Complex Genital Trauma: Lessons Learned from Operation Iraqi Freedom and Operation Enduring Freedom

Purpose of Review: To discuss the contemporary management of genital trauma focusing on innovations that occurred as a result of the increased number of patients with genital trauma treated during contemporary armed conflicts. Recent Findings: An unprecedented number of US service members sustained genital injuries during the recent wars in Iraq and Afghanistan. Genital injuries were commonly one component of a complex pattern of polytrauma, usually including extremity amputation(s), pelvic fracture, and colorectal injuries. The initial management of genital injuries must adhere to damage control principles while ensuring adequate urinary drainage, genital tissue preservation, and early psychological assistance when needed. Long-term management must focus on the restoration of urinary, sexual, and reproductive function, each of which can be challenged by the negative impact polytrauma can have on each of these functions in the long term. Summary: Restoration and rehabilitation of urinary, sexual, and reproductive function is achievable in the majority of patients who sustain complex genital trauma provided a patient centered, multidisciplinary approach is followed. Future studies should focus on evaluating the long-term outcomes of genital trauma as well as investigating novel methods of genital reconstruction and fertility restoration.