Genito-urinary fistulae--an evaluation.

A total number of 39 cases of genito-urinary fistulae were managed during the period January, 2001 to August, 2006 in the department of obstetrics and gynaecology, Burdwan Medical College, Burdwan. All patients were evaluated clinically and investigations done accordingly. The incidence of genito-urinary fistula was 0.74% of all gynaecological operations. Out of 39 cases, 23 were primipara, 41.02% were in the age group 20-30 years. In 20 cases the site was at midvaginal region. Prolonged and obstructed labour constituted the major aetiology in 25 cases. Surgery was contemplated in 34 cases. Thirty cases had successful operation after primary surgery, 3 cases had successful repair after second attempt. Only one case needed third attempt. Urethral catheter was required in 15 cases. Proper training of the care providers, more vigilant intrapartum care and timely referral are the important factors to minimise the distressing disorder.

Ovarian neoplasms in adolescence and childhood--an analysis of twenty cases.

Between January, 1999 and June, 2001 consecutive twenty cases of ovarian tumours in girls below 20 years of age admitted in Burdwan Medical College, Burdwan, West Bengal were analysed. Commonest presentation was lump abdomen (80%), 15% presented with acute abdomen, one patient presented with virilisation and another with precocious puberty and 85% had single ovarian involvement. Among 5 cases of torsion of ovarian tumours, one along with the twisted uterus was detected. Conservative surgery in the form of cystectomy or unilateral oophorectomy with or without salpingectomy was possible in 85% cases. Germ cell tumours (60%) took the leading place followed by epithelial (3 0%) and sex-cord stromal tumour (10%). Fifty percent neoplasms were malignant with majority (80%) being instage I. Combination chemotherapy was considered for 7 out of 10 cases. Conservative surgery in one hand and the fear of malignancy on the other are the real problems in these cases. Early detection, optimal therapy and intense follow-up are the key points of the management.