{Reference Type}: Journal Article
{Title}: Guideline of guidelines: a review of urological trauma guidelines.
{Author}: Bryk DJ;Zhao LC;
{Journal}: BJU Int
{Volume}: 117
{Issue}: 2
{Year}: Feb 2016
{Factor}: 5.969
{DOI}: 10.1111/bju.13040
{Abstract}: <B>OBJECTIVE: </B>To review the guidelines released in the last decade by several organisations for the optimal evaluation and management of genitourinary injuries (renal, ureteric, bladder, urethral and genital).<BR><B>METHODS: </B>This is a review of the genitourinary trauma guidelines from the European Association of Urology (EAU) and the American Urological Association (AUA), and renal trauma guidelines from the Société Internationale d'Urologie (SIU).<BR><B>RESULTS: </B>Most recommendations are guided by the American Association for the Surgery of Trauma (AAST) organ injury severity system. Grade A evidence is rare in genitourinary trauma, and most recommendations are based on Grade B or C evidence. The findings of the most recent urological trauma guidelines are summarised. All guidelines recommend conservative management for low-grade injuries. The major difference is for haemodynamically stable patients who have high-grade renal trauma; the SIU guidelines recommend exploratory laparotomy, the EAU guidelines recommend renal exploration only if the injury is vascular, and the AUA guidelines recommend initial conservative management.<BR><B>CONCLUSIONS: </B>There is generally consensus among the three guidelines. Recommendations are based on observational or retrospective studies, as well as clinical principles and expert opinions. Multi-institutional collaborative research can improve the quality of evidence and direct more effective evaluation and management of urological trauma.