Summary Paper of the Updated 2023 European Association of Urology Guidelines on Urological Trauma

Eur Urol Focus. 2023 Nov 13:S2405-4569(23)00196-7. doi: 10.1016/j.euf.2023.08.011. Online ahead of print.

Abstract

Context: The European Association of Urology (EAU) Guidelines Panel for Urological Trauma has produced guidelines in order to assist medical professionals in the management of urological trauma in adults for the past 20 yr. It must be emphasised that clinical guidelines present the best evidence available to the experts, but following guideline recommendations will not necessarily result in the best outcome. Guidelines can never replace clinical expertise when making treatment decisions for individual patients regarding other parameters such as experience and available facilities. Guidelines are not mandates and do not purport to be a legal standard of care.

Objective: To present a summary of the 2023 version of the EAU guidelines on the management of urological trauma.

Evidence acquisition: A systematic literature search was conducted from 1966 to 2022, and articles with the highest certainty evidence were selected. It is important to note that due to its nature, genitourinary trauma literature still relies heavily on expert opinion and retrospective series.

Evidence synthesis: Databases searched included Medline, EMBASE, and the Cochrane Libraries, covering a time frame between May 1, 2021 and April 29, 2022. A total of 1236 unique records were identified, retrieved, and screened for relevance.

Conclusions: The guidelines provide an evidence-based approach for the management of urological trauma.

Patient summary: Trauma is a serious public health problem with significant social and economic costs. Urological trauma is common; traffic accidents, falls, intrapersonal violence, and iatrogenic injuries are the main causes. Developments in technology, continuous training of medical professionals, and improved care of polytrauma patients reduce morbidity and maximise the opportunity for quick recovery.

Keywords: Bladder injury; Genital injury; Renal injury; Trauma; Ureteral injury; Urethral injury.