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[Perineal injuries in wartime]
D Mianné1, J Guillotreau, H Sergent
1Service d'Urologie, Hôpital d'Instruction des Armées Laveran, Marseille.
Annales D'Urologie
|January 1, 1997
Summary
Perineal war wounds in men, though rare, pose significant risks to urinary, gastrointestinal, and sexual function. Surgical management prioritizes diversion and debridement to preserve function and prevent further complications.
Area of Science:
- Trauma surgery
- Urology
- Proctology
Context:
- Perineal war wounds are uncommon but severe injuries affecting young men.
- These injuries often involve adjacent structures like the sacrum, buttocks, and abdomino-pelvic regions.
- They pose a significant threat to functional prognosis, including urinary, gastrointestinal, and sexual health.
Purpose:
- To outline the management principles for perineal war wounds in men.
- To emphasize the importance of preserving functional outcomes despite challenging circumstances.
- To detail immediate and secondary surgical strategies for urethral and anal injuries.
Summary:
- Perineal war wounds encompass both urogenital and ano-sphincteric regions, frequently associated with other trauma.
- Key surgical principles include urinary diversion (cystostomy) for urogenital injuries and fecal diversion (colostomy) for ano-sphincteric injuries.
- Conservative debridement, wound management, and consideration of primary repair or staged procedures are crucial.
Impact:
- Effective management can mitigate permanent sequelae, improving quality of life for affected soldiers.
- This approach guides surgical decision-making in emergency settings with limited resources.
- Highlights the need for specialized urological and proctological follow-up for optimal recovery.