New clinical practice guidelines for overactive bladder, urodynamics, hematuria, and vasectomy

"These guidelines are a great resource not only to AUA members, but also to physicians and patients worldwide," says J. Stuart Wolf, Jr., MD, Chair, AUA Practice Guidelines Committee. "Some variation in treatment is appropriate for any number of reasons, but much of the variation in patient care is undesirable and reduces the quality of health care. The guidelines, if read carefully and applied to practice, will improve the quality of patient care."

The new guideline on the diagnosis and treatment of overactive bladder is based on a systematic review commissioned by the Agency on Healthcare Research and Quality. It was produced by an 11-member collaborative multidisciplinary panel convened by the AUA and the Society of Urodynamics, Female Pelvic Medicine & Urogenital Reconstruction. The collaboration also produced the guideline on adult urodynamics. This guideline elucidates the principles of selection and performance of urodynamic tests, based on the evidence in 393 published articles.

The guideline for the diagnosis, evaluation, and followup of asymptomatic microhematuria, in which red blood cells appear in urine and may be related to a number of conditions such as kidney stones or urinary tract infection, is useful to primary care physicians as well as urologists. This guideline is a revision of an earlier "best practice" document from the AUA. It reflects significant changes, including a reduction in the number of urinalyses required to determine need for evaluation, the preferred radiological imaging, and followup.

The AUA guideline on vasectomy was produced by a panel of eight, including a specialist in preventive medicine and a family medicine physician. The panel reviewed 284 articles published from 1949 to 2011. This guideline includes clear and concise statements that will help standardize and improve care for vasectomy patients by urologists and other vasectomy providers.

"It can be difficult to sift through the vast repository of clinical information to decide what the most cost- effective care is," says journal Editor-in-Chief William D. Steers, MD. "I am proud that The Journal of Urology® serves as a platform to disseminate these valuable documents to the urological community in the United States and abroad."