njemački

Verletzungen des Urogenitaltraktes wahrend des Krieges in Kroatien 1991/92

A total of 142 war injuries to the urogenital organs in 115 of 4425 wounded patients were treated at our clinical hospital during 18 months of warfare in Osijek, Croatia. Kidney injury was the most common (64 cases) and urethral injury (4) the least common, with a relatively large number of urethral injuries (11). Twothirds of the injuries were associated with other trauma, most frequently abdominal injuries. The mortality rate was high (15,6%), explained by the proximity of the battlefield and resulting rapid patient transport (average 52,2 minutes), which excluded the possibility of separating out the moribund cases, as well as the exceptional destructive power of modern explosives and firearms, and associated wounds of the vital organs. Of the wounded, 60 % were members of the Croatian armed forces, 1 was a member of the United Nations Professional Force and 39,1% were civilians. Surgical intervention was characterized a tendency towards conservation and the avoidance of organ sacrifice. Thus, nephrectomy was performed in only one quarter of the cases of renal injury. Nevertheless, orchiectomy was performed in two-thirds of the cases of testicular injury. In 5 of 8 cases of corpus spongiosum, injury to the tunica albuginea was primarily reconstructed with free transplantation of the fascia lata. For urethral injury,resection with primary suture yielded good results in contrast to stents without resection in cases of urethral wall contusion, which resulted in urethral stenosis in our patients.

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