Michael Coburn, MD, FACS, presented “Evidence-based Management of Renal Trauma” during the 28th Annual Innovations in Urologic Practice conference on September 22, 2024, in Denver, Colorado.
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How to cite: Coburn, Michael. “Evidence-based Management of Renal Trauma.” September 22, 2024. Accessed Nov 2024. https://grandroundsinurology.com/evidence-based-management-of-renal-trauma/
Evidence-based Management of Renal Trauma – Summary
Michael Coburn, MD, FACS, delves into the complexities of kidney trauma management, emphasizing the challenges associated with limited high-level evidence and reliance on expert consensus.
In this 26-minute presentation, Coburn reflects on decades of experience in urologic trauma. Guidelines for trauma have seen revisions, with updates in 2017 and 2020 by the AUA and more forthcoming. He sees a shift towards non-surgical management in hemodynamically stable patients, reflecting a growing emphasis on observation rather than immediate intervention. He shares images illustrating different levels of renal injury.
Coburn relates that follow-up imaging is advised for high-grade injuries to monitor for hematoma expansion, potentially preventing severe complications. Angioembolization has emerged as a valuable tool for controlling bleeding in stable patients, reducing the need for nephrectomy. Specific injuries, such as pseudoaneurysms, often require immediate embolization, while surgical intervention is recommended when substantial kidney tissue is damaged.
Pediatric injuries are highlighted for their unique management needs. Coburn’s presentation concludes with a call for careful patient selection, especially in cases of severe vascular trauma or concomitant visceral injuries, where early intervention can mitigate future complications.
About The 28th Annual Innovations in Urologic Practice:
Presented by co-chairs Mohit Khera, MD, MBA, MPH, and Michael Coburn, MD, FACS, the Innovations in Urologic Practice conference provides a detailed review and commentary on multiple genitourinary and urologic diseases. Among the featured oncological topics are bladder cancer and immunotherapies, as well as upper tract cancer management, prostate cancer, including state-of-the-art imaging, focal therapy, and MRI. Experts also discuss new tools and techniques for nephrectomy and treating advanced renal cell carcinoma. In terms of general urological approaches, the conference also includes pelvic reconstruction and trauma; men’s health topics like male infertility, andrology, and sexual dysfunction; OAB and voiding dysfunctions; and ways to diagnose and treat infections in the urology patient.
For further educational activities from this conference, visit our collection page.