The structure of damage of the genitourinary system in modern armed conflict.

Introduction. In military conflicts of the 20th century, the frequency of damage to the genitourinary system in the structure of all combat pathology was 2-4%. At present, the use of new types of high-precision weapons in combat operations has led to the prevalence of explosive wounds over bullet wounds and has changed the structure and severity of injuries. The purpose of the study. To analyze information on the frequency and structure of injuries to the genitourinary system in modern armed conflict. Materials and methods. The data of primary medical documentation (Form 100, transfer medical reports) and medical histories of combatants with combat surgical pathology and general diseases for 18 months (December 2022 – June 2024) of the work of the clinics of the S.M. Kirov Military Medical Academy were analyzed. The average age of the wounded was 36,4±9,1 years (minimum 20, maximum 63). The data are presented in relative figures. Results. Among all combatants, combat trauma accounted for 95%, general surgical and medical diseases – 5%. Among the wounded with combat trauma, the proportion of victims with injuries to the genitourinary system was 4,6%. The structure of injuries to the organs of the urinary and genitourinary systems: kidney – 36,8%, ureter – 1,4%, bladder – 10,4%, urethra – 3,1%, penis – 10,1%, soft tissues of the scrotum – 23,8% and testicles – 14,4%. By etiology, gunshot wounds (bullet, shrapnel, explosive) prevailed (96,2%) over non-gunshot wounds (0,9%). By localization, isolated wounds (10,2%) were less common than multiple (18,6%) and combined (71,2%). The severity of injuries was distributed as follows: mild 10,5%, moderate 49,6%, severe 35,1%, and extremely severe 4,8%. Unilateral nephrectomy was performed in almost every fifth (19,9%) patient with kidney injury, and orchiectomy in every second (54,3%) patient with testicular injury, of which unilateral was performed in 41,9% and bilateral in 12,4%. Conclusions. The data obtained are intermediate, the final data can be generalized after the end of the military operations. The prevalence of blast and shrapnel wounds over bullet wounds and, probably, insufficient armor protection of the groin area and perineum increased the number and severity of injuries to the external genitalia and, as a consequence, the scale of organ-removal operations.