History of Urology Forum
Presentation Authors: Samuel R. Donnenfeld*, Salt Lake City, UT, Marc J. Rogers, Charleston, SC
Introduction: It is largely unknown that at the time of the American Civil War varicoceles were considered to be a significant medical problem. When a soldier was found to have a varicocele he was deemed to be in urgent need of medical care and, in some cases, he was relieved of duty. Following the conflict, varicoceles also cost a significant monetary expense for the nation's first military pension program.
Methods: We attained sources through the Medical University of South Carolina Colbert Library as well as the use of online databases.
Results: Physicians considered varicoceles a grave disease capable of causing lifelong disability during the American Civil War. If entry examination identified a potential soldier to have an asymptomatic varicocele or one in which the dilatation was more substantial than either testicle, the recruiter would deny entry into either army. Soldiers found to have varicoceles were sent away from the conflict due to the believed severity of the disease, the thought that marching led to the condition, and the perceived inability to perform their duties as a soldier due to pain. Varicoceles resulted in the highest rate of discharge from either military of any urological condition. Other urological disorders including testis tumors, stones, and urethral strictures were considered stable chronic diseases without the need for medical attention, rarely resulting in discharge. Following the conflict, varicoceles occupied the twenty-second most common reason for lifetime military pension payouts being more common than asthma, spinal cord disorders, and all bladder conditions. Monthly pay for privates was over 36% and was equitable with other conditions today deemed much more serious including large hernias, loss of an eye, or loss of a thumb.
Conclusions: Varicoceles were considered disabling conditions during the era of the American Civil War. Union or Confederate armies denied recruits found to have symptomatic varicoceles before the conflict and discharged those who developed the condition during the war at a higher rate than any other urological disease.
Source of Funding: None