Abstract
Objective: To compare our experience of genitourinary injuries during the war against terrorism with the record of those in previous wars of the World.
 Study Design: Cross sectional study.
 Place and Duration of Study: Urology department, Combined Military Hospital Peshawar, from Jun 2011 to Aug 2014.
 Methodology: We treated 89 (5.6%) cases of genitourinary injuries received in our tertiary care hospital in Khyber Pakhtunkhwa. The hospital was located at a distance of 2-3 hours of evacuation time by helicopter from the forward operational area.
 Results: The frequency of genitourinary injuries among 1589 war casualties was (5.6%). Out of these 49 (55%) were due to sniper shots and 40 (45%) due to improvised explosive device. Kidney was the most common organ injured 30 (33.7%), followed by bladder 20 (22.5%) and urethra 14 (15.7%). Majority of renal and bladder injuries were afflicted in those soldiers who were not wearing the protective jackets. Associated injuries to other organs were identified in 81% cases. Salvage of all genitourinary organs was the aim; however, nephrectomy and orchiectomy had to be performed in 30% and 50% respectively.
 Conclusion: Salvage of genitourinary war injuries poses a challenge to the trauma surgeon as lifesaving measures take precedence over organ preservation. Renal trauma in war was found to be the leading critical genitourinary injury.
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