Urethral and penile war injuries: The experience from civil violence in Iraq
Objective: Todetermine the incidence,mechanismof injury,wounding patternandsurgicalmanagementofurethral andpenile injuries sustainedincivil violenceduringtheIraqwar. Patientsandmethods: Inall,2800casualtieswithpenetratingtraumatotheabdo menandpelviswerereceivedattheAl-YarmoukHospital,Baghdad, fromJanuary 2004toJune2008.Ofthesecasualties504(18%)hadgenitourinarytrauma, includ ing45(8.9%)withurethraland/orpenileinjuries. Results:Of45patients,29(64%)wereciviliansand16(36%)wereIraqimilitary personnel.The injurywas causedbyan improvisedexplosivedevice (IED) in25 (56%)patientsandbyindividualfirearmsin20(44%).Ofthepatients,24hadpenile injuries,15hadaninjurytothebulbarurethraandsixhadaninjurytotheposterior urethra.Anteriorurethral injuriesweremanagedbyprimaryrepair,whileposterior urethralinjuriesweremanagedbyprimaryrealignmentinfivepatientsandbyasupra pubiccystostomyaloneinone.Anassociatedinjurytomajorbloodvesselswasthe causeofdeathineightofninepatientswhodiedsoonaftersurgery(P<0.001). Conclusion:UrethralandpenileinjurieswerecausedbyIEDsandindividualfire armswithasimilarfrequency.Mostofthecasualtieswereciviliansandaminoritywere militarypersonnel.Injuriestotheanteriorurethracanbemanagedbyprimaryrepair
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