What are the key decision points in managing renal, bladder, and urethral trauma? In this episode of BackTable Urology, Dr. Niels Johnson (Vanderbilt University Medical Center) joins host Dr. George Koch (Ohio State University) to discuss the 2025 American College of Surgeons (ACS) best practice guidelines for genitourinary trauma.

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Timestamps

00:00 - Introduction
05:09 - Who Manages GU Trauma?
13:53 - Purpose of ACS Guidelines
16:13 - Development of ACS Guidelines
20:01 - Foley Catheter Debate
23:26 - Renal Trauma
26:40 - Imaging Protocols and Delays
29:30 - Bladder Trauma and Special Populations
33:15 - Urethral Injuries
38:02 - Genital Wounds and Antibiotics
39:42 - Transfer Criteria and Resources
41:26 - Conclusions

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More about this episode

Dr. Johnson and Dr. Koch review the rationale for developing multidisciplinary guidelines and the variability in genitourinary trauma care across institutions. The discussion highlights key management principles, including non-operative strategies for renal trauma, decision-making in bladder and urethral injuries, and how urinary diversion impacts orthopedic and trauma surgical planning. The episode also addresses considerations for special populations, long-term functional outcomes, and practical implementation tools, such as the ACS gap analysis checklist, designed to improve coordination and quality of care across trauma systems.

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Resources

ACS Best Practices Guidelines: Management of Genitourinary Injuries (August 2025)
https://www.facs.org/media/ya5hcu0s/genitourinary_guidelines.pdf