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J Urol. 2017 Feb;197(2):414-419. doi: 10.1016/j.juro.2016.08.005. Epub 2016 Aug 6.

Epidemiology of Genitourinary Injuries among Male U.S. Service Members Deployed to Iraq and Afghanistan: Early Findings from the Trauma Outcomes and Urogenital Health (TOUGH) Project.

Author information

1
United States Army Institute of Surgical Research, JBSA Fort Sam Houston, Texas.
2
San Antonio Military Medical Center, JBSA Fort Sam Houston, Texas.
3
San Antonio Military Medical Center, JBSA Fort Sam Houston, Texas. Electronic address: Steven.J.Hudak2.mil@mail.mil.

Abstract

PURPOSE:

In this study we report the number, nature and severity of genitourinary injuries among male U.S. service members deployed to Operations Iraqi Freedom and Enduring Freedom.

MATERIALS AND METHODS:

This retrospective cross-sectional study of the Department of Defense Trauma Registry used ICD-9-CM codes to identify service members with genitourinary injuries, and used Abbreviated Injury Scale codes to determine injury severity, genitourinary organs injured and comorbid injuries.

RESULTS:

From October 2001 to August 2013, 1,367 male U.S. service members sustained 1 or more genitourinary injuries. The majority of injuries involved the external genitalia (1,000, 73.2%), including the scrotum (760, 55.6%), testes (451, 33.0%), penis (423, 31%) and/or urethra (125, 9.1%). Overall more than a third of service members with genitourinary injury sustained at least 1 severe genitourinary injury (502, 36.7%). Loss of 1 or both testes was documented in 146 men, including 129 (9.4%) unilateral orchiectomies and 17 (1.2%) bilateral orchiectomies. Common comorbid injuries included traumatic brain injury (549, 40.2%), pelvic fracture (341, 25.0%), colorectal injury (297, 21.7%) and lower extremity amputations (387, 28.7%).

CONCLUSIONS:

An unprecedented number of U.S. service members sustained genitourinary injury while deployed to Operation Iraqi Freedom/Operation Enduring Freedom. Further study is needed to describe the long-term impact of genitourinary injury and determine the potential need for novel treatments to improve sexual, urinary and/or reproductive function among service members with severe genital injury.

KEYWORDS:

blast injuries; organ transplantation; penis; urogenital system; wounds and injuries

PMID:
27506692
DOI:
10.1016/j.juro.2016.08.005
[Indexed for MEDLINE]

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