American Urological Assn. Adds 5 More Unnecessary Practices to Choosing Wisely

By Kelly Young

Edited by Susan Sadoughi, MD, and André Sofair, MD, MPH

As part of the Choosing Wisely campaign, the American Urological Association has added five more medical treatments and tests that patients and clinicians should question.

Among them:

• Clinicians shouldn't treat low-risk localized prostate cancer (Gleason score, <7; prostate-specific antigen, <10 ng/mL; tumor stage T2 or less) before discussing active surveillance with the patient.

• Women with uncomplicated cystitis shouldn't be given fluoroquinolones if other oral antibiotics will work.

• Opioids shouldn't be given following the immediate postoperative period. Opioids should be prescribed at the lowest effective doses and the lowest number of doses possible.

• Urine cytology or markers shouldn't be routinely used for patients with microhematuria.

• Computed tomography shouldn't be used to assess children and adolescents who have suspected nephrolithiasis.