Genitourinary Fistula - An Experience from a Tertiary Care Hospital

Genito urinary fistula remains a frustrating condition for patients in the developing world. We retrospectively analysed twenty three women who underwent fistula repair over the last 5 years in one unit at Department of Obstetric and Gynaecology, All India Institute of Medical Sciences. Twenty-seven fistulae were repaired in 23 women of which 78.2% were vesecovaginal fistula. Majority of these fistula (73.9%) were obstetric in origin, as a result of neglected, mismanaged labour. Surgical repair was the mainstay with 100% success for those undergoing primary repair and an overall success rate of 83.3% for vesico vaginal fistula. Though principles of fistula repair were adhered to by the operating surgeon, each patient was unique. Surgeons trained in such repair can individually vary approach and technique to suit each patient giving high success rate.

Losartan induced fetal toxicity.

Losartan is a specific angiotensin II receptor antagonist. Although the teratogenic effects of angiotensin converting enzyme (ACE) inhibitors are well documented there are limited reports of losartan induced fetal toxicity. The authors report a case of incomplete ossification of skull bones, transient oliguria and feed intolerance in a newborn following in-utero exposure to losartan.