MP27-05 SEVERE WAR-RELATED GENITOURINARY INJURIES AMONG MALE SERVICE MEMBERS IN OPERATIONS ENDURING FREEDOM AND IRAQI FREEDOM

You have accessJournal of UrologyGeneral & Epidemiological Trends & Socioeconomics: Quality of Life1 Apr 2015MP27-05 SEVERE WAR-RELATED GENITOURINARY INJURIES AMONG MALE SERVICE MEMBERS IN OPERATIONS ENDURING FREEDOM AND IRAQI FREEDOM Jud Janak, Steven Hudak, Douglas Soderdahl, Jean Orman, Kristy Pottol, and Wendy Dean Jud JanakJud Janak More articles by this author , Steven HudakSteven Hudak More articles by this author , Douglas SoderdahlDouglas Soderdahl More articles by this author , Jean OrmanJean Orman More articles by this author , Kristy PottolKristy Pottol More articles by this author , and Wendy DeanWendy Dean More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2015.02.1167AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail INTRODUCTION AND OBJECTIVES Severe genitourinary (GU) injuries among service members (SMs) from Operations Iraqi Freedom and Enduring Freedom (OIF/OEF) are of great concern for military and VA urologists because of both the physical and psychological complexity of the injuries, as well as the challenges of restoration. Growing interest in applying the most effective approaches to treat these injuries has raised questions about the number of SMs with severe GU injuries. No previous reports have addressed either the number or types of such injuries; therefore, the objective of this study was to describe the epidemiology of severe war-related GU injuries in this population. METHODS Data for US male SMs injured in OEF/OIF during the years 2001-2013 were obtained from the Department of Defense Trauma Registry (DoDTR). The DoDTR includes data for SMs wounded in theater who survived to be admitted to a combat support hospital. Severe GU injury was defined as any injury with at least one Abbreviated Injury Scale code for a “serious” injury OR at least one code for a major/massive laceration to the GU tract. Patients who died of wounds were excluded. Basic demographic and injury characteristics were analyzed. RESULTS Among 1291 male US SMs deployed to OIF/OEF who sustained one or more GU injuries, 482 (37.3%) were classified as severe. This subset of severely GU-injured males were largely young (median age: 24, IQR 21-27) and injured during battle (n=437; 90.7%). The most common injury type and mechanism were penetrating (n=364; 75.5%) and explosive injuries (n=368; n=76.4%); respectively. Regarding the severity of their overall injuries, the median Injury Severity Score (ISS) was in the severe range (ISS = 25; IQR 17-35). Two important associated injuries included amputation(s) of the upper and/or lower extremity (n=202; 41.9%) and colorectal injuries (n=141; 29.3%). The most common severe GU injuries were: renal (n=78; 16.2%); scrotum (n=87; 18.1%); testes (n=275; 57.1%); and penis injuries (n=84; 17.4%). 19 SMs had a complete loss of penis and/or testis(es). CONCLUSIONS A substantial number of SMs have sustained severe GU injury during OIF/OEF. In general, conventional reconstructive surgical techniques have allowed for restoration of form and function in less severe GU injuries. However, these data indicate that some SMs have sustained more severe injuries such as penile amputation and/or orchiectomy which could potentially benefit from advanced restorative approaches. Further studies are needed to determine what types of restorative techniques are most feasible in this population. © 2015 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 193Issue 4SApril 2015Page: e303-e304 Advertisement Copyright & Permissions© 2015 by American Urological Association Education and Research, Inc.MetricsAuthor Information Jud Janak More articles by this author Steven Hudak More articles by this author Douglas Soderdahl More articles by this author Jean Orman More articles by this author Kristy Pottol More articles by this author Wendy Dean More articles by this author Expand All Advertisement Advertisement PDF downloadLoading ...