Combat urologic trauma in US military overseas contingency operations.
BACKGROUND
This article reports on the occurrences and patterns of genitourinary (GU) trauma in the contemporary high-intensity conflict of the overseas contingency operations (OCOs).


METHODS
The Joint Theater Trauma Registry was queried for all US military members who received treatment for GU wounds and concomitant injuries sustained in OCOs for >75 months between October 2001 and January 2008.


RESULTS
Of the 16,323 trauma admissions annotated in the Joint Theater Trauma Registry, 819 (5%) had one or more GU injuries. Of the GU casualties, 90% were sustained in Iraq and 65% were because of explosions. The average casualty age was 26 years (range, 18-58 years) and 98.5% were men. There were 887 unique GU injuries distributed as follows: scrotum, 257 (29.0%); kidney, 203 (22.9%); bladder, 189 (21.3%); penis, 126 (14.2%); testicle, 81 (9.1%); ureter, 24 (2.7%); and urethra, 7 (0.8%). Of the 203 patients with kidney injuries, 22% went to the operating room with 31 patients having nephrectomies. There were 189 bladder injuries with 26 patients (14%) having concomitant pelvic fractures.


CONCLUSIONS
This is the largest report of GU injuries during any military conflict. The distribution and percentage of casualties with GU injuries in the OCO are similar to those of previous conflicts. Consideration should be given to personnel protective equipment for the areas associated with GU injuries and predeployment training directed at the care of these injuries.
Serkin
Faye B
FB
Department of Urology, San Antonio Military Medical Center, Fort Sam Houston, Texas, USA. fayeserkin@yahoo.com
Soderdahl
Douglas W
DW
Hernandez
Javier
J
Patterson
Maria
M
Blackbourne
Lorne
L
Wade
Charles E
CE
D000007:Abdominal Injuries / Q000175:diagnosis / Q000453:epidemiology*; D000293:Adolescent; D000328:Adult; D005260:Female; D006772:Hospitals, Military / Q000706:statistics & numerical data; D006801:Humans; D015994:Incidence; D054542:Iraq War, 2003-2011; D008297:Male; D008875:Middle Aged; D008889:Military Personnel; D010388:Pelvis / Q000293:injuries*; D011379:Prognosis; D012189:Retrospective Studies; D014193:Trauma Centers / Q000706:statistics & numerical data; D015599:Trauma Severity Indices; D014481:United States / Q000453:epidemiology; D014551:Urinary Tract / Q000293:injuries*; D055815:Young Adult