For the 2021 Management of 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. The scope search identified 2,057 unique references of which 129 full texts were reviewed resulting in 13 additional references and text updates being incorporated throughout the 2021 version of the Urological trauma Guidelines. Specific changes include:
- 4.4 Summary of evidence and recommendations for the evaluation and management of urethral trauma – the recommendations for the treatment of partial and complete blunt anterior urethral injuries have been updated.
| Summary of evidence | LE |
| Complete blunt anterior urethral ruptures are unlikely to be cured by urinary diversion alone, whereas immediate urethroplasty has an equal success rate compared to delayed urethroplasty. The main advantage of immediate urethroplasty is to reduce the time to spontaneous voiding. | 3 |
| With early endoscopic re-alignment the stricture rate is reduced to 44-49% without increased risk of incontinence or erectile dysfunction. | 3 |
| Recommendations | Strength rating |
| Treat complete blunt anterior urethral injuries by immediate urethroplasty, if surgical expertise is available, otherwise perform suprapubic diversion with delayed urethroplasty. | Weak |