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MILITARY
MEDICINE

Acute
management
of genitourinary
injuries

By Michael Liss, MD

Complex battlefield genitourinary injuries remain poorly Dr. Michael Liss is a member to the TOUGH
characterized beyond initial quantitative studies and rec- (Trauma Outcomes and Urogenital Health) project
ommendations for acute management. The far-reaching joining Byron Hepburn, M.D., representing the Mil-
impact of these injuries in the domains of urinary, en- itary Health Institute at UT Health San Antonio, and
docrine, reproductive, sexual and psychosocial function Lt. Col. Michael Davis, M.D. (transplant, reconstruc-
mandate thoughtful and comprehensive multidisciplinary tion), Maj. Steven Hudack M.D., and Jean Orman MsC. MPH at and
medical care. Genitourinary reconstruction is often done SAMHS and Mary Jo Pugh, Ph.D. Dr. Liss is a VA investigator em-
in a staged fashion over the course of months to years and ployed by the VA and UT Health and is initiating the collaboration to
in the context of concurrent attempts at limb salvage and the South Texas Veterans Affairs Medical System specifically at the Audie
physical rehabilitation. Murphy VA in San Antonio.

A study done at UT Health San Antonio is particularly
significant in light of recent health care policy initiatives.
The National Defense Authorization Act of 2014 calls for
a “comprehensive policy on improvements to care and tran-
sition of members of the Armed Forces with Urotrauma.”
We aim to characterize the quality and efficiency of transi-
tion of care. Herein, we focus on the transition of recover-
ing service members from the Department of Defense to
the Department of Veteran Affairs.

Our group will be the first to address genitourinary
trauma access to care issues and propose solutions regard-
ing veterans transitioning to Veteran’s Affairs Health Sys-
tem and community care. Significantly, strides have been made
in the areas of screening for Agent Orange in Vietnam-era veter-
ans and for traumatic brain injury in OEF/OIF deployments;
however, the rise in genitourinary trauma has highlighted a need
for improvement in care of genitourinary trauma issues. These in-
juries have long-term effects and urgently need research to assess
and address the needs of current and future veterans afflicted with
these injuries. Our proposal will provide the necessary informa-
tion to develop screening tools, assessments, and additional spe-
cialized clinics to address these concerns.

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