Abstract：
OBJECTIVE: We present an overview of the 2024 updates for the European Association of Urology (EAU)/European Society for Paediatric Urology (ESPU) guidelines on paediatric urology to offer evidence-based standards for perioperative management, minimally invasive surgery (MIS), hydrocele, congenital lower urinary tract obstruction (CLUTO), trauma/emergencies, and fertility preservation.
METHODS: A broad literature search was performed for each condition. Recommendations were developed and rated as strong or weak on the basis of the quality of the evidence, the benefit/harm ratio, and potential patient preferences.
UNASSIGNED: Recommendations for perioperative management include points related to fasting, premedication, antibiotic prophylaxis, pain control, and thromboprophylaxis in patients requiring general anaesthesia. MIS use is increasing in paediatric urology, with no major differences observed among different MIS approaches. For hydrocele, observation is the initial approach recommended. For persistent cases, treatment varies according to the type of hydrocele. CLUTO cases should be managed in tertiary centres with multidisciplinary expertise in prenatal and postnatal management. Neonatal valve ablation remains the mainstay of treatment, but associated bladder dysfunction requires continuous treatment. Among urological traumas and emergencies, renal trauma is still an important cause of morbidity and mortality. Conservative management has become the standard approach in haemodynamically stable children. Ischaemic priapism is a medical emergency and requires stepwise management. Initial management of nonischaemic priapism is conservative. Fertility preservation in prepubertal children and adolescents has become an increasingly relevant issue owing to the ever-increasing number of cancer survivors receiving gonadotoxic therapies. A major limitation is the scarcity of relevant literature.
CONCLUSIONS: This summary of the 2024 EAU/ESPU guidelines provides updated guidance for evidence-based management of some paediatric urological conditions.
RESULTS: We provide a summary of the updated European Association of Urology/European Society for Paediatric Urology guidelines on paediatric urology. There are recommendations on steps to take before and immediately after surgery, management of hydrocele, congenital lower urinary tract obstruction, and urological trauma/emergencies, as well as preservation of fertility. Recommendations are based on a comprehensive review of recent studies.
METHODS: A broad literature search was performed for each condition. Recommendations were developed and rated as strong or weak on the basis of the quality of the evidence, the benefit/harm ratio, and potential patient preferences.
UNASSIGNED: Recommendations for perioperative management include points related to fasting, premedication, antibiotic prophylaxis, pain control, and thromboprophylaxis in patients requiring general anaesthesia. MIS use is increasing in paediatric urology, with no major differences observed among different MIS approaches. For hydrocele, observation is the initial approach recommended. For persistent cases, treatment varies according to the type of hydrocele. CLUTO cases should be managed in tertiary centres with multidisciplinary expertise in prenatal and postnatal management. Neonatal valve ablation remains the mainstay of treatment, but associated bladder dysfunction requires continuous treatment. Among urological traumas and emergencies, renal trauma is still an important cause of morbidity and mortality. Conservative management has become the standard approach in haemodynamically stable children. Ischaemic priapism is a medical emergency and requires stepwise management. Initial management of nonischaemic priapism is conservative. Fertility preservation in prepubertal children and adolescents has become an increasingly relevant issue owing to the ever-increasing number of cancer survivors receiving gonadotoxic therapies. A major limitation is the scarcity of relevant literature.
CONCLUSIONS: This summary of the 2024 EAU/ESPU guidelines provides updated guidance for evidence-based management of some paediatric urological conditions.
RESULTS: We provide a summary of the updated European Association of Urology/European Society for Paediatric Urology guidelines on paediatric urology. There are recommendations on steps to take before and immediately after surgery, management of hydrocele, congenital lower urinary tract obstruction, and urological trauma/emergencies, as well as preservation of fertility. Recommendations are based on a comprehensive review of recent studies.
摘要：
目的：我们概述了2024年欧洲泌尿外科协会（EAU）/欧洲儿科泌尿外科学会（ESPU）儿科泌尿外科指南的更新，为围手术期管理提供循证标准。微创手术（MIS），鞘膜积液,先天性下尿路梗阻（CLUTO），创伤/紧急情况，和生育力保护。
方法：对每种情况进行了广泛的文献检索。根据证据的质量制定了建议，并将其评为强或弱，利益/伤害比，和潜在的患者偏好。
■围手术期管理建议包括与禁食有关的要点，术前用药,抗生素预防，疼痛控制,需要全身麻醉的患者的血栓预防。MIS在儿科泌尿科的使用正在增加，在不同的MIS方法之间没有观察到重大差异。对于鞘膜积液，观察是最初推荐的方法。对于持续的情况，治疗根据鞘膜积液的类型而变化。CLUTO病例应在具有产前和产后管理多学科专业知识的三级中心进行管理。新生儿瓣膜消融仍是治疗的主要手段,但相关的膀胱功能障碍需要持续治疗。在泌尿系统创伤和紧急情况中，肾损伤仍然是发病和死亡的重要原因。保守管理已成为血液动力学稳定儿童的标准方法。缺血性阴茎异常勃起是一种医疗紧急情况，需要逐步管理。非缺血性阴茎异常勃起的初始治疗是保守的。由于接受性腺毒性疗法的癌症幸存者数量不断增加，青春期前儿童和青少年的生育力保护已成为一个日益相关的问题。一个主要的限制是相关文献的匮乏。
结论：此2024EAU/ESPU指南摘要为某些儿科泌尿系统疾病的循证管理提供了最新指导。
结果：我们提供了最新的欧洲泌尿外科协会/欧洲儿科泌尿外科学会儿科泌尿外科指南的摘要。有关于手术前和手术后立即采取的步骤的建议，鞘膜积液的管理，先天性下尿路梗阻,泌尿系统创伤/紧急情况，以及保存生育能力。建议是基于对最近研究的全面审查。
方法：对每种情况进行了广泛的文献检索。根据证据的质量制定了建议，并将其评为强或弱，利益/伤害比，和潜在的患者偏好。
■围手术期管理建议包括与禁食有关的要点，术前用药,抗生素预防，疼痛控制,需要全身麻醉的患者的血栓预防。MIS在儿科泌尿科的使用正在增加，在不同的MIS方法之间没有观察到重大差异。对于鞘膜积液，观察是最初推荐的方法。对于持续的情况，治疗根据鞘膜积液的类型而变化。CLUTO病例应在具有产前和产后管理多学科专业知识的三级中心进行管理。新生儿瓣膜消融仍是治疗的主要手段,但相关的膀胱功能障碍需要持续治疗。在泌尿系统创伤和紧急情况中，肾损伤仍然是发病和死亡的重要原因。保守管理已成为血液动力学稳定儿童的标准方法。缺血性阴茎异常勃起是一种医疗紧急情况，需要逐步管理。非缺血性阴茎异常勃起的初始治疗是保守的。由于接受性腺毒性疗法的癌症幸存者数量不断增加，青春期前儿童和青少年的生育力保护已成为一个日益相关的问题。一个主要的限制是相关文献的匮乏。
结论：此2024EAU/ESPU指南摘要为某些儿科泌尿系统疾病的循证管理提供了最新指导。
结果：我们提供了最新的欧洲泌尿外科协会/欧洲儿科泌尿外科学会儿科泌尿外科指南的摘要。有关于手术前和手术后立即采取的步骤的建议，鞘膜积液的管理，先天性下尿路梗阻,泌尿系统创伤/紧急情况，以及保存生育能力。建议是基于对最近研究的全面审查。
