[The practice guideline 'Urolithiasis' (first revision) from the Dutch College of General Practitioners; a response from the perspective of urology].
The Dutch College of General Practitioners has made a useful revision of its practice guideline 'Urolithiasis', in which new imaging techniques and medical treatment modalities are implemented. Sonography is useful but CT has now become the gold standard imaging technique. CT images should be examined by both the radiologist and the urologist. Therefore, requests for CT should preferably be made by urologists. This guideline should focus more on the differential diagnosis of urolithiasis in the acute phase, and in particular on aortic aneurysm in the elderly patient. Complaints of irritative micturition should be considered to indicate a distal localization ofa ureteral stone rather than a urinary tract infection. When prescribing selective alpha-1 blocking agents, the doctor should inform the patient that both retrograde ejaculation and orthostatic hypotension are side effects.
d'Ancona
F C H
FC
Universitair Medisch Centrum St Radboud, afd. Urologie, Nijmegen.
Mulders
P F A
PF
D005194:Family Practice / Q000592:standards*; D006801:Humans; D009426:Netherlands; D017410:Practice Guidelines as Topic; D010818:Practice Patterns, Physicians'; D011859:Radiography; D012955:Societies, Medical; D052878:Urolithiasis / Q000175:diagnosis* / Q000000981:diagnostic imaging; D014572:Urology / Q000592:standards*