Penetrating gunshot wounds to the penis: a case report of combat patient injured in the war in Ukraine

Abstract

Background The current war in Ukraine is associated with frequent applications of multiple-launch rocket systems and cruise missiles as well as other various high-energy weapons to cause severe injuries in military personnel including abdomen wounds, vascular injury, and limb amputations as well as genitourinary trauma. The aim of this report is to demonstrate a case of successful penile salvage by restoring its function in a combat patient with gunshot genitourinary trauma in conditions of an interrupted supply of medical equipment. Case presentation We describe a case of a 48-year-old male patient with a combined shrapnel gunshot wound to the penis with damage to the urethra and combined injury to the soft tissues of the left thigh. Several hours after the injury, the patient underwent primary surgical debridement of the left thigh, ligation of the great saphenous vein of the thigh, primary sutures on the penile urethra and navicular fossa, suturing of the rupture of the head and penis, drainage of the wound, catheterization of the bladder, and epicystostomy. An artificial erection was performed intraoperatively. The urethral catheter was removed 3 weeks after urethral suturing (May 4, 2022). The epicystostomy was removed 5 months after the injury (August 4, 2022) and 2 days after the restoration of spontaneous urination. At the follow-up of 7 months after the injury, the patient has normal urination with minor urinary dribbling, sufficient erection, and ejaculation. Conclusions We have shown that in a case of gunshot wounds to the penis and hanging part of the urethra, even in the presence of combined severe purulent lesions of non-urological localizations, it is possible to perform a primary reconstruction of urogenital injuries using a primary urethral suture and applying a negative pressure device. Findings from this case report shed new light on the management of penile gunshot injury in ongoing warfare as well as provide evidence of the possibility to perform adequate management for penile injury in conditions of limited medical resources, violation of international humanitarian law, and under frequent strikes of high-energy weapons.

Retrieval of ferromagnetic fragments from the lung using video-assisted thoracoscopic surgery and magnetic tool: a case report of combat patient injured in the war in Ukraine

“…In this case report, we presented our clinical experience in the management of gunshot wounds with the application of VATS with magnet guidance to remove ferromagnetic fragments in combat patient. We believe this case report provides additional knowledge about the role of minimally invasive surgery and the magnets in the active war conditions accompanied by the violation of humanitarian law by the Russian army and in terms of limited medical resources in Ukraine [ 2 , 14 , 15 , 17 ]. In regards to our previous reports, management of gunshot injury to the lungs is presented for the first time in the patient injured during the active (invasion) period of the Russo-Ukrainian war.…”

A new approach for reconstruction of the gunshot defect of the flexor surface of the ungual (distal) phalanx by the proper transverse branch of the digital artery: a case report of combat patient injured in the Russo-Ukrainian war

“…Reconstructing gunshot defects of zone I of the hand remains difficult for reconstructive plastic surgeons, as it is important for a transplanted tissue not to be soft as the flexor skin must resist shear and pressure forces. The war conditions are also considered an obstacle to provide an adequate microsurgical intervention within the appropriate time after the injury because of interruptions in the medical evacuation by Russian strikes on medical convoys and other medical facilities in the ongoing Russo-Ukrainian war [ 3 – 5 , 8 , 15 – 17 ].…”

“…The management of gunshot wounds to the upper extremity is well-described in patients injured in previous wars, but little is known about the clinical course of such trauma in the ongoing war in Ukraine. It is also worth emphasizing the fact that all kinds of hospitals (both combat and civilian) at all Levels of medical care are at high risk of attacks by cruise missiles or drones from the Russian army, which is a violation of humanitarian international law [ 3 ]. Such circumstances make it difficult to provide medical care for patients with gunshot trauma, including patients requiring a microsurgical approach for gunshot trauma to the hand.…”

Successful management of penetrating shrapnel injury to the left ureter with delayed projectile migration through the urinary tract

“…The ongoing conflict in Ukraine has witnessed the frequent use of multiple‐launch rocket systems, cruise missiles, and other high‐energy weapons, resulting in severe injuries among military personnel. These injuries include abdominal wounds, vascular damage, limb amputations, as well as genitourinary trauma 1 . Ureteral trauma is relatively rare and accounts for less than 1% of both blunt and penetrating genitourinary injuries 2 .…”

“…These injuries include abdominal wounds, vascular damage, limb amputations, as well as genitourinary trauma. 1 Ureteral trauma is relatively rare and accounts for less than 1% of both blunt and penetrating genitourinary injuries. 2 Gunshot wounds are the most common cause of ureteral injuries, with the proximal ureter being the most frequently affected site.…”