Urologic Trauma Management for Military Providers

Area of Science:

• Urology
• Trauma Surgery
• Military Medicine

Background:

• Genitourinary (GU) trauma is an under-explored aspect of combat medicine.
• Improvised explosive devices (IEDs) have led to an increase in GU injuries in modern conflicts.
• Advanced body armor has shifted injury patterns towards the bladder and external genitalia.

Purpose of the Study:

• To provide an overview of genitourinary trauma in combat settings.
• To enhance medical readiness for managing battlefield GU injuries.
• To review the current literature on urologic trauma management in combat.

Main Methods:

• A systematic review of PubMed, Cochrane Central, Scopus, and Web of Science databases.
• Search terms included variations of "wounds," "injuries," "hemorrhage," "trauma," "penile," "genital," and "combat."
• Inclusion criteria focused on English-based publications concerning combat-related urologic trauma after 2001.

Main Results:

• 33 articles met the inclusion criteria for the review.
• The review focused on the management of injuries to the kidneys, ureters, bladder, penis, urethra, and testes.
• Central nervous system (CNS) injuries and female GU injuries were also considered.

Conclusions:

• Treatment of GU trauma in modern conflicts must be secondary to Advanced Trauma Life Support (ATLS).
• Increased severity of GU trauma is linked to explosive devices, highlighting the need for protection.
• Military medics are crucial for GU injury evaluation and management, emphasizing training and integration into polytrauma care.