Universität zu Köln

Ruf, Christian, Kluth, Luis, Wahlen, Sarah ORCID: 0000-0002-9902-8024, Breuing, Jessica ORCID: 0000-0002-3433-6464 and Nestler, Tim ORCID: 0000-0001-6033-6364 (2025). Initial surgical management of injuries to the urogenital tract in patients with polytrauma and/or severe injuries: a systematic review and clinical practice guideline update. European Journal of Trauma and Emergency Surgery, 51 (1). pp. 1-13. Springer Nature. ISSN 1863-9933

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Abstract

[Artikel-NR.: 182] Purpose: Our aim was to update evidence-based and consensus-based recommendations for the initial surgical management of urogenital injuries in patients with polytrauma and/or severe injuries based on current evidence. This guideline topic is part of the 2022 update of the German Guideline on the Treatment of Patients with Polytrauma and/or Severe Injuries. Methods: MEDLINE and Embase were systematically searched to June 2021. Randomised controlled trials, prospective cohort studies, and comparative registry studies were included if they compared surgical and/or therapeutic interventions for urogenital injuries in the hospital setting. We considered patient-relevant clinical outcomes such as mortality and bleeding control, or coagulation parameters as surrogate outcomes. Risk of bias was assessed using NICE 2012 checklists. The evidence was synthesised narratively, and expert consensus was used to develop recommendations and determine their strength. Results: Two new studies were identified. The topics covered were the comparison of outcomes after surgical and nonsurgical management as well as the use of surgical repair versus catheter drainage in patients with extraperitoneal bladder injuries. Three recommendations were modified, one of which for editorial reasons. All achieved strong consensus. Conclusion: The following key recommendations are made. 1. Renal artery injuries can be managed using an endovascular approach. 2. Depending on the type and severity of the injury and concomitant injuries, renal injuries should be managed with the intent to preserve the organ. 3. Extraperitoneal bladder ruptures without involvement of the bladder neck should be conservatively treated with catheterisation.

Item Type:	Article
Creators:	Creators Email ORCID ORCID Put Code Ruf, Christian UNSPECIFIED UNSPECIFIED UNSPECIFIED Kluth, Luis UNSPECIFIED UNSPECIFIED UNSPECIFIED Wahlen, Sarah UNSPECIFIED https://orcid.org/0000-0002-9902-8024 UNSPECIFIED Breuing, Jessica UNSPECIFIED https://orcid.org/0000-0002-3433-6464 UNSPECIFIED Nestler, Tim UNSPECIFIED https://orcid.org/0000-0001-6033-6364 UNSPECIFIED
URN:	urn:nbn:de:hbz:38-802508
Identification Number:	10.1007/s00068-025-02847-1
Journal or Publication Title:	European Journal of Trauma and Emergency Surgery
Volume:	51
Number:	1
Page Range:	pp. 1-13
Number of Pages:	13
Date:	29 April 2025
Publisher:	Springer Nature
ISSN:	1863-9933
Language:	English
Faculty:	Faculty of Medicine
Divisions:	Faculty of Medicine > Urologie > Klinik und Poliklinik für Urologie
Subjects:	Medical sciences Medicine
Uncontrolled Keywords:	Keywords Language Surgery ; Catheter drainage ; Urogenital tract ; Genitourinary tract ; Polytrauma guideline English
['eprint_fieldname_oa_funders' not defined]:	Publikationsfonds UzK
Refereed:	Yes
URI:	http://kups.ub.uni-koeln.de/id/eprint/80250