Skip to main content

Ballistic Genitourinary Trauma

  • Chapter
  • First Online:
Ballistic Trauma
  • 1049 Accesses

Abstract

Injury to the GU tract occurs in 10% of cases of trauma [1]. Penetrating injury accounts for about 16% of all GU trauma [2, 3]. GU tract injury is relatively rare due to the protected position of the organs: the kidneys in the retroperitoneum, the bladder deep within the pelvis, and the testes mobile in the perineum.

This is a preview of subscription content, log in via an institution to check access.

Access this chapter

Chapter
USD 29.95
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
eBook
USD 109.00
Price excludes VAT (USA)
  • Available as EPUB and PDF
  • Read on any device
  • Instant download
  • Own it forever
Softcover Book
USD 139.99
Price excludes VAT (USA)
  • Compact, lightweight edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info
Hardcover Book
USD 199.99
Price excludes VAT (USA)
  • Durable hardcover edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info

Tax calculation will be finalised at checkout

Purchases are for personal use only

Institutional subscriptions

Notes

  1. 1.

    Percutaneous epididymal sperm aspiration (PESA), Microsurgical epididymal sperm aspiration (MESA) Testicular sperm aspiration (TESA), also described as testicular fine needle aspiration (TEFNA), Testicular sperm extraction (TESE) and Microdissection testicular exploration and sperm extraction (mTESE).

References

  1. Shewakramani S, Reed KC. Genitourinary trauma. Emerg Med Clin North Am. 2011;29(3):501–18.

    Article  PubMed  Google Scholar 

  2. McGeady JB, Breyer BN. Current epidemiology of genitourinary trauma. Urol Clin North Am. 2013;40(3):323–34.

    Article  PubMed  PubMed Central  Google Scholar 

  3. Voelzke BB, Leddy L. The epidemiology of renal trauma. Trans Androl Urol. 2014;3(2):143–9.

    Google Scholar 

  4. Mossadegh S, Tai N, Midwinter M, Parker P. Improvised explosive device related pelvi-perineal trauma: anatomic injuries and surgical management. J Trauma Acute Care Surg. 2012;73(2 Suppl 1):S24–31.

    Article  PubMed  Google Scholar 

  5. Lucas PA, Page PRJ, Phillip RD, Bennett AN. The impact of genital trauma on wounded servicemen: qualitative study. Injury. 2014;45:825–9.

    Article  CAS  PubMed  Google Scholar 

  6. Sharma DM, Bowley DM. Immediate surgical management of combat-related injury to the external genitalia. J R Army Med Corps. 2013;159(Suppl):i18–20.

    Article  PubMed  Google Scholar 

  7. Shaftan GW. Indications for operation in abdominal trauma. Am J Surg. 1960;99(5):657–64.

    Article  CAS  PubMed  Google Scholar 

  8. Nance FC, Cohn I. Surgical judgment in the management of stab wounds of the abdomen: a retrospective and prospective analysis based on a study of 600 stabbed patients. Ann Surg. 1969;170(4):569–80.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  9. Kong V, Oosthuizen G, Sartorius B, Clarke D. Selective non-operative management of stab wounds to the posterior abdomen is safe: the Pietermaritzburg experience. Injury. 2015;46(9):1753–8. https://doi.org/10.1016/j.injury.2015.01.004.

    Article  PubMed  Google Scholar 

  10. Lamb CM, Garner JP. Selective non-operative management of civilian gunshot wounds to the abdomen: a systematic review of the evidence. Injury. 2014;45(4):659–66. https://doi.org/10.1016/j.injury.2013.07.008.

    Article  CAS  PubMed  Google Scholar 

  11. Moolman C, Navsaria PH, Lazarus J, Pontin A, Nicol AJ. Nonoperative management of penetrating kidney injuries: a prospective audit. J Urol. 2012;188(1):169–73. https://doi.org/10.1016/j.juro.2012.03.009.

    Article  CAS  PubMed  Google Scholar 

  12. Kevric J, O’Reilly GM, Gocentas RA, Hasip O, Pilgrim C, Mitra B. Management of haemodynamically stable patients with penetrating abdominal stab injuries: review of practice at an Australian major trauma centre. Eur J Trauma Emerg Surg. 2015:1–5.

    Google Scholar 

  13. Bretan PN Jr, McAninch JW, Federle MP, Jeffrey RB Jr. Computerized tomographic staging of renal trauma: 85 consecutive cases. J Urol. 1986;136(3):561–5.

    Article  PubMed  Google Scholar 

  14. Heller MT, Schnor N. MDCT of renal trauma: correlation to AAST organ injury scale. Clin Imaging. 2014;38(4):410–7. https://doi.org/10.1016/j.clinimag.2014.02.001.

    Article  PubMed  Google Scholar 

  15. Alonso RC, Nacenta SB, Martinez PD, Guerrero AS, Fuentes CG. Kidney in danger: CT findings of blunt and penetrating renal trauma. Radiographics. 2009;29(7):2033–53.

    Article  PubMed  Google Scholar 

  16. Charbit J, Manzanera J, Millet I, Roustan J-P, Chardon P, Taourel P, et al. What are the specific computed tomography scan criteria that can predict or exclude the need for renal angioembolization after high-grade renal trauma in a conservative management strategy? J Trauma. 2011;70(5):1219–27. discussion 1227–8

    Article  PubMed  Google Scholar 

  17. Baldan M, Giannou C, Parker P. War surgery. Vol. 1. 2009. Available from: https://www.icrc.org/eng/assets/files/other/icrc_002_0973.pdf.

  18. Hirshberg A, Mattox KL. Top knife: the art & craft of trauma surgery. tfm (Shrewsbury), 2005; 2004 [cited 2016 Nov 21]. p. 240. Available from: http://books.google.com/books?hl=en&lr=&id=JuzQAgAAQBAJ&pgis=1.

  19. Santucci RA, Fisher MB. The literature increasingly supports expectant (conservative) management of renal trauma – a systematic review. J Trauma. 2005;59(2):493–503.

    Article  PubMed  Google Scholar 

  20. Santucci RA, McAninch JM. Grade IV renal injuries: evaluation, treatment, and outcome. World J Surg. 2001;25(12):1565–72.

    Article  CAS  PubMed  Google Scholar 

  21. Thall EH, Stone NN, Cheng DL, Cohen EL, Fine EM, Leventhal I, et al. Conservative management of penetrating and blunt type III renal injuries. Br J Urol. 1996;77(4):512–7.

    Article  CAS  PubMed  Google Scholar 

  22. Moore EE, Shackford SR, Pachter HL, McAninch JW, Browner BD, Champion HR, et al. Organ injury scaling: spleen, liver, and kidney. J Trauma. 1989;29(12):1664–6.

    Article  CAS  PubMed  Google Scholar 

  23. Hotaling JM, Sorensen MD, Smith TG, Rivara FP, Wessells H, Voelzke BB. Analysis of diagnostic angiography and angioembolization in the acute management of renal trauma using a national data set. J Urol. 2011;185(4):1316–20.

    Article  PubMed  PubMed Central  Google Scholar 

  24. Sugihara T, Yasunaga H, Horiguchi H, Nishimatsu H, Fukuhara H, Enomoto Y, et al. Management trends, angioembolization performance and multiorgan injury indicators of renal trauma from Japanese administrative claims database. Int J Urol. 2012;19(6):559–63.

    Article  PubMed  Google Scholar 

  25. Wein AJ, Kavoussi LR, Partin AW, Peters CA. Campbell-Walsh urology. Upper urinary tract trauma. 11th ed. Philadelphia: Elsevier; 2016 [cited 2017 Feb 24]. p. 1153, Figure 50–6. Available from: https://www.clinicalkey.com/#!/content/book/3-s2.0-B9781455775675000509?scrollTo=%23hl0000255.

  26. Kitrey ND, Djakovic N, Gonsalves M, Kuehhas FE, Lumen N, Serafetinidis E, et al. EAU guidelines on urological trauma. 2016. The guidelines are here: http://uroweb.org/wp-content/uploads/EAU-Guidelines-Urological-Trauma-2016-1.pdf.

  27. Morey AF, Brandes SB, Dugi III DD, Armstrong JH, Breyer BN, Broghammer JA, et al. American Urological Association (AUA) guideline. AUA Clin Guidel. 2014;1–57.

    Google Scholar 

  28. Rostas J, Simmons JD, Frotan MA, Brevard SB, Gonzalez RP. Intraoperative management of renal gunshot injuries: Is mandatory exploration of Gerota’s fascia necessary? This study was a poster presentation at the 2013 Clinical Congress of the American College of Surgeons, October 6–10, 2013, Washington DC. Am J Surg. 2016;211(4):783–6. https://doi.org/10.1016/j.amjsurg.2015.09.023.

    Article  PubMed  Google Scholar 

  29. Matthews LA, Smith EM, Spirnak JP. Nonoperative treatment of major blunt renal lacerations with urinary extravasation. J Urol. 1997;157(6):2056–8.

    Article  CAS  PubMed  Google Scholar 

  30. Santucci RA, Wessells H, Bartsch G, Descotes J, Heyns CF, JW MA, et al. Evaluation and management of renal injuries: consensus statement of the renal trauma subcommittee. BJU Int. 2004;93(7):937–54. https://doi.org/10.1111/j.1464-4096.2004.04820.x.

    Article  CAS  PubMed  Google Scholar 

  31. Broghammer JA, Fisher MB, Santucci RA. Conservative management of renal trauma: a review. Urology. 2007;70(4):623–9.

    Article  PubMed  Google Scholar 

  32. Sangthong B, Demetriades D, Martin M, Salim A, Brown C, Inaba K, et al. Management and hospital outcomes of blunt renal artery injuries: analysis of 517 patients from the National Trauma Data Bank. J Am Coll Surg. 2006;203(5):612–7.

    Google Scholar 

  33. Shariat SF, Jenkins A, Roehrborn CG, Karam JA, Stage KH, Karakiewicz PI. Features and outcomes of patients with grade IV renal injury. BJU Int. 2008;102(6):728–33; discussion 733.

    Google Scholar 

  34. Beyer C, Zakaluzny S, Humphries M, Shatz D. Multidisciplinary management of blunt renal artery injury with endovascular therapy in the setting of polytrauma: a case report and review of the literature. Ann Vasc Surg. 2017;38:318.e11–318.e16. https://doi.org/10.1016/j.avsg.2016.05.130. Epub 2016 Aug 20.

  35. Iflazoglu N, Ureyen O, Oner OZ, Tusat M, Akcal MA. Complications and risk factors for mortality in penetrating abdominal firearm injuries: analysis of 120 cases. Int J Clin Exp Med. 2015;8(4):6154–62.

    PubMed  PubMed Central  Google Scholar 

  36. McCombie SP, Thyer I, Corcoran NM, Rowling C, Dyer J, Le Roux A, et al. The conservative management of renal trauma: a literature review and practical clinical guideline from Australia and New Zealand. BJU Int. 2014;114(S1):13–21.

    Article  PubMed  Google Scholar 

  37. Muir MT, Inaba K, Ong A, Barmparas G, Branco BC, Zubowicz EA, et al. The need for early angiography in patients with penetrating renal injuries. Eur J Trauma Emerg Surg. 2012;38(3):275–80.

    Article  CAS  PubMed  Google Scholar 

  38. Shrimpton PC, Hillier MC. NRPB-W67 doses from computed tomography (ct) examinations in the UK – 2003 review. 2005. http://www.biophysicssite.com/Documents/NRPB_W67/NRPB_W67.pdf.

  39. Rober PE, Smith JB, Pierce JM. Gunshot injuries of the ureter. J Trauma. 1990;30(1):83–6.

    Google Scholar 

  40. Bright TC, Peters PC. Ureteral injuries due to external violence: 10 years’ experience with 59 cases. J Trauma. 1977;17(8):616–20.

    Google Scholar 

  41. Peterson NE, Pitts JC. Penetrating injuries of the ureter. J Urol. 1981;126(5):587–90.

    Google Scholar 

  42. Campbell EW, Filderman PS, Jacobs SC. Ureteral injury due to blunt and penetrating trauma. Urology. 1992;40(3):216–20.

    Google Scholar 

  43. Moore EE, Cogbill TH, Jurkovich GJ, McAninch JW, Champion HR, Gennarelli TA, et al. Organ injury scaling. III: chest wall, abdominal vascular, ureter, bladder, and urethra. J Trauma. 1992;33(3):337–9.

    Google Scholar 

  44. Thompson IM, Flaherty SF, Morey AF. Battlefield urologic injuries: the Gulf War experience. J Am Coll Surg. 1998;187(2):139–41.

    Article  CAS  PubMed  Google Scholar 

  45. Selikowitz SM. Penetrating high-velocity genitourinary injuries. Part I. Statistics mechanisms, and renal wounds. Urology. 1977;9(4):371–6.

    Google Scholar 

  46. Akay AF, Girgin S, Akay H, Sahin H, Bircan MK. Gunshot injuries of the ureter: one centre’s 15-year experience. Acta Chir Belg. 2006;106(5):572–7.

    Google Scholar 

  47. Cline KJ, Mata JA, Venable DD, Eastham JA. Penetrating trauma to the male external genitalia. J Trauma. 1998;44(3):492–4.

    Article  CAS  PubMed  Google Scholar 

  48. Morey A, Rozanski T. Genital and lower urinary tract trauma. In: Wein A, Kavoussi L, Novick A, Partin A, Peters C, editors. Campbell-Walsh urology. 9th ed. Philadelphia: Saunders; 2006. p. 1274–92.

    Google Scholar 

  49. Brosman SA, Fay R. Diagnosis and management of bladder trauma. J Trauma. 1973;13(8):687–94.

    Google Scholar 

  50. Carroll PR, McAninch JW. Major bladder trauma: mechanisms of injury and a unified method of diagnosis and repair. J Urol. 1984;132(2):254–7.

    Google Scholar 

  51. Molde CGMBÃ…. War surgery, Vol II. Oxford: Oxford University Press; 2009. p. 146. Available from: https://www.icrc.org/eng/assets/files/publications/icrc-002-4105.pdf.

  52. Custalow CB, Roberts JR, Thomsen TW, Hedges JR. Roberts and Hedges’ clinical procedures in emergency medicine. 2nd ed. Philadelphia: Elsevier/Saunders; 2014. p. 113–1154

    Google Scholar 

  53. Patel BN, Gayer G. Imaging of iatrogenic complications of the urinary tract: kidneys, ureters, and bladder. Radiol Clin North Am. 2014;52(5):1101–16.

    Google Scholar 

  54. Lehnert BE, Sadro C, Monroe E, Moshiri M. Lower male genitourinary trauma: a pictorial review. Emerg Radiol. 2014;21(1):67–74.

    Google Scholar 

  55. Simhan J, Rothman J, Canter D, Reyes JM, Jaffe WI, Pontari MA, et al. Gunshot wounds to the scrotum: a large single-institutional 20-year experience. BJU Int. 2012;109(11):1704–7.

    Google Scholar 

  56. Nicola R, Carson N, Dogra VS. Imaging of traumatic injuries to the scrotum and penis. Am J Roentgenol. 2014;202(6):512–20.

    Article  Google Scholar 

  57. Richard A, Santucci JWM. Bladder injuries: evaluation and management. Brazil J Urol. 2000;26(4):408–14.

    Google Scholar 

  58. Tausch TJ, Cavalcanti AG, Soderdahl DW, Favorito L, Rabelo P, Morey AF. Gunshot wound injuries of the prostate and posterior urethra: reconstructive armamentarium. J Urol. 2007;178(4):1346–8.

    Article  PubMed  Google Scholar 

  59. Mundy AR, Andrich DE. Pelvic fracture-related injuries of the bladder neck and prostate: their nature, cause and management. BJU Int. 2010;105(9):1302–8.

    Google Scholar 

  60. Inaba K, Okoye OT, Browder T, Best C, Branco BC, Teixeira PG, et al. Prospective evaluation of the utility of routine postoperative cystogram after traumatic bladder injury. J Trauma Acute Care Surg. 2013;75(6):1019–23.

    Google Scholar 

  61. Inaba K, McKenney M, Munera F, de Moya M, Lopez PP, Schulman CI, et al. Cystogram follow-up in the management of traumatic bladder disruption. J Trauma. 2006;60(1):23–8.

    Google Scholar 

  62. McAninch JW, Kahn RI, Jeffrey RB, Laing FC, Krieger MJ. Major traumatic and septic genital injuries. J Trauma. 1984;24(4):291–8.

    Google Scholar 

  63. Mulhall JP, Gabram SGA, Jacobs LM. Emergency management of blunt testicular trauma. Acad Emerg Med. 1995;2(7):639–43. https://doi.org/10.1111/j.1553-2712.1995.tb03604.x.

    Article  CAS  PubMed  Google Scholar 

  64. Phonsombat S, Master VA, McAninch JW. Penetrating external genital trauma: a 30-year single institution experience. J Urol. 2008;180(1):192–6.

    Article  PubMed  Google Scholar 

  65. Bjurlin MA, Kim DY, Zhao LC, Palmer CJ, Cohn MR, Vidal PP, et al. Clinical characteristics and surgical outcomes of penetrating external genital injuries. J Trauma Acute Care Surg. 2013;74(3):839–44.

    Article  PubMed  Google Scholar 

  66. Mohr AM, Pham AM, Lavery RF, Sifri Z, Bargman V, Livingston DH. Management of trauma to the male external genitalia: the usefulness of American Association for the Surgery of Trauma organ injury scales. J Urol. 2003;170(6 Pt 1):2311–5.

    Article  PubMed  Google Scholar 

  67. Gadda F, Spinelli MG, Cozzi G, Paffoni A, Carmignani L, Rocco F. Emergency testicular sperm extraction after scrotal trauma in a patient with a history of contralateral orchiopexy for cryptorchidism: case report and review of the literature. Fertil Steril. 2012;97(5):1074–7.

    Article  PubMed  Google Scholar 

  68. Jones GH, Kirkman-Brown J, Sharma DM, Bowley D. Traumatic andropause after combat injury. BMJ Case Rep. 2015;2015

    Google Scholar 

  69. Davendra MS, Webster CE, Kirkman-Brown J, Mossadegh S, Whitbread T. Blast injury to the perineum. J R Army Med Corps. 2013;159(Suppl):i1–3.

    PubMed  Google Scholar 

  70. Moore EE, Malangoni MA, Cogbill TH, Peterson NE, Champion HR, Jurkovich GJ, et al. Organ injury scaling VII: cervical vascular, peripheral vascular, adrenal, penis, testis, and scrotum. J Trauma. 1996;41(3):523–4.

    Google Scholar 

  71. Corrales JG, Corbel L, Cipolla B, Staerman F, Darnault P, Guille F, et al. Accuracy of ultrasound diagnosis after blunt testicular trauma. J Urol. 1993;150(6):1834–6.

    Google Scholar 

  72. Ugarte R, Spaedy M, Cass AS. Accuracy of ultrasound in diagnosis of rupture after blunt testicular trauma. Urology. 1990;36(3):253–4.

    Google Scholar 

  73. Bhatt S, Dogra VS. Role of US in testicular and scrotal trauma. Radiographics. 2008;28(6):1617–29.

    Article  PubMed  Google Scholar 

  74. Hunter SR, Lishnak TS, Powers AM, Lisle DK. Male genital trauma in sports. Clin Sports Med. 2013;32(2):247–54.

    Google Scholar 

  75. Buckley JC, McAninch JW. Diagnosis and management of testicular ruptures. Urol Clin North Am. 2006;33(1):111–6, vii.

    Google Scholar 

  76. Altarac S. A case of testicle replantation. J Urol. 1993;150(5 Pt 1):1507–8.

    Article  CAS  PubMed  Google Scholar 

  77. Chang AJ, Brandes SB. Advances in diagnosis and management of genital injuries. Urol Clin North Am. 2013;40(3):427–38. https://doi.org/10.1016/j.ucl.2013.04.013.

    Article  PubMed  Google Scholar 

  78. Summerton D, Djakovic N, Kitrey N, Kuehhas F, Lumen N, Serafetinidis E, et al. Guidelines on urological trauma. European Association of Urology; 2015.

    Google Scholar 

  79. Gomez RG, Castanheira AC, McAninch JW. Gunshot wounds to the male external genitalia. J Urol. 1993;150(4):1147–9.

    Article  CAS  PubMed  Google Scholar 

  80. Baniel J, Sella A. Sperm extraction at orchiectomy for testis cancer. Fertil Steril. 2001;75(2):260–2.

    Google Scholar 

  81. Wessells H, Long L. Penile and genital injuries. Urol Clin North Am. 2006;33(1):117–26.

    Article  PubMed  Google Scholar 

  82. Tiguert R, Harb JF, Hurley PM, Gomes De Oliveira J, Castillo-Frontera RJ, Triest JA, et al. Management of shotgun injuries to the pelvis and lower genitourinary system. Urology. 2000;55(2):193–7.

    Article  CAS  PubMed  Google Scholar 

  83. Buckley JC, McAninch JW. Use of ultrasonography for the diagnosis of testicular injuries in blunt scrotal trauma. J Urol. 2006;175(1):175–8.

    Article  PubMed  Google Scholar 

  84. Cass AS, Luxenberg M. Testicular injuries. Urology. 1991;37(6):528–30.

    Google Scholar 

  85. Morey AF, Metro MJ, Carney KJ, Miller KS, McAninch JW. Consensus on genitourinary trauma: external genitalia. BJU Int. 2004;94(4):507–15.

    Article  PubMed  Google Scholar 

  86. Gross M. Rupture of the testicle: the importance of early surgical treatment. J Urol. 1969;101(2):196–7.

    Article  CAS  PubMed  Google Scholar 

  87. Kukadia AN, Ercole CJ, Gleich P, Hensleigh H, Pryor JL. Testicular trauma: potential impact on reproductive function. J Urol. 1996;156(5):1643–6.

    Article  CAS  PubMed  Google Scholar 

  88. Hedayati V, Sellars ME, Sharma DM, Sidhu PS. Contrast-enhanced ultrasound in testicular trauma: Role in directing exploration, debridement and organ salvage. Br J Radiol. 2012;85(1011):65–8.

    Article  Google Scholar 

  89. Pollen JJ, Funckes C. Traumatic dislocation of the testes. J Trauma. 1982;22(3):247–9.

    Article  CAS  PubMed  Google Scholar 

  90. Kochakarn W, Choonhaklai V, Hotrapawanond P, Muangman V. Traumatic testicular dislocation a review of 36 cases. J Med Assoc Thail. 2000;83(2):208–12.

    CAS  Google Scholar 

  91. Wu C-J, Tsai W-F, Tsai J-L, Chue Y, Chang H-C. Bilateral traumatic dislocation of testes. J Chin Med Assoc. 2004;67(6):311–3.

    PubMed  Google Scholar 

  92. Papatsoris AG, Mpadra FA, Karamouzis MV. Post-traumatic testicular torsion. Ulus Travma Acil Cerrahi Derg. 2003;9(1):70–1.

    PubMed  Google Scholar 

  93. Elsaharty S, Pranikoff K, Magoss IV, Sufrin G. Traumatic torsion of the testis. J Urol. 1984;132(6):1155–6.

    Article  CAS  PubMed  Google Scholar 

  94. Manson AL. Traumatic testicular torsion: case report. J Trauma. 1989;29(3):407–8.

    Article  CAS  PubMed  Google Scholar 

  95. Al-Azzawi IS, Koraitim MM. Lower genitourinary trauma in modern warfare: the experience from civil violence in Iraq. Injury. 2014;45(5):885–9. https://doi.org/ 10.1016/j.injury.2014.01.005.

  96. Hudak SJ, Morey AF, Rozanski TA, Fox CW. Battlefield urogenital injuries: changing patterns during the past century. Urology. 2005;65(6):1041–6.

    Article  PubMed  Google Scholar 

  97. Oh JS, Do NV, Clouser M, Galarneau M, Philips J, Katschke A, et al. Effectiveness of the combat pelvic protection system in the prevention of genital and urinary tract injuries. J Trauma Acute Care Surg. 2015;79(4):S193–6.

    Article  PubMed  Google Scholar 

  98. Davies M. Live birth despite traumatic bilateral testicular amputation. Mail Online 2015. Available from: http://www.dailymail.co.uk/health/article-3253515/Joy-soldier-legs-testicles-blown-bomb-expecting-baby-fianc-scientists-FROZE-sperm.html.

  99. Slavis SA, Scholz JN, Hewitt CW, Black KS, Campbell RS, Patel M, et al. The effects of testicular trauma on fertility in the Lewis rat and comparisons to isoimmunized recipients of syngeneic sperm. J Urol. 1990;143(3):638–41.

    Google Scholar 

  100. Srinivas M, Chandrasekharam VVSS, Degaonkar M, Gupta DK, Jha P, Jagannathan NR, et al. Effects of unilateral grade I testicular injury in rat. Urology. 2002;60(3):548–51.

    Google Scholar 

  101. Lin WW, Kim ED, Quesada ET, Lipshultz LI, Coburn M. Unilateral testicular injury from external trauma: evaluation of semen quality and endocrine parameters. J Urol. 1998;159(3):841–3.

    Google Scholar 

  102. Ward MA, Burgess PL, Williams DH, Herrforth CE, Bentz ML, Faucher LD. Threatened fertility and gonadal function after a polytraumatic, life-threatening injury. J Emerg Trauma Shock. 2010;3(2):199–203.

    Article  Google Scholar 

  103. Liguori G, Pavan N, D’Aloia G, Bucci S, de Concilio B, Mazzon G, et al. Fertility preservation after bilateral severe testicular trauma. Asian J Androl. 2014;16(4):650–1.

    Article  PubMed  PubMed Central  Google Scholar 

  104. NHS England Specialised Services Clinical Reference Group for Specialised Urology (URO). Clinical commissioning policy: surgical sperm retrieval for male infertility. London: National Insitute for Health and Clinical Care Excellence; 2016. p. 25. Available from: https://www.england.nhs.uk/commissioning/wp-content/uploads/sites/12/2013/05/16040_FINAL.pdf

  105. Woods DR, Phillip R, Quinton R. Managing endocrine dysfunction following blast injury to the male external genitalia. J R Army Med Corps. 2013;159(Suppl):i45–8.

    Article  PubMed  Google Scholar 

  106. Frappell-Cooke W, Wink P, Wood A. The psychological challenge of genital injury. J R Army Med Corps. 2013;159(Suppl):i52–6.

    Article  PubMed  Google Scholar 

  107. Skoogh J, Steineck G, Cavallin-Ståhl E, Wilderäng U, Håkansson UK, Johansson B, et al. Feelings of loss and uneasiness or shame after removal of a testicle by orchidectomy: a population-based long-term follow-up of testicular cancer survivors. Int J Androl. 2011;34(2):183–92.

    Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to Angus Campbell .

Editor information

Editors and Affiliations

Rights and permissions

Reprints and permissions

Copyright information

© 2017 Springer International Publishing AG

About this chapter

Cite this chapter

Campbell, A., Sharma, D. (2017). Ballistic Genitourinary Trauma. In: Breeze, J., Penn-Barwell, J., Keene, D., O'Reilly, D., Jeyanathan, J., Mahoney, P. (eds) Ballistic Trauma. Springer, Cham. https://doi.org/10.1007/978-3-319-61364-2_20

Download citation

  • DOI: https://doi.org/10.1007/978-3-319-61364-2_20

  • Published:

  • Publisher Name: Springer, Cham

  • Print ISBN: 978-3-319-61363-5

  • Online ISBN: 978-3-319-61364-2

  • eBook Packages: MedicineMedicine (R0)

Publish with us

Policies and ethics