BATTLEFIELD UROLOGIC INJURIES - THE GULF-WAR EXPERIENCE

Background: We sought to ascertain the incidence and type of urologic injuries requiring operations during the Gulf War. Study Design: Of th e 31 United States urologic surgeons deployed to the Persian Gulf thea ter of operations, 11 responded to a survey concerning the type and fr equency of urologic trauma surgical procedures. Results: The 11 urolog ic surgeons performed a total of 55 surgical procedures, 30 of which w ere for urologic injuries. Most injuries were due to fragmentation dev ices. Only 17% involved the kidney and none involved the ureter; 83% i nvolved the pelvic organs and external genitalia. The majority of surg ical procedures performed for these injuries were conservative (organ sparing). Anecdotal observations by the surgeons suggested that the us e of the flak vest may have led to a shift away from abdominal injurie s to injuries of the pelvis and genitalia. Conclusions: Urologic injur ies in the Gulf War primarily involved the pelvis and genitalia and we re frequently managed conservatively. The prevalence of fragmentation injuries and use of the flak vest may explain this observation. (J Am Coll Surg 1998;187:139-141. (C) 1998 by the American College of Surgeo ns)