Army veteran, UTSW surgeon helps fellow vets deal with sensitive battle injuries: Newsroom


Many US service members struck by ground explosives during the conflicts in Iraq and Afghanistan suffered genitourinary (GU) injuries to their urinary, genital, and reproductive systems. Photo credit: Getty Images

DALLAS – 08 November 2022 – Combat injuries to a soldier’s genital area are not as well understood as those to other parts of the body due to the intimate nature of the injuries. A new investigation, co-led by Steven J. Hudak, MD, associate professor of urology at UT Southwestern and former US Army officer, aims to shed light on these injuries and improve treatment.

Steven J. Hudak, MD

Over the past two decades, an unprecedented number of service members have been hit by ground explosives during the conflicts in Iraq and Afghanistan, causing serious injuries. In addition to losing limbs, these troops often suffered genitourinary (GU) damage to their urinary, genital, and reproductive systems.

Understanding the long-term impact of these injuries, including effects on sexual and reproductive abilities and mental health, is key to providing the best possible care, said Dr. Hudak, a former Army surgeon who has healed many service members who suffered GU injuries. He also provides reconstructive genitourinary surgery at UT Southwestern, which is ranked #11 in the nation for urology care by US News and World Report.

Dr. Hudak was part of the team that designed and conducted the initial phase of the TOUGH (Trauma Outcomes and Urogenital Health Project) survey, which identified nearly 1,500 male military personnel who suffered GU injuries in Iraq and Afghanistan. The investigation, which has the backing of the Ministry of Defence, classified the types and severity of injuries.

“In 2010, there was an increase in troops in Afghanistan, and we started to see a level of GU injuries that we had never seen. This was research that needed to be done,” Dr. Hudak said.

The results of the first TOUGH survey were released in 2017. Phase 2 of the survey, which will look at the long-term impact of these injuries, began in September.

“Phase 1 looked to the past. Most of these men were in their twenties. Many had not yet had children,” Dr. Hudak said. “The new study attempts to identify what life is like for these people years after their injury. What are the gaps in care?”

The main categories of health effects for GU injuries are sexual, urinary, and reproductive functions. But the survey will also look at how these injuries affect mental health, intimate relationships and overall quality of life.

The purpose of the survey is to guide improvements in the area of ​​GU injuries, such as protective clothing to reduce injury severity, sperm banking before service members enter combat, improved surgical techniques and more widely available couples counseling services.

“This investigation will be an important step in providing these veterans with the support and care they so richly deserve and our nation owes them,” Dr. Hudak said.

The survey takes approximately one hour to complete and can be viewed at

About UT Southwestern Medical Center

UT Southwestern, one of the nation’s leading academic medical centers, integrates pioneering biomedical research with exceptional clinical care and education. The institution’s faculty has received six Nobel Prizes and includes 24 members of the National Academy of Sciences, 18 members of the National Academy of Medicine, and 14 researchers from the Howard Hughes Medical Institute. Full-time faculty of more than 2,900 are responsible for groundbreaking medical advances and committed to rapidly translating scientific research into new clinical treatments. UT Southwestern physicians provide care in more than 80 specialties to more than 100,000 inpatients, more than 360,000 emergency room cases, and oversee nearly 4 million outpatient visits annually.


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