Clinical and radiological criteria of genito-urinary fistulae presenting with menouria

Menouria [voiding menstrual blood mixed with urine at time menstruation] is a well known, but rare gynaecological complaint. The present work is a clinical and radiological study of twelve cases of menouria associated with genito-urinary fistulae. Vesico-uterine fistulae following lower segment cesarean section were found to be the main type of fistulae causing such complaint. Amenorrhoea with patent cervical canal and urinary continence were associated in four cases to form true Youssef syndrome, which was proved to be a rarity of all cases of menouria. Radiolgical studies proved that urinary continence and amenorrhoea were essentially determined by the length, the width and the course of the fistulae in addition to the relative position of the bladder and the uterus. Long narrow and ascending fistulae in which there was a significant level difference between the bladder and the uterus were essentially associated with urinary continence. The vesicovaginal fistula recorded in this study was an exceptional case and the first oneto be recorded in which menouria and urinary continence were a feature inspite of the extensive loss of enterior vaginal wall, posterior bladder wall and the urethera continence in this case was maintained by a potent perineal sphincter controlling the vaginal introitus and the external uretheral meatus

Effect of intra-umbilical injection of some embolic drugs on the third stage of labour

Sixty normal parturients were enrolled into a r and omized protocol. Within one minute after cord clamping 12 women received 20 units of oxytocin diluted to 20 ml in normal saline, 12 women received 2 ampoules of Methergine diluted to 20 ml in normal saline, 12 women received 1 mg of prostagl and in F2 alpha [Enzaprost] diluted in 20 ml of normal saline, 12 women received 20 ml of normal saline and 12 women received no injections with spontaneous third stage. The mean durations of third stage were 5.79 +/- 1.72 minutes, 5.0 +/- 1.9 minutes, 4.5 +/- 1.83 minutes, 9.75 +/- 2.22 and 11.08 +/- 3.12 minutes, respectively. The mean amount of blood loss was 300.83 +/- 86.4 ml, 267.5 +/- 137.9 ml, 208.3 +/- 70.4 ml, 328.3 +/- 57.66 ml, and 330.83 +/- 76.3 ml, respectively. This means that intraumbilical injection of Syntocinon, Methergine or Prostagl and in is effective in shortening the third stage and in minimizing the amount of blood loss