ACS issues new best practices for managing genitourinary trauma

Editor's Note

The American College of Surgeons (ACS) has released updated Best Practices Guidelines for the Management of Genitourinary Injuries, providing trauma teams with evidence-based recommendations to improve outcomes for patients with injuries to the kidneys, bladder, ureters, urethra, and genitalia. According to an ACS August 26 news release, the guidance emphasizes both surgical and nonoperative strategies, with tailored considerations for pediatric and older adult populations.

As detailed in the news release, genitourinary trauma occurs in up to 10% of all trauma patients and can result in lasting renal, urinary, or sexual health complications if not managed appropriately. The new guidelines cover the full spectrum of care, from initial evaluation and imaging through operative decision-making, with input from a multidisciplinary panel of urologists, trauma surgeons, and military medicine experts.

Nonoperative management is now recommended for hemodynamically stable patients with renal trauma, even in high-grade cases, with angioembolization highlighted as a critical tool for hemorrhage control. For bladder and urethral injuries, the document provides detailed imaging and repair protocols, including management of pelvic fracture–associated injuries. Ureteral injuries receive focused guidance on endoscopic and surgical approaches to preserve renal function, while genital trauma management includes recommendations for penile, scrotal, and female genital injuries such as fractures and bite wounds.

According to ACS, special populations were a priority in the guideline development. Pediatric and geriatric patients often present with unique anatomical, physiological, and social needs, and the recommendations include specific adjustments for these groups. The updated guidelines are available on the ACS website and are intended to standardize care across trauma centers, reduce complications, and improve long-term outcomes for patients with complex genitourinary injuries.