You have accessJournal of UrologyTrauma/Reconstruction: Traum & Reconstructive Surgery (1)1 Apr 201315 TESTOSTERONE RECOVERY IN POLY-TRAUMA AND SCROTAL INJURY IN PATIENTS FROM OPERATION ENDURING FREEDOM AND OPERATION IRAQI FREEDOM Molly Williams, Inger Rosner, Yongmei Chen, Jennifer Cullen, James Jezior, and Robert Dean Molly WilliamsMolly Williams Bethesda, MD More articles by this author , Inger RosnerInger Rosner Bethesda, MD More articles by this author , Yongmei ChenYongmei Chen Rockville, MD More articles by this author , Jennifer CullenJennifer Cullen Rockville, MD More articles by this author , James JeziorJames Jezior Bethesda, MD More articles by this author , and Robert DeanRobert Dean Bethesda, MD More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2013.02.1389AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail INTRODUCTION AND OBJECTIVES There have been over 30,000 and 12,000 wounded in action in Operation Iraqi Freedom (OIF) and Operation Enduring Freedom (OEF) respectively. Five percent of these injuries include the genitourinary structures. Three-quarters of these GU injuries involve the urethra and external genitalia. There have been no long term studies as to the impact of poly-trauma and scrotal injuries on serum testosterone level recovery. METHODS The operative log for patients identified as OEF or OIF and having any urologic surgery from 2001 until August 2011 was obtained. A retrospective chart review was completed to identify the mechanism of injury, time since injury, types of injury, testosterone values, and use of exogenous testosterone. Of the 192 charts reviewed, 127 had testosterone values available and of these, 13 had no documented scrotal injury with the remainder having varying degrees of scrotal injury. Mean follow up was 149.4 days. RESULTS Of the 127 patients included in this study, 21 were from OIF and 106 were from OEF. The average age of the patients was 24.7 years. The degree of scrotal injury was classified as: (1) no scrotal injury, (2) scrotal injury without testicular loss, (3) scrotal injury with testicular loss, (4) bilateral orchiectomy. The majority of injuries were caused by improvised explosive devices (IEDs) (N=104, 81.9%). Initial testosterone value after injury was inversely proportional to the degree of injury, but all groups were hypogonadal in the immediate post injury setting. Thirty-nine patients received testosterone replacement, while 40 patients recovered normal testosterone levels without intervention. The group that recovered their testosterone without replacement did so on average of 7.5 months after injury. Those who needed replacement testosterone therapy were more likely to have testicular loss than those who did not get replacement (p=0.0017). CONCLUSIONS All patients were found to be hypogonadal in the immediate post injury setting. Those with minimal or no scrotal injury recovered their testosterone levels within 7.5 months of injury. This differs from the average time to replacement which was only 2.9 months. As expected, patients with significant testicular injury will require testosterone replacement. Our study demonstrates that testosterone recovery occurs in severely injured patients without significant testicular loss in 7.5 months. © 2013 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 189Issue 4SApril 2013Page: e6 Advertisement Copyright & Permissions© 2013 by American Urological Association Education and Research, Inc.MetricsAuthor Information Molly Williams Bethesda, MD More articles by this author Inger Rosner Bethesda, MD More articles by this author Yongmei Chen Rockville, MD More articles by this author Jennifer Cullen Rockville, MD More articles by this author James Jezior Bethesda, MD More articles by this author Robert Dean Bethesda, MD More articles by this author Expand All Advertisement Advertisement PDF downloadLoading ...