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Abstract

We appreciate the reviewer's comments. We present our review of a large cohort of trauma patients in a single institutional study over 12 years, with all the limitations entailed in a retrospective trauma registry database review. We agree that it would be interesting to stratify the immediate versus the delayed from the overlooked injuries that subsequently declare themselves. However, we are not able to stratify these diverse injuries with the currently available dataset in a meaningful manner. We appreciate this limitation of trauma registry databases after our experience with this review. In many urban trauma centers throughout the United States and the world, there is poor clinical follow-up in trauma patients in general, and in gunshot victims in particular. As such, detailed treatment outcomes and follow-up data are often not available. This is a limitation of trauma series throughout the contemporary literature and is ,unfortunately, all too frequent with trauma registry databases. Many trauma centers have their own trauma team, and Urology may be involved and involved early. However, sometimes the fact is that Urology becomes involved late or not at all. Whether trauma center teams engage their Urology service directly and early contributes to variability in treatment protocols and clinical outcomes between trauma centers. This further makes prospective investigation of the evaluation, management, and outcomes of this heterogeneous and complex population with gunshot wound injuries trauma very challenging. A comprehensive multidisciplinary approach involving the Urology service in the evaluation and management of gunshot victims is highly recommended. Editorial CommentUrologyVol. 76Issue 4PreviewThis is a well written, comprehensive review of one institution's experience with civilian gunshot wounds to the genitourinary (GU) tract and genitalia. The authors demonstrate a correlation of associated injuries to other organs, both urological and nonurological, thus demonstrating how a ‘magic bullet’ can cause more damage than one initially might think. Full-Text PDF