Warfare Injuries: A Case Series of Retained Foreign Bodies in the Genitourinary Tract.

OBJECTIVE To present the management of retained foreign bodies in the genitourinary system resulting from warfare, bomb blasts, and firearm-related injuries. STUDY DESIGN Descriptive case series. Place and Duration of the Study: Department of Urology, Institute of Kidney Diseases, Hayatabad Medical Complex, Peshawar, Pakistan, from June 2017 to December 2023. METHODOLOGY Patients with retained foreign bodies in the genitourinary tract, resulting from previous exposure to bomb blasts, mines, and firearm-related injuries, were included in this study. All patients underwent surgical management. Descriptive statistics were determined for location, duration of retention, type of foreign body, outcome, length of hospital stay, and postoperative complications. RESULTS All 14 patients included in the study were male, with a mean age of 30.85 ± 13.38 years. The average indwelling time of these foreign bodies was 33.50 ± 16.34 months, ranging from 10 to 61 months. These foreign bodies were retained in the kidney (n = 5), urinary bladder (n = 4), and testes and ureter (n = 2; each); penis was involved in one case. The extracted foreign bodies were metal pellets (n = 12) and bullets (n = 2). The successful removal of pellets and bullets from kidneys and bladder was achieved endoscopically in nine cases. The mean length of hospital stays for open and endourological procedures was 4.0 ± 1.41 days and 3.5 ± 2.13 days, respectively (p = 0.630). Postoperative complications were reported in one case only, which required a blood transfusion; it was labelled as Clavien-Dindo Grade II. CONCLUSION Retained foreign bodies in the genitourinary tract in warfare injuries are uncommon and can be managed effectively with endourological as well as open surgery. KEY WORDS Retained foreign bodies, Genitourinary tract, Bomb blasts, Warfare.