الفهرس 
War related urethral and penile injuries management and short term outcomes: Experience from war in Yemen
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Abstract
To investigate the mechanism of injury, wounds’ pattern and surgical management
and outcomes of urethral and penile injures caused by firearm and explosion during the present
war in Yemen.
Methods: This prospective descriptive study was conducted in the Department of Urology at Kars
El Ainy hospitals. We included 46 Yemeni military victims who sustained penile and/or urethral
injuries during the existing Yemeni war. These patients received primary surgical care in Yemen
and referred for further definitive treatment in Egypt from October 2018 to October 2020. Besides
patients’ demographics, the cause of injury, site and severityof injuries and associated injuries were
addressed together with the management, postoperative complications, and outcomes for these
injuries.
Results: 46 males with war-related penile and urethral injuries were enrolled in the study. The
median age of the included subjects was 28 years and ranged from 18-50 years. More than half of
participants [27 (58.7%)] endured posterior urethral injuries; 11 (23.9%) and 5 (10.9%) of whom
had PUDD and associated urethra-rectal fistula, respectively. The remaining posterior urethral
injuries were distributed as membranous 5 (10.9%), Membrano-prostatic 4 (8.6%) and
bulbomembranous 2 (4.3%). 10 (21.7%) patients sustained anterior urethral injuries. Five of
whom (10.9%) had bulbar urethral injuries and 5 (10.9%) had combined penile tissue and anterior
urethral injuries. Isolated penile injuries represent 9 (19.6%), 4 of them had corpus cavernosum,
glans injuries 3, complete avulsion
2. Injuries to the penis and anterior urethra were inflicted by Improvised Explosive Devices(IEDs)
in 90% and 67%, respectively, while injuries to the posterior urethra were inflicted by firearms in
85%. During the 6-12-month follow-up period, only 4 cases (8.7%) demonstrated recurrent
strictures which were doomed to be a failed procedure and were thus re-operated. Two additional
patients (4.3%) developed ring strictures that was also repaired in a second intervention.
Conclusion: Our study highlights the need for flexibility in managing urethral and penile
GSW/explosions trauma. Further, the success rate of operating these injuries require highly
experienced surgeons to enhance the outcome and minimize complications.