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

World J Emerg Surg. 2023 Sep 9;18(1):45. doi: 10.1186/s13017-023-00513-8.

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.

Publication types

  • Practice Guideline

MeSH terms

  • Digestive System Surgical Procedures*
  • Humans
  • Iatrogenic Disease / prevention & control
  • Quality of Life
  • Surgeons*
  • Urinary Tract*