Military Women's Urinary Complications in Deployment Settings
Military Women's Urinary Complications in Deployment Settings
Existing literature suggests that deployed military women are hesitant to seek GU health care because of a lack of confidence in providers, embarrassment, lack of confidentiality, lack of female providers, inability to leave their work position, and/or transportation issues (Nielsen et al., 2009; Ryan-Wenger & Low, 2000). Lowe and Ryan-Wenger (2003) reported on military women's risk factors for and symptoms of GU infections during deployment. Of the 4,254 surveys sent to military women at 88 military units, 1,626 completed surveys were returned, with 841 of these from women who had been deployed in the past five years. Findings suggested deployed military women were significantly less likely to visit a health care provider during deployment than at their home duty station and were significantly less comfortable seeking care. Approximately half of the deployed military women (n = 411) were uncomfortable going to a health care provider during deployment, with nearly onequarter (n = 199) stating they would not seek care. Nearly 30% reported vaginal infections, and 18% reported having UTIs. Five common symptoms of UTIs (urgency, frequency, burning, lower abdominal pain, and foulsmelling urine) were reported by 20% of the participants. In women who did not report a UTI, more than 30% reported having at least three of the common symptoms of a UTI. Approximately 70% of the deployed military women reported unsanitary toilet facilities, and 56% reported restricting fluids to avoid having to urinate in the latrines.
A study by Thomson and Nielsen (2006) regarding the perceptions of women's health care during OIF reported that "[21%] of soldiers (52 of 251) had gynecologic problems during deployment; however, 44% (23 of 52 soldiers) were unable to receive the medical care they needed to resolve this problem" (p. 217). Another OIF study conducted with deployed military women presenting for any medical reason to the clinic of a combat support hospital between August 2005 and March 2006 revealed that nearly half of those surveyed (189/372) reported urinary symptoms (Nielsen et al., 2009). Urinary frequency (37%) and inability to hold urine (23%) were the most common urinary complaints. Painful urination was reported by 9.3%. The investigators suggested these symptoms may have been the result of poor access to toilet facilities, intentional dehydration to avoid urination, and hygiene opportunities that were few and far between. When asked about commercially available urination devices, only 4.5% (21/372) reported using a urinary device during their deployment. About one-third (107/372) reported being unaware of urination devices.
A current study by Wilson and Nelson (2012) explored the management of GU symptoms by military women (N = 43) in deployment settings. Using an ethnographic design, the respondents described several physical hindrances to managing their GU health. They commented on heat and moisture problems with military uniforms, unavailable feminine supplies, and unsanitary toilet and shower facilities as key factors that hampered their ability to manage their GU symptoms. Urination was a challenge when they traveled away from the base camp. Many military women suffered from urine leakage and urgency, and began to think of these symptoms as being "normal." Mistrust in health care providers during deployment was expressed. This mistrust caused them to obtain information about GU health from other sources, such as peers. Respondents also expressed beliefs that health care providers were not proactive about providing them the health information they need prior to deployment. Health briefings were more about preventing malaria and psychiatricrelated health issues than preventing GU symptoms.
Deployment and Genitourinary Health Care
Existing literature suggests that deployed military women are hesitant to seek GU health care because of a lack of confidence in providers, embarrassment, lack of confidentiality, lack of female providers, inability to leave their work position, and/or transportation issues (Nielsen et al., 2009; Ryan-Wenger & Low, 2000). Lowe and Ryan-Wenger (2003) reported on military women's risk factors for and symptoms of GU infections during deployment. Of the 4,254 surveys sent to military women at 88 military units, 1,626 completed surveys were returned, with 841 of these from women who had been deployed in the past five years. Findings suggested deployed military women were significantly less likely to visit a health care provider during deployment than at their home duty station and were significantly less comfortable seeking care. Approximately half of the deployed military women (n = 411) were uncomfortable going to a health care provider during deployment, with nearly onequarter (n = 199) stating they would not seek care. Nearly 30% reported vaginal infections, and 18% reported having UTIs. Five common symptoms of UTIs (urgency, frequency, burning, lower abdominal pain, and foulsmelling urine) were reported by 20% of the participants. In women who did not report a UTI, more than 30% reported having at least three of the common symptoms of a UTI. Approximately 70% of the deployed military women reported unsanitary toilet facilities, and 56% reported restricting fluids to avoid having to urinate in the latrines.
A study by Thomson and Nielsen (2006) regarding the perceptions of women's health care during OIF reported that "[21%] of soldiers (52 of 251) had gynecologic problems during deployment; however, 44% (23 of 52 soldiers) were unable to receive the medical care they needed to resolve this problem" (p. 217). Another OIF study conducted with deployed military women presenting for any medical reason to the clinic of a combat support hospital between August 2005 and March 2006 revealed that nearly half of those surveyed (189/372) reported urinary symptoms (Nielsen et al., 2009). Urinary frequency (37%) and inability to hold urine (23%) were the most common urinary complaints. Painful urination was reported by 9.3%. The investigators suggested these symptoms may have been the result of poor access to toilet facilities, intentional dehydration to avoid urination, and hygiene opportunities that were few and far between. When asked about commercially available urination devices, only 4.5% (21/372) reported using a urinary device during their deployment. About one-third (107/372) reported being unaware of urination devices.
A current study by Wilson and Nelson (2012) explored the management of GU symptoms by military women (N = 43) in deployment settings. Using an ethnographic design, the respondents described several physical hindrances to managing their GU health. They commented on heat and moisture problems with military uniforms, unavailable feminine supplies, and unsanitary toilet and shower facilities as key factors that hampered their ability to manage their GU symptoms. Urination was a challenge when they traveled away from the base camp. Many military women suffered from urine leakage and urgency, and began to think of these symptoms as being "normal." Mistrust in health care providers during deployment was expressed. This mistrust caused them to obtain information about GU health from other sources, such as peers. Respondents also expressed beliefs that health care providers were not proactive about providing them the health information they need prior to deployment. Health briefings were more about preventing malaria and psychiatricrelated health issues than preventing GU symptoms.
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