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Sources of Funding: VA Health Services Research and Development Service Project # I01 HX000329-05; The view(s) expressed herein are those of the author(s) and do not reflect the official policy or position of Brooke Army Medical Center, the U.S. Army Medical Department, the U.S. Army Office of the Surgeon General, the Department of the Army or the Department of Defense or the U.S. Government.

Introduction

Outcomes of military genitourinary injuries (GUI) have not been well-studied. Although US servicemen with GUI sustained during Operations Iraqi and Enduring Freedom (OIF/OEF) have been identified separately in the Department of Defense Trauma Registry (DoDTR) and VA electronic medical records, no previous studies have linked DoD and VA data to investigate outcomes in the population of Veterans with combat deployment-related GUI.

Methods

VA electronic medical records were searched for male OIF/OEF Veterans receiving VA care at least once between 1 October 2001 and 30 September 2011. VA records were linked with DoDTR records for male US service members injured while deployed to OIF/OEF during the same time period. Variables extracted from the DoDTR included type of GUI, severity of GUI, and Injury Severity Scores (ISS). Outcome diagnoses from VA electronic medical records included sexual dysfunction, urinary symptoms, and neuropsychiatric conditions. Injury characteristics and prevalence of outcomes among those with and without GUI were compared.

Results

Of the 12,923 injured male OIF/OEF Veterans identified in both VA electronic medical records and the DoDTR, n=591 (4.6%) had a diagnosis of combat deployment-related GUI in the DoDTR. Of note, only 3.0% of patients with a GUI diagnosis in the DoDTR also had a GUI diagnosis documented in VA medical records. The 591 patients with GUI were injured early in OIF/OEF, with 80.0% injured before 2008. A total of 30.3% had severe GUI. Overall injury severity was greater (ISS ≥ 16: 58.5% vs. 14.9%; p<0.01) and the prevalence of both urinary symptoms (6.3% vs. 3.1%; p<0.01) and sexual dysfunction (13.5% vs. 7.1%; p<0.01) higher among those with GUI vs. without GUI, respectively. Traumatic brain injury prevalence was higher among those with vs. without GUI (48.0 % vs. 40.0%; p<0.01) and post-traumatic stress disorder (PTSD) was common among both groups (51.6% vs. 50.6%; p=0.64).

Conclusions

A minority of VA patients with GUI sustained during OIF/OEF have GUI documented in their VA medical record. However, VA patients with GUI have substantially higher rates of urinary and sexual problems treated at VA facilities. Thus, comprehensive care for OIF/OEF Veterans could be improved with better documentation of GUI upon transfer from DoD to VA care.

Funding

VA Health Services Research and Development Service Project # I01 HX000329-05; The view(s) expressed herein are those of the author(s) and do not reflect the official policy or position of Brooke Army Medical Center, the U.S. Army Medical Department, the U.S. Army Office of the Surgeon General, the Department of the Army or the Department of Defense or the U.S. Government.