The American Urological Association (AUA) has issued new set of recommendations that identify certain tests or treatments that are commonly ordered, but are not always necessary, in urology or urologic management. This is the third list released by the AUA for the Choosing Wisely campaign, an initiative aimed at reducing the use of unnecessary medical tests, treatments, and procedures.

The 2017 AUA list contains evidence-based recommendations to guide conversations between physicians and patients about what care is appropriate:

  • DON’T treat low-risk clinically localized prostate cancer (eg, Gleason score <7, PSA <10.0ng/mL, and tumor stage T2 or less) without discussing active surveillance as part of the shared decision-making process.
  • DON’T treat uncomplicated cystitis in women with fluoroquinolones if other oral antibiotic treatment options exist. 
  • DON’T continue opioid analgesia beyond the immediate postoperative period; prescribe the lowest effective dose and number of doses required to address the expected pain.
  • DON’T obtain urine cytology or urine markers as a part of the routine evaluation of the asymptomatic patient with microhematuria.
  • DON’T routinely use computed tomography (CT) to screen pediatric patients with suspected nephrolithiasis.

AUA members were initially asked to submit recommendation suggestions for this list. Members then voted for their top suggestions based on a list formed by the Choosing Wisely Workgroup. 

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