Guidelines

Urological Trauma

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2. METHODS

2.1. Evidence sources

For the 2023 Urological Trauma Guidelines, new and relevant evidence has been identified, collated and appraised through a structured assessment of the literature. A broad and comprehensive literature search, covering all sections of the Urological Trauma Guidelines was performed. Databases searched included Medline, EMBASE, and the Cochrane Libraries, covering a time frame between May 1st, 2021, and April 29th, 2022. A total of 1,236 unique records were identified, retrieved and screened for relevance. A detailed search strategy is available online: https://uroweb.org/guidelines/urological-trauma/publications-appendices. The majority of identified publications were comprised of case reports and retrospective case series. The lack of high-powered randomised controlled trials (RCTs) makes it difficult to draw meaningful conclusions. The panel recognises this critical limitation.

Recommendations within the Guidelines are developed by the panels to prioritise clinically important care decisions. The strength of each recommendation is determined by the balance between desirable and undesirable consequences of alternative management strategies, the quality of the evidence (including certainty of estimates), and the nature and variability of patient values and preferences [6,7]. This decision process, which can be reviewed in the strength rating forms which accompany each guideline statement, addresses a number of key elements:

  1. the overall quality of the evidence which exists for the recommendation [8];
  2. the magnitude of the effect (individual or combined effects);
  3. the certainty of the results (precision, consistency, heterogeneity and other statistical or study related factors);
  4. the balance between desirable and undesirable outcomes;
  5. the impact of patient values and preferences on the intervention.

Strong recommendations typically indicate a high degree of evidence quality and/or a favourable balance of benefit to harm and patient preference. Weak recommendations typically indicate availability of lower quality evidence, and/or equivocal balance between benefit and harm, and uncertainty or variability of patient preference [9].

Additional information can be found in the general Methodology section of this print, and online at the EAU website; http://www.uroweb.org/guideline/. A list of associations endorsing the EAU Guidelines can also be viewed online at the above address.

2.2. Peer review

The Urological Trauma Guidelines was peer reviewed prior to publication in 2019.