Penetrating trauma to the external genitalia in Operation Iraqi Freedom

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.

Missile injuries to the external genitalia: a five year experience in Maiduguri, North Eastern Nigeria

“…The labia, scrotum, penis and testes are all vulnerable. 3 These injuries are rarely life threatening in themselves, however most of these patients are multiply injured. Therefore, more often the injuries to other systems take precedence.…”

Current Approachs to Urogenital System Injuries in High Energy Trauma Exposed

“…Waxman ve ark. (55) , 6 aylık periyod içerisinde bir savaş hastanesinde görülen genitoüriner yaralanmaların %68'inin dış genital sistemi içerdiğini bildirmiştir. Penetran parçalardan gelen savaş yaralanmalarıyla karşılaştırıldığında, sivil deneyim genellikle düşük velositedeki silah yaralarını içerir ve bunlar çoğu durumda tamir edilebilir (56) .…”

“…Afganistan'da sürekli öz-gürlük operasyonu (Operation Enduring Freedom in Afghanistan: OEF) ve Irak özgürlüğü operasyonu (Operation Iraqi Freedom: OIF) birleşimi, modern zamanların en uzun süren savaşları haline geldi. 2001'de başlamasından yaklaşık 12 yıl sonra yapı-lan yayınlarda 50.000'in üzerinde Amerikan askeri personeli yaralandığı, bu yaralanmaların yaklaşık %1-5'i genitoüriner sistemle ilgili olduğu ortaya konmuştur (55,66) . Savaş zamanı genitoüriner sistem yaralanmaları insidansı tarihsel olarak %0,5-8 arasındadır.…”

“…Savaş zamanı genitoüriner sistem yaralanmaları insidansı tarihsel olarak %0,5-8 arasındadır. Bunların yaklaşık 2/3'lik bir kısmı (%57-83,1) üretra ve dış genital bölgeyi içerir (55,64,65) . Bu geniş genital yaralanmalar, uzun süreli üriner, hormonal ve cinsel işlev bozukluklarından etkilenen kişiler arasında yaygın olarak görülen önemli fiziksel, psikolojik ve sosyal etkilere sahiptir (55) .…”

Male External Genital Injuries; Pattern of Presentation and Management at the Jos University Teaching Hospital

“…Although injuries to the external genitalia are typically not in and of themselves life threatening, they are commonly associated with other potentially life-threatening injuries (for example, to abdomen, pelvis or groin) [2]. Traumatic injuries to the genitourinary tract are seen in 2.2-10.3% of patients admitted to hospitals [3], [4], [5].…”