Introduction: Urinary stone disease remains a significant global and national health concern. This underscores the need for measures to improve disease outcomes. The development and implementation of clinical practice guidelines for urolithiasis was deemed essential due to variations in practice and the evolving urologic field with its emerging interventions, which may have significant cost implications.

Methods: The CPG was developed following the GRADE Adolopment method, the CORE GRADE Approach and the GRADE Evidence to Decision framework, and utilized the Technical Manual for Clinical Practice Guideline Development of the Department of Health (2^nd edition). The guideline development group was organized after review and management of the members’ conflict of interest declarations. Clinical questions were prioritized, and a systematic search and synthesis of the relevant literature to answer the questions was done. Considering the balance of benefits and harms, certainty of the evidence, cost and cost-effectiveness, accessibility, acceptability and feasibility of the interventions, the guideline panel developed recommendations by consensus.

Results: The CPG addresses eleven priority clinical questions involving diagnosis and treatment of acute flank pain due to suspected urolithiasis among adults, minimally invasive treatment of nephrolithiasis measuring 1-2 cm, and the use of alpha-blockers after ESWL through twelve recommendations and one good practice statement.

Conclusion: The Philippine CPG on the management of urolithiasis in adults provides actionable recommendations to address important clinical questions on the diagnosis and management of urinary stone disease. The full text of the clinical practice guideline may be viewed and downloaded from https://doh.gov.ph/dpcb/doh-approved-cpg/

Keywords: Practice guidelines, urolithiasis, Philippines, urinary stone disease, adult, evidence-based medicine

1. GBD 2021 Urolithiasis Collaborators. The global, regional, and national burden of urolithiasis in 204 countries and territories, 2000-2021: a systematic analysis for the Global Burden of Disease Study 2021. EClinicalMedicine. 2024;78(102924):102924. doi:10.1016/j.eclinm.2024.102924
2. Villar M. Senate Resolution No. 332: Kidney Stone Disease in Filipino Adults. Manila: Senate of the Philippines, 19th Congress.; 2011.
3. Alip S, Arboleda J, Tapay-Plumo R, Guevara D, Burog A, Lapitan M. Clinical Practice Guideline for the Diagnosis and Management of Urolithiasis in Adults (Protocol). Phil J Urol. 2025;35:1-37.
4. Schünemann HJ, Wiercioch W, Brozek J, et al. GRADE Evidence to Decision (EtD) frameworks for adoption, adaptation, and de novo development of trustworthy recommendations: GRADE-ADOLOPMENT. J Clin Epidemiol. 2017;81:101-110. doi:10.1016/j.jclinepi.2016.09.009
5. Brouwers MC, Kho ME, Browman GP, et al. AGREE II: advancing guideline development, reporting and evaluation in health care. CMAJ. 2010;182(18):E839-42. doi:10.1503/cmaj.090449
6. Guyatt G, Agoritsas T, Brignardello-Petersen R, et al. Core GRADE 1: overview of the Core GRADE approach. BMJ. 2025;389:e081903. doi:10.1136/bmj-2024-081903