2023 WSES guidelines for the prevention, detection, and management of iatrogenic urinary tract injuries (IUTIs) during emergency digestive surgery

Nicola de’Angelis, Carlo Alberto Schena, Francesco Marchegiani, Elisa Reitano, Belinda De Simone, Geoffrey Yuet Mun Wong, Aleix Martínez-Pérez, Fikri M. Abu-Zidan, Vanni Agnoletti, Filippo Aisoni, Michele Ammendola, Luca Ansaloni, Miklosh Bala, Walter Biffl, Graziano Ceccarelli, Marco Ceresoli, Osvaldo Chiara, Massimo Chiarugi, Stefania Cimbanassi, Federico CoccoliniRaul Coimbra, Salomone Di Saverio, Michele Diana, Marco Dioguardi Burgio, Gustavo Fraga, Paschalis Gavriilidis, Angela Gurrado, Riccardo Inchingolo, Alexandre Ingels, Rao Ivatury, Jeffry L. Kashuk, Jim Khan, Andrew W. Kirkpatrick, Fernando J. Kim, Yoram Kluger, Zaher Lakkis, Ari Leppäniemi, Ronald V. Maier, Riccardo Memeo, Ernest E. Moore, Carlos A. Ordoñez, Andrew B. Peitzman, Gianluca Pellino, Edoardo Picetti, Manos Pikoulis, Michele Pisano, Mauro Podda, Oreste Romeo, Fausto Rosa, Edward Tan, Richard P. Ten Broek, Mario Testini, Brian Anthony Tian Wei Cheng, Dieter Weber, Emilio Sacco, Massimo Sartelli, Alfredo Tonsi, Fabrizio Dal Moro, Fausto Catena

Research output: Contribution to journalReview articlepeer-review

1 Citation (Scopus)


Iatrogenic urinary tract injury (IUTI) is a severe complication of emergency digestive surgery. It can lead to increased postoperative morbidity and mortality and have a long-term impact on the quality of life. The reported incidence of IUTIs varies greatly among the studies, ranging from 0.3 to 1.5%. Given the high volume of emergency digestive surgery performed worldwide, there is a need for well-defined and effective strategies to prevent and manage IUTIs. Currently, there is a lack of consensus regarding the prevention, detection, and management of IUTIs in the emergency setting. The present guidelines, promoted by the World Society of Emergency Surgery (WSES), were developed following a systematic review of the literature and an international expert panel discussion. The primary aim of these WSES guidelines is to provide evidence-based recommendations to support clinicians and surgeons in the prevention, detection, and management of IUTIs during emergency digestive surgery. The following key aspects were considered: (1) effectiveness of preventive interventions for IUTIs during emergency digestive surgery; (2) intra-operative detection of IUTIs and appropriate management strategies; (3) postoperative detection of IUTIs and appropriate management strategies and timing; and (4) effectiveness of antibiotic therapy (including type and duration) in case of IUTIs.

Original languageEnglish
Article number45
JournalWorld Journal of Emergency Surgery
Issue number1
Publication statusPublished - Dec 2023


  • Antimicrobial treatment for urinary tract injury
  • Bladder injury
  • Iatrogenic urinary tract injury
  • Ureteral injury
  • Urinary injury diagnosis
  • Urinary injury management
  • Urinary injury prevention

ASJC Scopus subject areas

  • Surgery
  • Emergency Medicine


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