[Causes of the occurrence of urogenital fistulae in obstetrics and gynecology].

Ninety-two women with urogenital fistulas of obstetric-gynecological origin have been treated at the Department of Urology of the Medical Academy in Sofia for the period Jan. 1974-July 1988. The causes of the fistulas in 17 patients (18.5 per cent) were of obstetric origin and in 75 (81.5 per cent) of gynecological origin. Analysis of the causes revealed that the incidence of obstetric fistulas was higher than in other developed countries. Higher was also the incidence of radiogenic urogenital fistulas. Gynecological fistulas following operations of benign genital diseases were more common than those developing after total hysterectomies and Wertheim's operations for malignant tumors of the internal genitals. This is in contradiction to reports by other authors. It is suggested that urologist be included in the surgeons' staff in risk hysterectomies (in cervical myomatosis).