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  4. Prioritization of risk situations in neuro‑urology: guidelines from Association Française d’Urologie (AFU), Association Francophone Internationale des Groupes d’Animation de la Paraplégie (A.F.I.G.A.P.), Groupe de Neuro‑urologie de Langue Française (GENULF), Société Française de Médecine Physique et de Réadaptation (SOFMER) and Société Interdisciplinaire Francophone d’UroDynamique et de Pelvi‑Périnéologie (SIFUD‑PP)

Prioritization of risk situations in neuro‑urology: guidelines from Association Française d’Urologie (AFU), Association Francophone Internationale des Groupes d’Animation de la Paraplégie (A.F.I.G.A.P.), Groupe de Neuro‑urologie de Langue Française (GENULF), Société Française de Médecine Physique et de Réadaptation (SOFMER) and Société Interdisciplinaire Francophone d’UroDynamique et de Pelvi‑Périnéologie (SIFUD‑PP)

World Journal of Urology, 2022 · DOI: 10.1007/s00345-021-03804-4 · Published: August 17, 2021

UrologyHealthcare

Simple Explanation

The current health crisis has drastically impacted patient management in many fields, including neuro-urology, leading to a mandatory reorganization. The present work aimed to establish guidelines regarding the prioritization and optimal timing of each step of NLUTD management. This multidisciplinary collaborative work helped to establish recommendations which may be complementary with existing guidelines.

Study Duration
Not specified
Participants
Forty-nine experts
Evidence Level
Expert opinions

Key Findings

  • 1
    Among the 206 initial items, 163 were selected and divided into four domains, diagnosis and assessment, treatment, follow-up, and complications, and two sub-domains, general and condition-specific.
  • 2
    The guidelines on initial assessment are reported in Table 1 and supplementary material 6 and 7.
  • 3
    By creating a comprehensive risk scale listing all relevant clinical situations encountered in neuro-urology, these recommendations would help clinicians to reorganize their patients' list in the long term with a personalized medicine approach, whatever is the situation.

Research Summary

The current health crisis has drastically impacted patient management in many fields, including neuro-urology, leading to a mandatory reorganization. The aim of this work was to establish guidelines regarding the prioritization and optimal timing of each step of neurogenic lower urinary tract dysfunction management. Forty-nine experts participated in the rating group. Among the 206 initial items, 163 were selected and divided into four domains, diagnosis and assessment, treatment, follow-up, and complications, and two sub-domains, general and condition-specific. The present multidisciplinary collaborative work generates recommendations which complement existing guidelines and help clinicians to reorganize their patients’ list in the long term with a personalized medicine approach, in the context of health crisis or not.

Practical Implications

Improved Patient Management

The guidelines help clinicians prioritize and optimally time each step of neurogenic lower urinary tract dysfunction management.

Personalized Medicine Approach

The risk scale and recommendations facilitate a personalized medicine approach in neuro-urology, considering individual clinical situations.

Complement to Existing Guidelines

The recommendations complement existing guidelines by addressing specific factors and allowing significant improvement in current practices.

Study Limitations

  • 1
    The literature review has not been able to bring out enough data to drive recommendations with a high level of evidence.
  • 2
    These guidelines are, therefore, an expert opinion.
  • 3
    These recommendations were established by a panel of French specialists, and some situations may not respond to another system of care, limiting the scalability of this work.

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