Magazine article Clinical Psychiatry News

Genitourinary Injuries Can Cause Long-Term Trauma

Magazine article Clinical Psychiatry News

Genitourinary Injuries Can Cause Long-Term Trauma

Article excerpt


WASHINGTON -- Despite improved surgical procedures aimed at repairing severe genitourinary injuries sustained in the line of duty, such injuries still can have profound long-term psychological effects on military service members, according to a pair of experts who spoke early last month at the Bob Woodruff Foundation: Intimacy After Injury meeting.

Sherrie L. Wilcox, Ph.D., who is a professor in the School of Social Work at the University of Southern California, Los Angeles, and head of the school's Sex & the Military program, said "sexual health" can be defined broadly as sexually related physical, emotional, mental, and social well-being, emphasizing both the absence of dysfunction and disease.

Calling sexual health a "vital component of overall quality of life," Dr. Wilcox cautioned that failure to adequately address those psychological issues can lead to long-term ramifications in service members' civilian lives.

Failure to address these issues predisposes the service members to sexual and marital problems, as well as to illnesses such as depression and posttraumatic stress disorder (PTSD).

Dr. Wilcox was one of two presenters who spoke during a session highlighting the steps necessary to mitigate long-term sexual dysfunction by focusing attention on physical and psychological health.

The other presenter was Jean L. Orman, Sc.D., chief of statistics and epidemiology at the U.S. Army Institute of Surgical Research and the Joint Trauma System.

"The wars in Iraq and Afghanistan are distinctive for having the highest rate of survival of wounded combatants in any major military conflict," Dr. Orman said. "But with that distinction comes an important price: larger numbers of service members surviving with multiple, complex, and often very severe injuries --including genital injuries."

Citing a review of data from the U.S. Department of Defense Trauma Registry, Dr. Orman explained that 1,291 American male service members have survived genitourinary (GU) injuries sustained in combat; nearly 75% of these men were injured by contact with an improvised explosive device, and the average age of the population was 25 years.

A total of 965 men had injuries to their urinary tracts or genitals, of which 65 sustained severe damage to the penis or penile area. Three service members ultimately lost either their penis, testicles, or scrotum, while others sustained injuries of several other kinds, including bilateral lower extremity amputation and traumatic brain injury (TBI), which occurred in more than 40% of service members with GU injury.

"Injuries this extreme no doubt have a very strong impact on the person who experiences them," Dr. Orman said. "Unfortunately, if you look for copious literature on any long-term effects [or] outcomes, there really isn't very much" regarding the urinary, sexual, fertility, social, and psychological aspects of living with severe GU injuries.

Sharing statistics comparing psychological disorders in military service members before and after deployment, Dr. Wilcox showed that 16% of personnel reported psycho logical injuries predeployment, but that number nearly doubled to 30% of personnel after returning from their tours.

Furthermore, 22.4% of male and female service members surveyed who joined the military after Sept. 11, 2001, reported having sexual issues upon returning from active duty. More than 30% of male military personnel surveyed reported symptoms of erectile dysfunction, with the probability of PTSD increasing by a factor of 30 in soldiers with erectile dysfunction. …

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