ACS Releases Guidelines on Management of Genitourinary Injuries

The ACS has released new Best Practices Guidelines for the Management of Genitourinary Injuries, which provide comprehensive, evidence-based strategies to improve care for patients with traumatic injuries to the kidneys, bladder, ureters, urethra, and genitalia. 

The new, freely available guidelines address critical aspects of genitourinary trauma care, from initial evaluation and imaging to surgical and nonoperative management, with special emphasis on pediatric and older adult populations, as well as considerations for different anatomy. 

“Traumatic genitourinary injuries require prompt and expert management to prevent life-threatening complications and ensure optimal long-term outcomes,” said Avery Nathens, MD, PhD, FACS, Medical Director of Trauma Quality Programs at ACS. “These guidelines provide a multidisciplinary, evidence-based framework to help trauma teams deliver high-quality care to patients with injuries that have the potential to cause significant morbidity.”  

Key areas include:

• Renal Trauma: Recommendations are provided for nonoperative management in hemodynamically stable patients, even with high-grade injuries. Angioembolization is emphasized as a key adjunct for controlling bleeding.
• Bladder and Urethral Injuries: Protocols are detailed for imaging (CT cystography, retrograde urethrogram) and surgical repair, including special considerations for pelvic fracture-associated injuries.
• Ureteral Injuries: Recommendations are given for endoscopic and surgical repair, with a focus on preserving renal function.
• Genital Trauma: Guidelines are listed for managing penile, scrotal, and female genital injuries, including bite wounds and fractures.
• Special Populations: Tailored recommendations are provided for pediatric and older adult patients, addressing unique social, anatomical, and physiological considerations. 

Download and read the guidelines.