title: Review of the current management of lower urinary tract injuries by the EAU Trauma Guidelines Panel.
abstract: BACKGROUND
  The most recent European Association of Urology (EAU) guidelines on urologic trauma were published in 2014.
  
  
  OBJECTIVE
  To present a summary of the 2014 version of the EAU guidelines on urologic trauma of the lower urinary tract with an emphasis on diagnosis and treatment.
  
  
  METHODS
  The EAU Trauma Panel reviewed the English-language literature via a Medline search for lower urinary tract injury (LUTI) up to November 2013. The focus was on newer publications and reviews, although older key references could be included.
  
  
  RESULTS
  A full version of the guidelines is available in print (EAU Guidelines 2014 edition, ISBN/EAN 978-90-79754-65-6) and online (www.uroweb.org). Blunt trauma is the main cause of LUTI. The preferred diagnostic modality for bladder and urethral injury is cystography and urethrography, respectively. In the treatment of bladder injuries, it is important to distinguish between extra- and intraperitoneal ruptures. Treatment of male anterior urethral injuries depends on the cause (blunt vs penetrating vs penile-fracture-related injury). Blunt posterior urethral injuries can be corrected by immediate/early endoscopic realignment. If this is not possible, such injuries are managed by suprapubic urinary diversion and deferred (>3 mo) urethroplasty. Treatment of female urethral injuries depends on the location of the injury and is usually surgical.
  
  
  CONCLUSIONS
  Correct treatment of LUTIs is important to minimise long-term urinary symptoms and sexual dysfunction. This review performed by the EAU trauma panel summarises the current management of LUTIs.
  
  
  RESULTS
  Patients with trauma to the lower urinary tract benefit from accurate diagnosis and appropriate treatment according to the nature and severity of their injury.
authors.affiliation: Department of Urology, Ghent University Hospital, Ghent, Belgium. Electronic address: nicolaas.lumen@uzgent.be.
authors.forename: Nicolaas
authors.initials: N
authors.lastname: Lumen
authors.affiliation: London Andrology Institute, London, UK.
authors.forename: Franklin E
authors.initials: FE
authors.lastname: Kuehhas
authors.affiliation: Department of Urology, Mühldorf General Hospital, Mühldorf am Inn, Germany.
authors.forename: Nenad
authors.initials: N
authors.lastname: Djakovic
authors.affiliation: Department of Urology, Chaim Sheba Medical Centre, Tel-Hashomer, Israel.
authors.forename: Noam D
authors.initials: ND
authors.lastname: Kitrey
authors.affiliation: Department of Urology, Asklipieion General Hospital, Athens, Greece.
authors.forename: Efraim
authors.initials: E
authors.lastname: Serafetinidis
authors.affiliation: Urology Department, St George's Healthcare NHS Trust, London, UK.
authors.forename: Davendra M
authors.initials: DM
authors.lastname: Sharma
authors.affiliation: Department of Urology, University Hospitals of Leicester NHS Trust, Leicester, UK.
authors.forename: Duncan J
authors.initials: DJ
authors.lastname: Summerton
mesh_terms: D004724:Endoscopy / Q000379:methods; D005060:Europe; D005260:Female; D006801:Humans; D008297:Male; D017410:Practice Guidelines as Topic; D012737:Sex Factors; D013518:Surgery, Plastic / Q000379:methods; D014521:Urethra / Q000293:injuries; D001743:Urinary Bladder / Q000293:injuries; D014551:Urinary Tract / Q000293:injuries* / Q000601:surgery; D014572:Urology / Q000458:organization & administration* / Q000592:standards*; D014949:Wounds, Nonpenetrating / Q000175:diagnosis / Q000601:surgery*; D014950:Wounds, Penetrating / Q000175:diagnosis / Q000601:surgery*
keywords: Bladder injury; Bladder trauma; European Association of Urology (EAU); Guidelines; Lower urinary tract; Urethral injury; Urethral trauma