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The worldwide increase of cesarean delivery rates is expected to lead to increased complications.<\/jats:p><\/jats:sec><jats:sec><jats:title>Objectives<\/jats:title><jats:p>To assess current evidence on VUF pathogenesis and surgical management.<\/jats:p><\/jats:sec><jats:sec><jats:title>Search Strategy<\/jats:title><jats:p>Pubmed and Embase databases were searched from January 2000 to January 2023 using relevant key words.<\/jats:p><\/jats:sec><jats:sec><jats:title>Selection Criteria<\/jats:title><jats:p>Only original articles including either transabdominal or transvaginal surgical routes for post\u2010cesarean VUF repair, in English language, were included.<\/jats:p><\/jats:sec><jats:sec><jats:title>Data Collection and Analysis<\/jats:title><jats:p>Two authors independently screened the references for eligibility, data extraction, and assessment of methodologic quality. All available surgical outcomes were recorded.<\/jats:p><\/jats:sec><jats:sec><jats:title>Main Results<\/jats:title><jats:p>Of the 1160 studies retrieved, 67 were selected for analysis. Most of these were case reports, case series, or observational cohort studies including a total of 284 patients. The majority (78.6%) of patients had more than one cesarean section, and approximately 10% of them experienced an overt bladder injury and\/or uterine rupture at the time of cesarean delivery. The supratrigonal part of the bladder was most commonly involved (92.5%). The majority of patients (88.8%) underwent delayed VUF repair through laparotomy. Length of stay and blood loss were significantly less in patients treated via a minimally invasive approach (<jats:italic>P<\/jats:italic>\u2009&lt;\u20090.001 and <jats:italic>P<\/jats:italic>\u2009=\u20090.02, respectively). Most patients had double\u2010layer bladder repair and single\u2010layer uterine repair. The overall success rate was 100% on first attempt for each independent combination of different surgical approaches and techniques. Live birth following VUF repair was reported in 23 patients.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Paying close attention to surgical details is crucial to reduce the incidence of this complication and recurrence rates. Double\u2010layer bladder closure and delayed timing of repair of VUF are recommended.<\/jats:p><\/jats:sec>","DOI":"10.1002\/ijgo.15256","type":"journal-article","created":{"date-parts":[[2023,12,7]],"date-time":"2023-12-07T02:07:24Z","timestamp":1701914844000},"page":"894-915","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":7,"title":["Surgical repair of post\u2010cesarean vesicouterine fistula: A systematic review and a plea for prevention"],"prefix":"10.1002","volume":"165","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-7342-0223","authenticated-orcid":false,"given":"Giulia","family":"Bonavina","sequence":"first","affiliation":[{"name":"Department of Obstetrics and Gynecology IRCCS Humanitas Research Hospital  Milan Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Andrea","family":"Busnelli","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology IRCCS Humanitas 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