Guideline updates

A number of sessions at AUA2022 presented updated guidelines or revealed new guidelines in the specialty of urology.

Trinity J. Bivalacqua, MD, PhD, director of urologic oncology at the Abramson Cancer Center at Penn Medicine in Philadelphia, Pennsylvania, capped off Sunday morning’s plenary session with a summary of the AUA’s newly updated clinical guideline for the diagnosis and management of priapism. A joint guideline developed with the Sexual Medicine Society of North America, the 2022 update is the first change to the guideline in more than two decades.

AUA guidelines for the evaluation, management and follow-up of localized renal cancer have been updated for the first time since 2017. The new guidelines are based on critical evaluations of the literature through January 2021.

“By 2020, it became clear that a number of elements in the 2017 guidelines needed to be updated,” said Steven A. Campbell, MD, PhD, chair of the AUA Guidelines Panel and professor of surgery at the Cleveland Clinic in Ohio. “Along with updating, the guidelines for following patients with localized kidney cancer after intervention have been merged with guidelines for evaluation and management. We now have just one guideline instead of two.”

James A. Eastham, MD, FACS, professor and chief of urology at the Memorial Sloan Kettering Cancer Center in New York, reviewed updates to clinically localized prostate cancer guidelines, developed in collaboration with ASTRO (the American Society for Radiation Oncology). Radical prostatectomy and radiation therapy no longer represent the only definitive answers to managing patients with clinically localized prostate cancer. Active surveillance has emerged as the preferred approach for low-risk prostate cancer over the last few years, just one of the changes reflected in recently updated AUA guidelines.