Interventional Radiology in the Management of Urologic Trauma: A Contemporary Review

Urologic trauma encompasses a spectrum of injuries involving the kidney, ureter, bladder, and urethra, with management strategies increasingly emphasizing organ preservation through minimally invasive, image-guided approaches. The updated American Association for the Surgery of Trauma 2025 grading system provides the most recent guideline for renal trauma classification, reflecting evolving imaging standards and management principles. In parallel, interventional radiology (IR) has assumed an increasingly important role in contemporary trauma care, offering effective, organ-preserving solutions through endovascular and percutaneous techniques. Renal trauma, the most frequent form of genitourinary injury, is now primarily managed non-operatively in hemodynamically stable patients, with transcatheter arterial embolization and stent-based repair serving as cornerstones of hemorrhage control and renal salvage in high-grade lesions. Clinical evidence demonstrates that selective or superselective embolization achieves high technical success and renal preservation, consolidating IR as a key component of multidisciplinary trauma management. Injuries to the lower urinary tract remain complex, but minimally invasive, image-guided interventions are increasingly recognized as integral to modern care, particularly in controlling hemorrhage and preserving function. Superselective embolization, percutaneous urine diversion, and fluoroscopic urethral realignment exemplify how IR provides life-saving, organ-preserving options for ureteral, bladder, and urethral trauma. Collectively, these developments underscore the expanding impact of IR across the full spectrum of urologic trauma management.