AUA Summit -


Battlefield Urology

To the list of so many things that COVID-19 has put on hold, we add the display of this year’s AUA History Exhibit: Battlefield Urology, which examines urology in war.

The battlefield has been a place of tremendous medical and surgical learning and progress over the generations. Many current urological interventions were developed and refined in the laboratory of war. The exhibit is a testimonial and a salute to the legions of urologists, trauma surgeons, APPs, nurses, medics, and technicians who wear or have worn the uniform and have contributed to the defense of our great nation and, in the process, to the advancement of urological care.

The central story line of the exhibit traces the changing nature of urological war injuries over the centuries. This evolution is directly influenced by the advances in weaponry and ballistics over time. Through the many wars and conflicts in Europe, America, and elsewhere through the 18th, 19th and 20th centuries, urological injury tended to vary directly with the size and velocity of fired projectiles. There was a paradigm shift in urological war injury in the mid-2000s as Operations Iraqi Freedom and Enduring Freedom (Afghanistan) wore on. With the enemies’ weapon of choice becoming the buried IED and the increasing necessity of foot patrol in the rugged Afghan terrain, a new injury pattern emerged: the dismounted complex blast injury (DCBI). The urological components of DCBI include injury to the penis and pendulous urethra, the scrotum and testicles, and in some cases bulbar and membranous urethral and bladder injuries.

Mash helicopter
Helicopter evacuation, courtesy National Library of Medicine

Woven into this storyline of urological injury evolution are several historical anecdotes of interest wherein urological disease or injury likely had a significant part in the outcome of various military campaigns. The indisposition of British Admiral Lord George Brydges Rodney (1718-1792) from bladder neck contracture and bladder stones was pivotal in a key Continental Army victory during the American Revolution. It is very possible that Napoleon’s well-documented urologic issues may have played a significant role in the French Army’s defeat at Waterloo. These are but two of many stories woven through this year’s exhibit.

We look forward to telling the complete story at the 2021 meeting. Many thanks to staff at the AUA for coordinating and building the infrastructure for this phenomenal exhibit. Thanks also to the many exhibit contributors who have donated artifacts and their time and energy to writing content for our exhibit. We are proud of it and look forward to sharing it with our friends and colleagues in 2021.

Mark T. Edney, MD
Courtesy Mark Edney, MD

Mark T. Edney, MD, MBA
Guest Curator, Battlefield Urology
April 12, 2020