EXTERNAL GENITALIA GUNSHOT WOUNDS - A 10-YEAR EXPERIENCE WITH 56 CASES

Objective: To determine the appropriate methods for the diagnosis and management of gunshot injuries to the external genitalia. Design: Retr ospective analysis, Materials and Methods: Fifty-six patients with gun shot wounds (GSWs) to the external genitalia were seen over the last 1 0 years, All patients underwent physical examination, radiographic sta ging, and surgical exploration, according to protocol, Results: There were 25 testicular, 19 scrotal soft tissue, 14 penile, 4 epididymal, 4 urethral, 4 vasal, and 3 superficial scrotal skin injuries. When poss ible, all injuries, except for the vasal and 1 urethral injury, were p rimarily repaired with excellent long-term results, Orchiectomy was re quired in half of testes struck by gunshots, Associated injuries with single GSWs were mostly to the proximity soft tissue and were amenable to conservative management, Major associated injuries were present in patients with multiple GSWs, In the absence of a suspected major asso ciated injury, genital GSWs required only two diagnostic studies, a re trograde urethrogram for suspected urethral injury and a routine abdom inal radiograph, Gunshot injuries to the penis or perineum, blood at t he penile meatus, or gross hematuria were highly suggestive of urethra l injury, Conclusions: Successful management of genital GSWs is depend ent upon prompt surgical exploration, conservative debridement, and pr imary repair.