Urotrauma Guideline 2020: AUA Guideline

Area of Science:

• Urology
• Trauma Surgery
• Evidence-Based Medicine

Background:

• Genitourinary (GU) injuries require prompt and accurate diagnosis and management.
• Existing guidelines for urologic trauma necessitate periodic updates to incorporate new research.
• Clinicians need current guidance for effective patient care.

Purpose of the Study:

• To review the urologic trauma literature and update clinical guidelines.
• To provide evidence-based recommendations for the evaluation and management of genitourinary injuries.
• To inform clinicians on the latest approaches to urotrauma.

Main Methods:

• Systematic review of urologic trauma literature through February 2020.
• Amendment of existing guideline statements based on new evidence.
• Inclusion of new statements for specific trauma scenarios.
• Assigning strength ratings (A, B, C) to evidence and recommendations.
• Supplementing evidence with Clinical Principles and Expert Opinions when necessary.

Main Results:

• Six existing statements on renal, ureteral, bladder, urethra, and genital trauma were updated.
• Four new statements were added, addressing hemodynamically unstable renal trauma, suprapubic tube placement after pelvic fractures, scrotal injury ultrasonography, and penetrating scrotal injuries.
• Specific updates include new evidence for managing renal trauma in unstable patients and urethral injuries post-pelvic fracture.
• Guidance was enhanced for scrotal injuries, including diagnostic imaging and surgical management.

Conclusions:

• The updated AUA Guidelines provide current, evidence-based information on urotrauma.
• These revisions enhance the management of genitourinary injuries.
• The guideline updates support improved clinical decision-making in urologic trauma care.