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Urethral and penile war injuries: The experience from civil violence in Iraq

OBJECTIVE: To determine the incidence, mechanism of injury, wounding pattern and surgical management of urethral and penile injuries sustained in civil violence during the Iraq war. PATIENTS AND METHODS: In all, 2800 casualties with penetrating trauma to the abdomen and pelvis were received at the A...

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Autores principales: Al-Azzawi, Issam S., Koraitim, Mamdouh M.
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Elsevier 2014
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4434606/
https://www.ncbi.nlm.nih.gov/pubmed/26019940
http://dx.doi.org/10.1016/j.aju.2013.11.002
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author Al-Azzawi, Issam S.
Koraitim, Mamdouh M.
author_facet Al-Azzawi, Issam S.
Koraitim, Mamdouh M.
author_sort Al-Azzawi, Issam S.
collection PubMed
description OBJECTIVE: To determine the incidence, mechanism of injury, wounding pattern and surgical management of urethral and penile injuries sustained in civil violence during the Iraq war. PATIENTS AND METHODS: In all, 2800 casualties with penetrating trauma to the abdomen and pelvis were received at the Al-Yarmouk Hospital, Baghdad, from January 2004 to June 2008. Of these casualties 504 (18%) had genitourinary trauma, including 45 (8.9%) with urethral and/or penile injuries. RESULTS: Of 45 patients, 29 (64%) were civilians and 16 (36%) were Iraqi military personnel. The injury was caused by an improvised explosive device (IED) in 25 (56%) patients and by individual firearms in 20 (44%). Of the patients, 24 had penile injuries, 15 had an injury to the bulbar urethra and six had an injury to the posterior urethra. Anterior urethral injuries were managed by primary repair, while posterior urethral injuries were managed by primary realignment in five patients and by a suprapubic cystostomy alone in one. An associated injury to major blood vessels was the cause of death in eight of nine patients who died soon after surgery (P < 0.001). CONCLUSION: Urethral and penile injuries were caused by IEDs and individual firearms with a similar frequency. Most of the casualties were civilians and a minority were military personnel. Injuries to the anterior urethra can be managed by primary repair, while injuries to the posterior urethra can be managed by primary realignment. An associated trauma to major blood vessels was the leading cause of death in these casualties.
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spelling pubmed-44346062015-05-27 Urethral and penile war injuries: The experience from civil violence in Iraq Al-Azzawi, Issam S. Koraitim, Mamdouh M. Arab J Urol Oncology/Reconstruction Original article OBJECTIVE: To determine the incidence, mechanism of injury, wounding pattern and surgical management of urethral and penile injuries sustained in civil violence during the Iraq war. PATIENTS AND METHODS: In all, 2800 casualties with penetrating trauma to the abdomen and pelvis were received at the Al-Yarmouk Hospital, Baghdad, from January 2004 to June 2008. Of these casualties 504 (18%) had genitourinary trauma, including 45 (8.9%) with urethral and/or penile injuries. RESULTS: Of 45 patients, 29 (64%) were civilians and 16 (36%) were Iraqi military personnel. The injury was caused by an improvised explosive device (IED) in 25 (56%) patients and by individual firearms in 20 (44%). Of the patients, 24 had penile injuries, 15 had an injury to the bulbar urethra and six had an injury to the posterior urethra. Anterior urethral injuries were managed by primary repair, while posterior urethral injuries were managed by primary realignment in five patients and by a suprapubic cystostomy alone in one. An associated injury to major blood vessels was the cause of death in eight of nine patients who died soon after surgery (P < 0.001). CONCLUSION: Urethral and penile injuries were caused by IEDs and individual firearms with a similar frequency. Most of the casualties were civilians and a minority were military personnel. Injuries to the anterior urethra can be managed by primary repair, while injuries to the posterior urethra can be managed by primary realignment. An associated trauma to major blood vessels was the leading cause of death in these casualties. Elsevier 2014-06 2014-01-23 /pmc/articles/PMC4434606/ /pubmed/26019940 http://dx.doi.org/10.1016/j.aju.2013.11.002 Text en © 2014 Production and hosting by Elsevier B.V. on behalf of Arab Association of Urology. http://creativecommons.org/licenses/by-nc-nd/3.0/ This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/3.0/).
spellingShingle Oncology/Reconstruction Original article
Al-Azzawi, Issam S.
Koraitim, Mamdouh M.
Urethral and penile war injuries: The experience from civil violence in Iraq
title Urethral and penile war injuries: The experience from civil violence in Iraq
title_full Urethral and penile war injuries: The experience from civil violence in Iraq
title_fullStr Urethral and penile war injuries: The experience from civil violence in Iraq
title_full_unstemmed Urethral and penile war injuries: The experience from civil violence in Iraq
title_short Urethral and penile war injuries: The experience from civil violence in Iraq
title_sort urethral and penile war injuries: the experience from civil violence in iraq
topic Oncology/Reconstruction Original article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4434606/
https://www.ncbi.nlm.nih.gov/pubmed/26019940
http://dx.doi.org/10.1016/j.aju.2013.11.002
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