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Instructional Course

Instructional Course - Available with the Platinum and Silver packages or Individual Course Ticket

031IC - Urological Trauma & Reconstruction

Saturday, May 14, 2022

10:00 AM – 12:00 PM

Location: Room 208

Instructional Course Director(s)

Steven Jeffrey Hudak, MD, FACS

UT Southwestern Medical Center

Instructional Course Faculty(s)

NA

Noel Anthony Armenakas, MD

Zucker School of Medicine, Hofstra University
MC

Michael Coburn, MD

Baylor College of Medicine Houston, Texas

Learning Objectives:

Describe guidelines-driven, evidence-based treatment algorithms for injuries to the kidney, ureter, bladder, urethra and external genitalia.
Apply principles of damage control surgery to the management of unstable trauma patients.
Distinguish between injuries that require non-operative surveillance, immediate surgery, and adjunctive interventions such as angio-embolization or endourologic management.
Explain the differing approaches to civilian and military genitourinary injuries.
Identify the importance of long-term multi-disciplinary care for the urinary, sexual, reproductive, interpersonal, and mental health sequelae which can result after urological injury.

This course, which has been offered at the AUA Annual Meeting for many years, provides a comprehensive, case-based approach to the assessment and management of all types of urological injury while focusing on trauma due to external violence (as opposed to iatrogenic injury). The course has been updated over the past 5 years to increase the emphasis on evidenced-based management decisions, applicability of the AUA Guidelines and the inclusion of both civilian and military trauma. The course is highly valuable to both our domestic and international attendees, as we demonstrate diagnostic and treatment approaches that are relevant in both the technology-replete, as well as austere care environments. Emphasis on the critical elements of related reconstructive surgery techniques are provided with case-based illustrations. The optimal working relationships between the urologist, the trauma surgeon, and other surgical and non-surgical specialists are addressed. Specifically, learners will be able to take the following back to their respective practices after attending:

1. Obtain a full understanding of the AUA Urotrauma Guidelines.
2. Apply principles of damage control surgery to the management of unstable trauma patients with urological injuries.
3. Renal trauma: understand the importance of nonoperative management of most renal injuries, reserving prompt intervention for those with high grade injury and ongoing hemorrhage and/or continued urinary extravasation.
4. Ureteral trauma: maintain a high index of suspicion for ureteral trauma in high-risk patients; understand the importance of early intervention for ureteral injuries during the primary laparotomy when able; consider endourologic or percutaneous approaches when ureteral injuries are diagnosed in a delayed manner.
5. Bladder trauma: understand the importance of operative repair (intraperitoneal and complex extraperitoneal injuries) and nonoperative management (simple extraperitoneal injuries).
6. Urethral trauma: diagnose and localize urethral injuries with retrograde urethrography; appropriately manage urethral injuries based on injury mechanism and anatomical location.
7. Genital trauma: stage and manage genital injuries with an appreciation for injury mechanism whether focal (i.e. penile fracture, penile amputation) or multi-system (i.e. high energy polytrauma); understand the importance of long-term multidisciplinary care given the potential for secondary interpersonal and mental health effects.