title: Urologic complications of sexual trauma among male survivors of torture.
abstract: OBJECTIVE
  To describe the urologic and sexual complications of male survivors of sexual torture, including prevalence, sequelae, diagnosis, and treatment.
  
  
  METHODS
  Through chart reviews, we identified all male survivors of torture who had been treated for physical and/or psychological symptoms due to sexual trauma at the Boston Center for Refugee Health and Human Rights at Boston Medical Center between January 1, 2001 and January 1, 2002. Of the 72 men seen, 20 (28%) were survivors of sexual trauma. Our study focused on genital trauma leading to urologic and/or sexual dysfunction. Therefore, all cases of male genital trauma that had been referred to the urology department (3 of 20) were selected for this review.
  
  
  RESULTS
  The patients presented with chronic genital and erectile pain, lower urinary tract symptoms, and sexual dysfunction. The diagnostic workup included history, physical examination, and ultrasonography. Treatment included steroid injections for chronic pain and oral erectogenic agents for sexual dysfunction.
  
  
  CONCLUSIONS
  The apparent prevalence and severity of the physical and mental sequelae to sexual trauma make it an important area for screening when treating survivors of torture. Our study is the first of its kind to document urologic complications of sexual torture in a foreign-born U.S. cohort of tortured men, including prevalence, diagnosis, and treatment. The proposed use of steroid injections in the clinical treatment of these patients has not been previously reported.
authors.affiliation: Department of Health Law, Bioethics, and Human Rights, Boston University School of Public Health, Boston, Massachusetts, USA. m.norredam@pubhealth.ku.dk
authors.forename: Marie
authors.initials: M
authors.lastname: Norredam
authors.forename: Sondra
authors.initials: S
authors.lastname: Crosby
authors.forename: Ricardo
authors.initials: R
authors.lastname: Munarriz
authors.forename: Lin
authors.initials: L
authors.lastname: Piwowarczyk
authors.forename: Michael
authors.initials: M
authors.lastname: Grodin
mesh_terms: D000328:Adult; D000349:Africa / Q000208:ethnology; D001003:Anal Canal / Q000293:injuries*; D001900:Boston; D002058:Burns, Electric; D015331:Cohort Studies; D004597:Electroshock; D007172:Erectile Dysfunction / Q000188:drug therapy / Q000209:etiology; D005837:Genitalia, Male / Q000293:injuries*; D006801:Humans; D008297:Male; D008875:Middle Aged; D010146:Pain / Q000188:drug therapy / Q000209:etiology; D010879:Piperazines / Q000627:therapeutic use; D011329:Prisoners; D011687:Purines; D011902:Rape; D012036:Refugees; D012742:Sex Offenses; D000068677:Sildenafil Citrate; D013450:Sulfones; D017741:Survivors; D014104:Torture; D014221:Triamcinolone / Q000627:therapeutic use; D014525:Urethral Stricture / Q000209:etiology / Q000601:surgery; D014551:Urinary Tract / Q000293:injuries*; D014949:Wounds, Nonpenetrating / Q000150:complications
chemical_list: D010879:Piperazines; D011687:Purines; D013450:Sulfones; D014221:Triamcinolone; D000068677:Sildenafil Citrate