@article{ref1,
title="Epidemiology of genitourinary injuries among male US service members deployed to Iraq and Afghanistan: early findings from the Trauma Outcomes and Urogenital Health (TOUGH) project",
journal="Journal of urology",
year="2016",
author="Janak, Judson C. and Orman, Jean A. and Soderdahl, Douglas W. and Hudak, Steven J.",
volume="197",
number="2",
pages="414-419",
abstract="PURPOSE: The objective of this study was to report the number, nature, and severity of genitourinary (GU) injuries among male US service members (SMs) deployed to Operations Iraqi Freedom (OIF) and Enduring Freedom (OEF). <br><br>MATERIALS AND METHODS: This retrospective cross-sectional study of the Department of Defense Trauma Registry used International Classification of Diseases, Ninth Revisions, Clinical Modifications codes to identify SMs with GU injuries and Abbreviated Injury Scale codes to determine injury severity, GU organs injured, and comorbid injuries. <br><br>RESULTS: From October 2001 to August 2013, 1367 male US SMs sustained one or more GU injuries. The majority of injuries involved the external genitalia (n=1000; 73.2%): scrotum (n=760; 55.6%); testes (n=451; 33.0%); penis (n=423; 31%); and/or urethra (n=125, 9.1%). Overall, more than one-third of SMs with GU injury sustained at least one severe GU injury (n=502, 36.7%). Loss of one or both testes was documented in 147 men including 129 (9.4%) unilateral orchiectomies and 17 (1.2%) bilateral orchiectomies. Common comorbid injuries included traumatic brain injury (n=549; 40.2%), pelvic fracture (n=341; 25.0%), colorectal injury (n=297; 21.7%), and lower extremity amputations (n=387; 28.7%). <br><br>CONCLUSION: An unprecedented number of US SMs sustained GU injury while deployed to OIF/OEF. Further study is needed to describe the long-term impact of GU injury and determine the potential need for novel treatments to improve sexual, urinary, and/or reproductive function among service men with severe genital injury.<br><br>Copyright © 2016 American Urological Association Education and Research, Inc. Published by Elsevier Inc. All rights reserved.<p /> <p>Language: en</p>",
language="en",
issn="0022-5347",
doi="10.1016/j.juro.2016.08.005",
url="http://dx.doi.org/10.1016/j.juro.2016.08.005"
}