Research needed for veterans with genital and reproductive wounds

Army Spc. Eric P. Jungels Jr.

An estimated 1,500 veterans of the wars in Iraq and Afghanistan are living with an often devastating type of combat wound that is severely understudied. Genitourinary, or GU, injuries, which include wounds to urinary, genital and reproductive areas, are increasingly survivable because of advancements in battlefield medicine. However, little research has been completed on the long-term health of the men and women who survive such wounds, which means we may not be providing these veterans with the best possible care.

As both a health scientist and wife of a combat wounded veteran who sustained a traumatic brain injury, I know how critical research is to the health of our veterans. Scientific data has the potential to improve every stage of care we offer those who serve, from the protection they wear on the battlefield and immediate treatments they receive to the medical options we offer over the course of their lives.

Research also provides veterans and their families with expectations for how their symptoms may change over time. For those who suffer GU injuries, those expectations may affect such consequential issues as the ability to conceive children, sexual health, and using the bathroom independently.

Anecdotally, we know GU injuries may come with a stigma, which could be one reason behind the shortage of research. GU injuries can be interlaced with sensitive issues, including a person’s gender identity, romantic relationships, social confidence and self esteem. Additionally, these injuries usually can be hidden from view. While a certain level of privacy is desirable, hiding wounds reduces the overall awareness of these challenges within the military and larger civilian population. It also limits a veteran’s ability to recognize others with similar injuries. These dynamics may cause some with GU wounds to feel isolated or embarrassed, suffer associated mental health issues, or avoid necessary medical check-ups.

This fall, healthcare experts from the University of Texas Health Science Center at San Antonio and Brooke Army Medical Center joined with others from the University of California Davis to launch a survey designed to fill the critical gap in research around GU injuries. The Trauma Outcomes and Urogenital Health (TOUGH) Project will generate a better understanding of how well those with GU injures are recovering, what their lives are like, and if we can make any improvements to their medical treatments. Veterans who sustained these wounds during the wars in Iraq and Afghanistan (i.e., Operation Iraqi Freedom, Operation Enduring Freedom or Operation New Dawn) may participate.

While the number of service members who sustained GU injuries is fewer than the number of veterans impacted by more common injuries, their sacrifices are no less significant. Wounds such as limb amputations can be devastating; however, our nation at least ensures that doctors treat them based on detailed case studies, informative surveys and proven best practices. We owe that same scientific due diligence to veterans who made such deeply personal, and possibly lifelong sacrifices, in service to our nation.

While we do not know what the results of the survey will reveal, we do know that they have the potential to improve our veterans’ physical and mental health, intimate relationships, family dynamics, and daily lives. Furthermore, the findings will be a critical investment for future generations of services members.

As research in this area grows, we may be able to offer better precautions and protection before service members even step foot onto the battlefield. We may also be able to improve our treatments and care, so that even when they sustain one of these wounds, we can help them maintain the same sense of independence and well-being that their service afforded each of us.

However, the only way to achieve any of this potential is for veterans to share their experiences. We strongly encourage any veteran who believes they qualify for this study to complete our safe and confidential survey. An hour of your time will give us valuable information and insight that we could not gain in any other way.

Dr. Roxana Delgado is an epidemiologist, health scientist and assistant professor at the University of Texas Health Science Center at San Antonio.

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