Purpose The authors of this guideline reviewed the urologic trauma literature to guide clinicians in the appropriate methods of evaluation and management of genitourinary injuries. Methods A systematic review of the literature using the MEDLINE® and EMBASE databases (search dates 1/1/90-9/19/12) was conducted to identify peer-reviewed publications relevant to urotrauma. The review yielded an evidence base of 372 studies after application of inclusion/exclusion criteria. These publications were used to inform the statements presented in the guideline as Standards, Recommendations or Options. When sufficient evidence existed, the body of evidence for a particular treatment was assigned a strength rating of A (high), B (moderate) or C (low). In the absence of sufficient evidence, additional information is provided as Clinical Principles and Expert Opinions.

We present a detailed map of regional LN involvement in patients treated with radical cystectomy and lymph node dissection for transitional cell cancer of the bladder. Extensive LN dissection is essential for the complete removal of disease and accurate staging.

Phalloplasty is an exceptionally complicated reconstructive procedure that attempts to create a structure that is penis-like. As patient goals vary widely, it is helpful to think about phalloplasty as a modular set of procedures that can be combined, mixed and matched to meet the needs of each individual patient while also taking into account their anatomy. Each module-but particularly the shaft and penile urethracan be performed using a variety of techniques. To date, there is no consensus among surgeons regarding the optimum staging of the reconstructive steps. Our primary goal is to outline the most frequently performed and reported options in phallic reconstruction and outline the various considerations that go into choosing a given sequence of procedures for the specific patient. The secondary goal of this article is to describe the complications common to each of those modules and how they interact when combined.

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On radiography a large perirenal hematoma, intravascular contrast extravasation and medial renal laceration are important risk factors associated with the need for urgent hemostatic intervention after renal trauma. Assessing these computerized tomography characteristics collectively shows that American Association for the Surgery of Trauma grade 4 renal injuries can and should be substratified into grades 4a (low risk) and 4b (high risk).