Nephrolithiasis

US vs EU key differences

• Document scope differs: the US guideline in use here is confined to surgical management of kidney and ureteral stones, while the EAU urolithiasis guideline runs the whole pathway from renal colic and medical expulsive therapy through shockwave lithotripsy, ureteroscopy and percutaneous nephrolithotomy to metabolic evaluation and recurrence prevention. source
• The European text also carries special-situation chapters that a surgery-focused US document does not, covering bladder stones, stone management in patients on antithrombotic therapy, and radiation exposure during stone procedures. source
• Revision rhythm differs: the EAU guideline runs an annual literature review, with the 2026 edition described as a full update of the 2025 text and the next comprehensive rewrite scheduled for 2028, whereas the American document is revised as a standalone release (2025 version). source

What changed recently

1. EU2025 → 20262026-01-01

   The 2026 EAU urolithiasis guideline is a full update of the 2025 edition incorporating 126 newly identified studies, with revised recommendations on renal colic management, medical expulsive therapy, antibiotic prophylaxis for shock wave lithotripsy, retrograde and antegrade ureteroscopy, percutaneous nephrolithotomy, management of antithrombotic therapy around stone treatment, and radiation protection in endourology.

   source ↗
2. US2016 → 20252025-11-20

   The AUA replaced its 2016 surgical stone guideline with a new edition released in November 2025, developed from a GRADE-based review of literature published between 2000 and 2025. It is issued as a three-part series spanning evaluation, treatment and future directions, and covers shock wave lithotripsy, ureteroscopy and both standard and mini percutaneous nephrolithotomy.

   source ↗curation confidence 90%