formal analysis, writing—review and editing; PA, KS, and GZ: conceptualization, formal analysis, investigation, project administration, visualization.

Corresponding authors

Correspondence to Peter Alken, Kermal Sarica or Guohua Zeng.

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All the authors declare that they have no conflict of interest.

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The present study adheres to the World Medical Association Declaration of Helsinki Ethical Principle for Medical Research Involving Human Subjects. The protocol is reviewed and approved by the hospital ethical committee. Informed consents are required from all participants.

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Zhong, W., Osther, P., Pearle, M. et al. International Alliance of Urolithiasis (IAU) guideline on staghorn calculi management. World J Urol 42, 189 (2024). https://doi.org/10.1007/s00345-024-04816-6

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