SAN DIEGO, CA, May 5, 2013—Veterans sustaining scrotal injuries suffer significant decrease in testosterone production, but this may resolve naturally even in some severely injured patients, according to a new study from Walter Reed National Military Medical Center and the Center for Prostate Disease Research. The study will be presented today during the 2013 American Urological Association Annual Meeting in San Diego, CA.
Researchers examined operative logs for patients identified as veterans of both Operation Enduring Freedom (OEF) and Operation Iraqi Freedom (OIF), and conducted a retrospective chart review for patients who had undergone urologic surgery between 2001 and 2011. Data reviewed included: mechanism of injury; type of injury; time since injury; testosterone values and use of exogenous (replacement) testosterone. Of the 127 patients reviewed (21 from OIF and 106 from OEF), 114 had documented scrotal injury. Nearly 82 percent of injuries in these patients were resultant from improvised explosive devices (IEDs). All groups were hypogonadal immediately following injury, regardless of severity (no scrotal injury; scrotal injury without testicular loss, scrotal injury with testicular loss and bilateral orchiectomy), and testosterone values were inversely proportional to the severity of the injury. The average patient age was 24.7 years.
Of the 79 patients with minimal or no scrotal injury, 40 recovered normal testosterone levels without intervention – within 7.5 months on average. The 39 who received replacement testosterone were more likely to have had testicular loss. On average, testosterone replacement therapy was initiated 2.9 months post-injury (p=0.0017).
“These data provide interesting insight into the likelihood of natural testosterone recovery following scrotal injury,” said Dr. Mark T. Edney, an AUA spokesperson and OIF veteran. “This knowledge can help injured service members and their physicians have more informed discussions as to the pros and cons of early testosterone replacement, depending on the severity of their injuries.”
More than 30,000 have been wounded in action in OIF and 12,000 have been wounded in OEF. Researchers estimate five percent of injuries sustained in the combat theater involve the genitourinary organs; three quarters of these involve the urethra and external genitalia.
NOTE TO REPORTERS: Experts are available to discuss these studies. To arrange an interview with an expert, please contact the AUA Communications Office at the number above or e-mail Communications@AUAnet.org.
About the American Urological Association: Founded in 1902 and headquartered near Baltimore, Maryland, the American Urological Association is a leading advocate for the specialty of urology, and has more than 19,000 members throughout the world. The AUA is a premier urologic association, providing invaluable support to the urologic community as it pursues its mission of fostering the highest standards of urologic care through education, research and the formulation of health policy.
Wendy Isett, AUA