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Genitourinary Trauma

  • Matthew Banti
  • Jack Ryan Walter
Chapter

Abstract

Trauma to the genitourinary structures, while rare in the civilian experience, has been a hallmark of American combat medicine dating back to the Civil War of 1861–1865. Due to advances in weaponry and armor countermeasures, the pattern of injury has shifted to complex wounds of the lower genitourinary structures. Penetrating blast wounds to the external genitals have been associated with improvised explosive devices encountered on the modern battlefield. Expeditious diagnosis and management of renal, ureteral, and bladder trauma is essential in reducing the morbidity and mortality of these injuries, while appropriate care of genital and urethral wounds is crucial to future urinary and sexual function.

Keywords

Genitourinary Testicular injury Perineal injury Renal trauma Bladder trauma External genital injury Wartime 

References

  1. 1.
    Dismounted Complex Blast Injury Task Force. Dismounted complex blast injury report of the army dismounted complex blast injury task force [Internet]. Fort Sam Houston: Army Medical Department; 2011. Available from: http://armymedicine.mil/Documents/DCBI-Task-Force-Report-Redacted-Final.pdf Google Scholar
  2. 2.
    Morey A, Brandes S, Dugi D, Armstrong J, Breyer B, Broghammer J, et al. Urotrauma: AUA guideline. J Urol. 2014;192(2):327–35.CrossRefGoogle Scholar
  3. 3.
    Young H. Wounds of the urogenital tract in modern warfare. J Urol. 1942;47:59–108.CrossRefGoogle Scholar
  4. 4.
    Hudak S, Morey A, Rozanski T, Fox C. Battlefield urogenital injuries: changing patterns during the past century. Urology. 2005;65(6):1041–6.CrossRefGoogle Scholar
  5. 5.
    Serkin F, Soderdahl D, Hernandez J, Patterson M, Blackbourne L, Wade C. Combat urologic trauma in US military overseas contingency operations. J Trauma. 2010;69:S175–8.CrossRefGoogle Scholar
  6. 6.
    Moore E, Malangoni M, Cogbill T, Peterson N, Champion H, Jurkovich G, et al. Organ injury scaling VII: cervical vascular, peripheral vascular, adrenal, penis, testis, and scrotum. J Trauma. 1996;41:523–4.CrossRefGoogle Scholar
  7. 7.
    McAninch J. Genitourinary trauma. World J Urol. 1999;17(2):65.CrossRefGoogle Scholar
  8. 8.
    Owens B, Kragh J, Wenke J, Macaitis J, Wade C, Holcomb J. Combat wounds in operation Iraqi Freedom and operation Enduring Freedom. J Trauma. 2008;64(2):295–9.CrossRefGoogle Scholar
  9. 9.
    Serafetinides E, Kitrey N, Djakovic N, Kuehhas F, Lumen N, Sharma D, et al. Review of the current management of upper urinary tract injuries by the EAU Trauma Guidelines Panel. Eur Urol. 2005;67(5):930–6.CrossRefGoogle Scholar
  10. 10.
    Hudak S, Hakim S. Operative management of wartime genitourinary injuries at Balad Air Force Theater Hospital, 2005 to 2008. J Urol. 2009;182:180–3.CrossRefGoogle Scholar
  11. 11.
    Morey A, Iverson A, Swan A, Harmon W, Spore S, Bhayani S, et al. Bladder rupture after blunt trauma: guidelines for diagnostic imaging. J Trauma. 2001;51(4):683–6.CrossRefGoogle Scholar
  12. 12.
    Elliott S, McAninch J. Extraperitoneal bladder trauma: delayed surgical management can lead to prolonged convalescence. J Trauma. 2009;66:274–5.CrossRefGoogle Scholar
  13. 13.
    Banti M, Walter J, Hudak S, Soderdahl D. Improvised explosive device-related lower genitourinary trauma in current overseas combat operations. J Trauma Acute Care Surg. 2016;80:131–4.CrossRefGoogle Scholar
  14. 14.
    Champion H, Holcomb J, Young L. Injuries from explosions: physics, biophysics, pathology, and required research focus. J Trauma. 2009;66:1468–77.CrossRefGoogle Scholar
  15. 15.
    Santucci R, Chang Y. Ballistics for physicians: myths about wound ballistics and gunshot injuries. J Urol. 2004;171:1408–14.CrossRefGoogle Scholar
  16. 16.
    Leddy L, Vanni A, Wessels H, Voelzke B. Outcomes of endoscopic realignment of pelvic fracture associated urethral injuries at a level 1 trauma center. J Urol. 2012;188(1):174–8.CrossRefGoogle Scholar
  17. 17.
    Johnsen N, Dmochowski R, Mock S, Reynolds W, Miliam D, Kaufman M. Primary endoscopic realignment of urethral disruption injuries—a double edged sword? J Urol. 2015;194(4):1022–6.CrossRefGoogle Scholar
  18. 18.
    Martinez-Pineiro L, Djakovic N, Plas E, Mor Y, Santucci R, Serafetinidis E, et al. EAU guidelines on urethral trauma. Eur Urol. 2010;57(5):791–803.CrossRefGoogle Scholar
  19. 19.
    Kimbrough J. War wounds of the urogenital tract. J Urol. 1946;55:179–89.CrossRefGoogle Scholar

Copyright information

© Springer International Publishing AG, part of Springer Nature 2018

Authors and Affiliations

  1. 1.Urology ServiceMadigan Army Medical CenterTacomaUSA

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