Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Practice Guideline
. 2023 Sep 9;18(1):45.
doi: 10.1186/s13017-023-00513-8.

2023 WSES guidelines for the prevention, detection, and management of iatrogenic urinary tract injuries (IUTIs) during emergency digestive surgery

Nicola de'Angelis  1   2 , Carlo Alberto Schena  3 , Francesco Marchegiani  1 , Elisa Reitano  4 , Belinda De Simone  5 , Geoffrey Yuet Mun Wong  6 , Aleix Martínez-Pérez  7 , Fikri M Abu-Zidan  8 , Vanni Agnoletti  9 , Filippo Aisoni  10 , Michele Ammendola  11 , Luca Ansaloni  12 , Miklosh Bala  13 , Walter Biffl  14 , Graziano Ceccarelli  15 , Marco Ceresoli  16 , Osvaldo Chiara  17 , Massimo Chiarugi  18 , Stefania Cimbanassi  17 , Federico Coccolini  18 , Raul Coimbra  19 , Salomone Di Saverio  20 , Michele Diana  4 , Marco Dioguardi Burgio  21 , Gustavo Fraga  22 , Paschalis Gavriilidis  23 , Angela Gurrado  24 , Riccardo Inchingolo  25 , Alexandre Ingels  26 , Rao Ivatury  27 , Jeffry L Kashuk  28 , Jim Khan  29 , Andrew W Kirkpatrick  30 , Fernando J Kim  31 , Yoram Kluger  32 , Zaher Lakkis  33 , Ari Leppäniemi  34 , Ronald V Maier  35 , Riccardo Memeo  36 , Ernest E Moore  37 , Carlos A Ordoñez  38   39 , Andrew B Peitzman  40 , Gianluca Pellino  41 , Edoardo Picetti  42 , Manos Pikoulis  43 , Michele Pisano  44 , Mauro Podda  45 , Oreste Romeo  46 , Fausto Rosa  47 , Edward Tan  48 , Richard P Ten Broek  49 , Mario Testini  24 , Brian Anthony Tian Wei Cheng  50 , Dieter Weber  51 , Emilio Sacco  52 , Massimo Sartelli  53 , Alfredo Tonsi  54 , Fabrizio Dal Moro  55 , Fausto Catena  56
Affiliations
Practice Guideline

2023 WSES guidelines for the prevention, detection, and management of iatrogenic urinary tract injuries (IUTIs) during emergency digestive surgery

Nicola de'Angelis et al. World J Emerg Surg. .

Abstract

Iatrogenic urinary tract injury (IUTI) is a severe complication of emergency digestive surgery. It can lead to increased postoperative morbidity and mortality and have a long-term impact on the quality of life. The reported incidence of IUTIs varies greatly among the studies, ranging from 0.3 to 1.5%. Given the high volume of emergency digestive surgery performed worldwide, there is a need for well-defined and effective strategies to prevent and manage IUTIs. Currently, there is a lack of consensus regarding the prevention, detection, and management of IUTIs in the emergency setting. The present guidelines, promoted by the World Society of Emergency Surgery (WSES), were developed following a systematic review of the literature and an international expert panel discussion. The primary aim of these WSES guidelines is to provide evidence-based recommendations to support clinicians and surgeons in the prevention, detection, and management of IUTIs during emergency digestive surgery. The following key aspects were considered: (1) effectiveness of preventive interventions for IUTIs during emergency digestive surgery; (2) intra-operative detection of IUTIs and appropriate management strategies; (3) postoperative detection of IUTIs and appropriate management strategies and timing; and (4) effectiveness of antibiotic therapy (including type and duration) in case of IUTIs.

Keywords: Antimicrobial treatment for urinary tract injury; Bladder injury; Iatrogenic urinary tract injury; Ureteral injury; Urinary injury diagnosis; Urinary injury management; Urinary injury prevention.

PubMed Disclaimer

Conflict of interest statement

Andrew W Kirkpatrick has consulted for the Innovative Trauma Care, 3 M/Acelity, and Geneva Foundation and is the PI of a Prospective Randomized Controlled Trial that was previously partially supported by the 3 M/Acelity Corporation. All the other authors declare that they have no competing interests in relation to the matter of this publication.

Figures

Fig. 1
Fig. 1
Decisional tree in case of intraoperatively suspected IUTI. N stands for no, Y for yes. IUTI, iatrogenic urinary tract injury; EDS, emergency digestive surgery
Fig. 2
Fig. 2
Decisional tree in case of postoperatively suspected IUTI. IUTI, iatrogenic urinary tract injury; EDS, emergency digestive surgery; CT, computed tomography; NOM, non-operative management
See this image and copyright information in PMC

References

    1. Sahai A, Ali A, Barratt R, Belal M, Biers S, Hamid R, Harding C, Parkinson R, Reid S, Thiruchelvam N, et al. British Association of Urological Surgeons (BAUS) consensus document: management of bladder and ureteric injury. BJU Int. 2021;128:539–547. doi: 10.1111/bju.15404. - DOI - PubMed
    1. Abboudi H, Ahmed K, Royle J, Khan MS, Dasgupta P, N'Dow J. Ureteric injury: a challenging condition to diagnose and manage. Nat Rev Urol. 2013;10:108–115. doi: 10.1038/nrurol.2012.254. - DOI - PubMed
    1. Brollo PP, Puggioni A, Tumminelli F, Colangelo A, Biddau C, Cherchi V, Bresadola V. Preventing iatrogenic ureteral injury in colorectal surgery: a comprehensive and systematic review of the last 2 decades of literature and future perspectives. Surg Today. 2023 doi: 10.1007/s00595-022-02639-9. - DOI - PubMed
    1. Hird AE, Nica A, Coburn NG, Kulkarni GS, Nam RK, Gien LT. Does prophylactic ureteric stenting at the time of colorectal surgery reduce the risk of ureteric injury? A systematic review and meta-analysis. Colorectal Dis. 2021;23:1060–1070. doi: 10.1111/codi.15498. - DOI - PubMed
    1. Li X, Yang K, Ding G, Zou X, Ye L, Wu J, Zhang P, Fang D, Hao H, Li Z, et al. Etiology, characteristics and management of ureteric injury: experience from a nationwide study. Transl Androl Urol. 2022;11:794–802. doi: 10.21037/tau-21-998. - DOI - PMC - PubMed

Publication types

LinkOut - more resources