STUDY MAPS WAR INJURIES TO GENITALS

>> WASHINGTON: A new report on one of the most dreaded war wounds finds that 1,367 men in the US military suffered injuries to their genitals or urinary tract in Iraq or Afghanistan from 2001-13, mostly from bomb blasts. More than one third of the injuries were severe.

The report, published this week by military researchers in The Journal of Urology, is thought to be the most comprehensive review of genitourinary injuries in veterans. The problem was recognised before, but the extent was uncertain.

The number of cases is “unprecedented” and the injuries “uniquely devastating”, because they can impair a man’s ability to have sex, father children or urinate normally, according to the report. Most of the wounded men — 94% — were 35 or younger, in “their peak years of sexual development and reproductive potential,” the report said, adding that the psychological toll was especially heavy in such young men.

Researchers say these men are at high risk of suicide.

More veterans have these injuries now than in the past because more are surviving than during previous wars, as a result of better body armor and battlefield medicine. Another reason for the increase, according to the report, is that the often rough terrain in Afghanistan forced troops to patrol on foot, which left the soldiers’ groin areas vulnerable to explosions from bombs planted in the ground.

The figures in the report come from records in the Department of Defence Trauma Registry. Of the 1,367 genitourinary injuries reported, 73% involved the external genitals. More than one third of the men had at least one injury that was considered severe; 129 lost one of their testes, 17 lost both and 86 had severe injuries to the penis. Fewer than five lost the penis.

Many had other wounds as well, including traumatic brain injuries, pelvic fractures, colorectal damage and leg amputations.

“Many of these have been my patients,” said one of the study’s authors, Dr Steven Hudak, a surgeon and a lieutenant colonel at Brooke Army Medical Centre in San Antonio.

Doctors at several medical centers hope to offer penis transplants from deceased organ donors to wounded veterans. The operation has been performed only once in the United States, last year at the Massachusetts General Hospital in Boston. The transplant recipient was not a veteran, but a man whose penis had been amputated because of cancer. He is doing well, and two more men are on the waiting list — another cancer patient, and a burn victim.