GENITOURINARY INJURIES DURING WAR AGAINST TERROR: A SINGLE-CENTER EXPERIENCE

Haroon Sabir Khan; Faaran Kiani; Muhammad Nawaz; Muhammad Sarwar Alvi; Muhammad Rafiq Zafar; Arshad Mahmood

doi:10.51253/pafmj.v71i3.3443

Authors

Haroon Sabir Khan Pakistan Naval Ship Shifa Hospital, Karachi Pakistan
Faaran Kiani Armed Forces Institute of Urology/National University of Medical Sciences (NUMS) Rawalpindi Pakistan
Muhammad Nawaz Armed Forces Institute of Urology/National University of Medical Sciences (NUMS) Rawalpindi Pakistan
Muhammad Sarwar Alvi Combined Military Hospital Peshawar/National University of Medical Sciences (NUMS) Pakistan
Muhammad Rafiq Zafar Armed Forces Institute of Urology/National University of Medical Sciences (NUMS) Rawalpindi Pakistan
Arshad Mahmood Armed Forces Institute of Urology/National University of Medical Sciences (NUMS) Rawalpindi Pakistan

DOI:

https://doi.org/10.51253/pafmj.v71i3.3443

Keywords:

genitourinary injuries, Management, War, Injuries

Abstract

Objective: To compare our experience of genitourinary injuries during the war against terrorism with the record of those in previous wars of the World.

Study Design: Cross sectional study.

Place and Duration of Study: Urology department, Combined Military Hospital Peshawar, from Jun 2011 to Aug 2014.

Methodology: We treated 89 (5.6%) cases of genitourinary injuries received in our tertiary care hospital in Khyber Pakhtunkhwa. The hospital was located at a distance of 2-3 hours of evacuation time by helicopter from the forward operational area.

Results: The frequency of genitourinary injuries among 1589 war casualties was (5.6%). Out of these 49 (55%) were due to sniper shots and 40 (45%) due to improvised explosive device. Kidney was the most common organ injured 30 (33.7%), followed by bladder 20 (22.5%) and urethra 14 (15.7%). Majority of renal and bladder injuries were afflicted in those soldiers who were not wearing the protective jackets. Associated injuries to other organs were identified in 81% cases. Salvage of all genitourinary organs was the aim; however, nephrectomy and orchiectomy had to be performed in 30% and 50% respectively.

Conclusion: Salvage of genitourinary war injuries poses a challenge to the trauma surgeon as lifesaving measures take precedence over organ preservation. Renal trauma in war was found to be the leading critical genitourinary injury.