Urologists play important role in Iraq, commander says


Honolulu--Operation Iraqi Freedom sees its share of sick and wounded soldiers. Primarily, specialists in orthopedics and general surgery are seeing an upswing in patients coming from the conflict. But you may be surprised to learn that urologic care is the third most important medical specialty needed for these soldiers.

Col. Rhonda Cornum, MD, is a urologist and commander of Landstuhl Regional Medical Center, Germany-the largest American hospital outside of the United States. Landstuhl is the primary hospital for soldiers involved in Operation Iraqi Freedom needing medical attention.

"It's the only location," said Dr. Cornum. "If you're sick or wounded, you're coming to Landstuhl."

"The biggest thing we see, certainly, are stones," said Dr. Cornum. "It's very hot there, and [the soldiers] are either too busy to drink a lot, or the water that comes out of the [water reservoir tank] with iodine in it just doesn't taste very good.

"Also, it's not rewarding to drink this water when it's hot. So, you might start off the day with cool water, but when you're gone all day, there's no way you're going to have cool water. And it can be over 100º every day, and they're wearing body armor, helmets, sleeves down, and heavy boots."

"And that spike has been sustained since then," she said. "They initially went into Afghanistan-Operation Enduring Freedom-in October of 2001, and that was a manageable increase, maybe 80 patients a month. But for the first part of 2003 and into 2004, we were seeing nearly 50 patients a day. We're down to 25 patients a day now, but it's still a lot."

Dr. Cornum explained that the acuity of patient care at Landstuhl Medical Center also skyrocketed with the start of the military action in Iraq.

"It used to be that we had a very quiet little ICU with a low acuity of around 2.7. Well, it went up to 5.2 in our ICU."

Except for dealing with an observed rise in stones cases, Dr. Cornum said that the role of urology in a combat situation is actually somewhat minimal.

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