Outcomes of Genitourinary Injury in U.S. Iraq and Afghanistan War Veterans Receiving Care from the Veterans Health Administration

Nina S. Nnamani, Mary J Pugh, Megan E. Amuan, Blessen C. Eapen, Steven J Hudak, Michael A. Liss, Jean A. Orman

Research output: Contribution to journalArticlepeer-review

15 Scopus citations


Introduction In the recent conflicts, unprecedented numbers of US service personnel have survived with genitourinary (GU) injury, but few reports have focused on outcomes of these injuries. Outcomes of combat-related GU injury were investigated in wounded US male veterans of Operations Enduring/Iraqi Freedom and New Dawn receiving Veterans Health Administration (VHA) care. Materials and Methods Department of Defense Trauma Registry (DoDTR) data for male service members injured in theater were linked with VHA electronic health records (EHRs) for veterans who received VHA care at least once from October 2001 through September 2011. Abbreviated Injury Scale scores and International Classification of Diseases-9th Revision-Clinical Modification codes were used to identify GU injuries, severity, and outcomes. Wounded veterans with vs. without GU injury were compared. Results A total of 12,923 injured veterans were found in both databases; 591 (4.6%) had a GU injury diagnosis in the DoDTR; 18 (3.0% of 591) had a GU injury diagnosis in VHA EHRs. Of the 591 with GU injury, 179 (30.3%) had at least one severe GU injury. The prevalence of both urinary symptoms (6.3% vs. 3.1%; p < 0.0001) and sexual dysfunction (13.5% vs. 7.1%; p < 0.0001) was higher among those with vs. without GU injury, respectively. Traumatic brain injury prevalence was also higher (48.0 % vs. 40.0%; p < 0.0001); post-traumatic stress disorder prevalence was similar between the two groups (51.6% vs. 50.6%). Conclusion We identified an opportunity to improve the diagnosis and coordination of care for veterans with GU injury. Routine screening and better documentation upon transfer from DoD to VHA care should be implemented to alert multi-specialty care teams to provide care for the urinary, sexual, fertility, and psychological health problems of these patients.

Original languageEnglish (US)
Pages (from-to)E297-E301
JournalMilitary medicine
Issue number3-4
StatePublished - Mar 1 2019


  • genitourinary injury
  • psychological health conditions
  • sexual dysfunction
  • urinary symptoms
  • urotrauma

ASJC Scopus subject areas

  • Public Health, Environmental and Occupational Health


Dive into the research topics of 'Outcomes of Genitourinary Injury in U.S. Iraq and Afghanistan War Veterans Receiving Care from the Veterans Health Administration'. Together they form a unique fingerprint.

Cite this