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Objective: To present the outcomes of patients treated at a tertiary center for a diagnosis of genitourinary fistula secondary to gynecological and obstetric etiologies.Study Design: In this retrospective study, analysis was made of 18 patients with a diagnosis of genitourinary fistula in a tertiary center between January 2006 and June 2016. Patient data were taken from the archives and patient histories. A record was made of examinations, diagnostic methods such as cystoscopy and fistulography and appropriate medical treatments, demographic data, intraoperative and post-operative complications, duration of hospital stay, surgical operations and types, diameter and location of fistulas.Results: Of the 18 cases, 14 were secondary to obstetric trauma. In 10 of these 14 cases, fistula had developed after difficult vaginal delivery and in four cases, after caesarean section. Four of the 18 cases were secondary to gynecological surgeries, namely hysterectomy and cystocele repairs. Vesicovaginal fistulas were repaired transvaginally while vesicouterine fistulas and bilateral ureterovaginal fistulas were repaired transabdominally. The mean hospital stay was 3.8±1.5 days (2-7 days). Patients were followed up closely in the first 3 months and recurrence developed in only one case.Conclusion: Fistulas secondary to gynecological procedures are uncommon while fistulas secondary to inadequate perineal care, insufficient labor monitoring and difficulties in vaginal delivery techniques are more prevalent in Turkey. Thorough evaluation, using all diagnostic tools for complete diagnosis, understanding the pathophysiology and choosing the best surgical procedure are mandatory to obtain good outcomes after the surgical

Objectives: We aimed to present urinary tract injuries occurring during obstetric and gynecological operations and their clinical consequences. Methods: Twenty-three patients had urological organ injury during obstetric and gynecological operations in a tertiary care center between January 2010 and June 2016, were analyzed retrospectively. Etiologies, type of injury, diagnostic process, treatment methods and complications of urologic injuries and success rate have been investigated. Injuries were categorized into two groups as intra-operative early injuries and post-op late injuries. Early injuries were laceration, rupture, ligation and late injuries were hydronephrosis, contrast material leakage or fistula. Results: Eight patients were diagnosed during operation period or post-op early period and 15 patients who were referred from other hospitals. Thirteen of the injuries were gynecologic and 10 of them were obstetric. Mean age of operated patients was 34.2±9.4 (23-65) years. Ureteral injury and bladder injury was detected respectively in six and two patients getting early diagnosis. Fistula (5/15), hydronephrosis secondary to urethral stricture (3/15) and vaginal erosion (3/15) were detected as late diagnosed injuries. In a patient whom ureter was ligated non-functioning kidney has developed. Conclusions: To reduce rate of urinary system injuries a sound knowledge of anatomy is required and corrected surgical techniques should be used. Early diagnosis and therapy may prevent complications and loss of organs that may lead to morbidity.

A patient with acute abdomen at 16th week of gestation underwent an emergency laparotomy. At laparotomy two litres of fibrinated and free blood and a dead fetus with placenta was detected intraabdominally. The right ovary and tube was normal and the uterus was normal in size. There was a ruptured and actively bleeding uterine horn on the left side of the uterus. The ruptured uterine horn was excised with the left tube by preserving the left ovary. The patient recovered without any complications, Onaltıncı gebelik haftasında akut batın tablosu ile gelen hasta acil laparotomiye alındı. Laparotomide intraabdominal iki litre fibrine ve defibrine kan ve ölü bir fetus ile birlikte plasentası tesbit edildi. Sağ over ve tüp normal görünümde ve uterus normal boyutlardaydı. Uterusun solunda rupture ve aktif kanamalı uterin horn gözlendi. Rupture uterin horn sol over korunarak sol tüp ile birlikte eksize edildi. Hasta herhangi bir komplikasyon gelişmeden taburcu edildi.