CHICAGO — The American College of Surgeons (ACS) has released its new Best Practices Guidelines for the Management of Genitourinary Injuries, offering health care providers comprehensive, evidence-based strategies to improve care for patients with traumatic injuries to the kidneys, bladder, ureters, urethra, and genitalia.
Genitourinary (GU) injuries occur in up to 10% of trauma patients and can lead to significant morbidity, including long-term urinary, renal, and sexual health complications. The new guidelines address critical aspects of GU 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 Dr. 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 points from the guidelines
- Renal Trauma: Nonoperative management is recommended for hemodynamically stable patients, even with high-grade injuries. Angioembolization is emphasized as a key adjunct for controlling bleeding.
- Bladder and Urethral Injuries: Detailed protocols for imaging (e.g., CT cystography, retrograde urethrogram) and surgical repair, including special considerations for pelvic fracture-associated injuries.
- Ureteral Injuries: Recommendations for endoscopic and surgical repair, with a focus on preserving renal function.
- Genital Trauma: Guidelines for managing penile, scrotal, and female genital injuries, including bite wounds and fractures.
- Special Populations: Tailored recommendations for pediatric and older adult patients, addressing unique social, anatomical, and physiological considerations.
The guidelines were developed by a multidisciplinary panel of experts, including urologists, trauma surgeons, and military medical professionals, and incorporate the latest evidence from civilian and military trauma care.
“Notably, the authors of these guidelines took great care to include considerations for special populations, including pediatrics and geriatrics, whose needs might differ, said Dr. Nathens. “This ensures equitable and effective care for all trauma patients.”
The Best Practices Guidelines for the Management of Genitourinary Injuries are now available on the ACS website, providing trauma centers with a vital resource to standardize and improve genitourinary trauma care.
