Abstract
This report details the incidence and description of trauma to the external genitalia experienced during Operation Iraqi Freedom at a United States Army Combat Support Hospital, and demonstrates that acceptable rates of testicular salvage are possible in the combat setting. The operating room logs and the Joint Theater Trauma Registry were used to conduct a retrospective review of the patients who sustained genitourinary (GU) injuries at an US Army Combat Support Hospital (CSH) in Iraq from 27 February 2007 to 14 August 2007. Of the 3595 battle trauma injuries seen at the CSH during the time period, 168 (4.7%) had one or more GU injuries for a total of 172 GU injuries. Of these patients, 115 (68%) with GU injuries had one or more injuries to the external genitalia for a total of 119 external GU injuries. Penetrating trauma to the penis and scrotum accounted for 59 of the injuries. In total, 43 testicles were injured in 34 patients (9 had bilateral injuries). In total, 32 testes were repaired primarily and 11 were removed. Injuries to the external genitalia continue to account for the vast majority of GU trauma in a combat setting. Of patients who presented with penetrating testicular trauma, there was a 74.4% salvage rate, which is higher than previous reports of combat external genitalia injuries. Treatment of penetrating trauma to the external genitalia in a combat setting requires attention to tissue preservation while coordinating associated surgical procedures.
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References
Paquette EL . Genitourinary trauma at a combat support hospital during operation Iraqi freedom: the impact of body armor. J Urol 2007; 177: 2196–2199.
Heidarpour A, Dabbagh A . Therapeutic urogenital modalities during the last three years of the Iran and Iraq war (1985–1987). Mil Med 1999; 164: 138.
Wettlaufer JN, Weigel JW . Urology in the Vietnam War: Casualty Management and Lessons Learned. Department of the Army Medical Department, and Borden Institute: Washington, D. C., 2004.
Salvatierra O, Rigdon WO, Norris DM, Brady TW . Vietnam experience with 252 urological war injuries. J Urol 1969; 101: 615.
Selikowitz SM . Penetrating high velocity genitor-urinary injuries, part I. Statistics, mechanisms, and renal wounds. Urology 1977; 9: 371.
Vuckovic I, Tucak A, Gotovac J, Karlovic B, Matos I, Grdovic K et al. Croatian experience in the treatment of 629 urogenital war injuries. J Trauma 1995; 39: 733.
Marshal DF . Urogenital wounds in an evacuation hospital. J Urol 1946; 55: 119.
Hudolin T, Hudolin I . Surgical management of urogential injuries at a war hospital in Bosnia-Herzegovina, 1992–1995. J Urol 2003; 169: 1357.
Herr HW . Urological injuries in the civil war. J Urol 2004; 172: 1800–1804.
Young HH . Wounds of the urogenital tract in modern warfare. J Urol 1942; 47: 59–108.
Kimbrough JC . War wounds of the urogenital tract. J Urol 1946; 55: 179–189.
Thompson IM, Flaherty SF, Morey AF . Battlefield urological injuries: the gulf war experience. J Am Coll Surg 1998; 187: 139.
Tucak A, Kukacevic T, Kuvezdic H, Zelijko P, Novak R . Urogenital wounds during the war in Croatia in 1991/1992. J Urol 1995; 153: 121.
Gondusky JS, Reiter MP . Protecting military convoys in Iraq: an examination of battle injuries sustained by a mechanized battalion during Operation Iraqi Freedom II. Mil Med 2005; 170: 546.
Hudak SJ, Morey AF, Rozanski TA, Fox CW . Battlefield urogenital injuries: changing patterns during the past century. Urology 2005; 65: 1041.
Tillet JW, Carney JK . Gunshot Wounds of the Male External Genitalia: AUA Update Series, American Urological Association, Education and Research Inc., Linthicum, MD, Lesson 5, Vol. 27 2008.
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Waxman, S., Beekley, A., Morey, A. et al. Penetrating trauma to the external genitalia in Operation Iraqi Freedom. Int J Impot Res 21, 145–148 (2009). https://doi.org/10.1038/ijir.2008.59
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DOI: https://doi.org/10.1038/ijir.2008.59
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