Youssef's syndrome is characterized by cyclic hematuria (menouria), absence of vaginal bleeding (amenorrhea), and urinary incontinence due to vesicouterine fistula (VUF), the least common of the urogynecological fistulas. Youssef's syndrome has a variable clinical presentation. A vesicouterine fistula is an abnormal pathway between the bladder and the uterus. The most common cause is lower segment Cesarean section. Conservative treatment may be appropriate in some cases, but surgery is the definitive treatment. Vesicouterine fistula should be suspected in cases presenting with urinary incontinence even years after Cesarean section. Diagnostic tests as well as necessary appropriate surgery should be performed on cases with suspected vesicouterine fistula. We present a 40-year-old multiparous woman with vesicouterine fistula after primary Cesarean section; she presented with urinary incontinence, hematuria, and amenorrhea 1 year after the birth. Here, we discuss our case with the help of previously published studies found in the literature.

Abstract

Background: Female genital mutilation (FGM) is common in Sub-Saharan Africa. It has been shown that it can cause sexual dysfunction. Materials and Methods: A total of 239 volunteer women were included in the study, which was conducted between April 2014 and January 2015; 210 of these women were circumcised and 29 were uncircumcised. Sexual functions of the women were evaluated by using Female Sexual Functioning Index (FSFI). Statistical analyses were performed by using the Mann-Whitney U-test, Kruskal-Wallis test, and chi-square test. Results: The ages of women examined ranged between 17 and 65 years (mean: 33.54 ± 10.25). The ratio of women circumcised was determined as 87.9%. The most commonly performed circumcision type was Type 2 (51%), followed by Type 3 (25.7%); the remaining cases were determined to be Type 1 circumcision (23.3%). Both the total FSFI scores and each individual score of sexual desire, arousal, lubrication, orgasm, satisfaction, and pain differed between the uncircumcised and circumcised women; these differences were statistically significant. When the circumcision types were compared to each other, the difference between Type 1 and 2 was not statistically significant, whereas the differences between Type 1 and 3, and between Type 2 and 3 were statistically significant. Discussion: Type 3 FGM is the most severe form of FGM, in which almost all of the female external genitalia is excised, and the remaining parts are sewn together; this procedure narrows the opening of the genital organ. In the current study, the lowest FSFI scores were determined in women with Type 3 FGM. Circumcision, and especially the Type 3, is still an important health problem causing female sexual function disorders in the women living in Darfur, Sudan.

Objective: To compare the obstetric and neonatal outcomes of pregnant women in the adolescent age group with the outcomes of those in reproductive age group in our region. Materials and Methods: The outcomes of 539 adolescent pregnancies between the ages of 10-19 years and 644 adult pregnancies between the ages of 20-35 years who gave birth in Osmaniye State Hospital Obstetrics and Gynecology Clinic between January 2013 and January 2015 were analyzed retrospectively. Results: The mean age of the adolescent group was determined as 17.60 ± 1.21, and the mean age of the adult group was detected as 26.77 ± 3.94. Compared to reproductive age group, in adolescent age group gestational diabetes mellitus (4.5%, 9.2%, respectively) and preterm birth (32.5%, 19.9%) incidence was detected to be significantly high (p<0.05). 1-minute and 5-minute APGAR scores were observed significantly low in adolescent age group. Conclusion: It is observed that adverse maternal and perinatal results are increased in pregnant women in adolescent age group compared to reproductive age group.

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