{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,17]],"date-time":"2026-04-17T14:55:56Z","timestamp":1776437756629,"version":"3.51.2"},"reference-count":52,"publisher":"MDPI AG","issue":"8","license":[{"start":{"date-parts":[[2023,8,12]],"date-time":"2023-08-12T00:00:00Z","timestamp":1691798400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Medicina"],"abstract":"<jats:p>Gynecological fistulae are a rare but severe complication of radiation therapy, pelvic surgery, prolonged labor, cesarean deliveries, or inflammatory bowel diseases. A gynecological fistula is an abnormal pathway formed between the urinary and gynecological tract, most commonly located between the urinary bladder and vagina. Vesico-uterine and vesicovaginal fistulae are an important health issue, common in women of reproductive age in developing countries with limited access to obstetrical care. Various surgical techniques have been described for VVF repair, depending on the location, severity, and cause of the fistula and the surgeon\u2019s experience. The purpose of our review was to evaluate the present state of knowledge about the prevalence and treatment of gynecological fistulae. The PubMed scientific database was searched for original articles on the subject of gynecological fistulae that had been published between 2013 and 2023.<\/jats:p>","DOI":"10.3390\/medicina59081455","type":"journal-article","created":{"date-parts":[[2023,8,14]],"date-time":"2023-08-14T10:20:14Z","timestamp":1692008414000},"page":"1455","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":7,"title":["Gynecological Fistulae\u2014Has Anything Changed in the Diagnosis and Treatment over the Last Decade? A Narrative Literature Review"],"prefix":"10.3390","volume":"59","author":[{"given":"Marek","family":"Misiak","sequence":"first","affiliation":[{"name":"Interdisciplinary Students Association of Metabolic and Systemic Disease \u201cSalus Aegroti\u201d Faculty of Medicine, Collegium Medicum, Cardinal Stefan Wyszynski University in Warsaw, 01-815 Warszawa, Poland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Michalina","family":"Dworak","sequence":"additional","affiliation":[{"name":"Interdisciplinary Students Association of Metabolic and Systemic Disease \u201cSalus Aegroti\u201d Faculty of Medicine, Collegium Medicum, Cardinal Stefan Wyszynski University in Warsaw, 01-815 Warszawa, Poland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ma\u0142gorzata","family":"Wyszomirska","sequence":"additional","affiliation":[{"name":"Interdisciplinary Students Association of Metabolic and Systemic Disease \u201cSalus Aegroti\u201d Faculty of Medicine, Collegium Medicum, Cardinal Stefan Wyszynski University in Warsaw, 01-815 Warszawa, Poland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Maria","family":"Kurt","sequence":"additional","affiliation":[{"name":"Interdisciplinary Students Association of Metabolic and Systemic Disease \u201cSalus Aegroti\u201d Faculty of Medicine, Collegium Medicum, Cardinal Stefan Wyszynski University in Warsaw, 01-815 Warszawa, Poland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4311-9995","authenticated-orcid":false,"given":"Maciej","family":"Wal\u0119dziak","sequence":"additional","affiliation":[{"name":"Department of General, Oncological, Metabolic and Thoracic Surgery, Military Institute of Medicine\u2014National Research Institute, Szaser\u00f3w 128 St., 04-141 Warsaw, Poland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5764-3811","authenticated-orcid":false,"given":"Anna","family":"R\u00f3\u017ca\u0144ska-Wal\u0119dziak","sequence":"additional","affiliation":[{"name":"Department of Human Physiology and Pathophysiology, Faculty of Medicine, Collegium Medicum, Cardinal Stefan Wyszynski University in Warsaw, 01-815 Warszawa, Poland"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1968","published-online":{"date-parts":[[2023,8,12]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"32","DOI":"10.1007\/s00261-012-9876-4","article-title":"Common and unusual urogenital Crohn\u2019s disease complications: Spectrum of cross-sectional imaging findings","volume":"38","author":"Tonolini","year":"2013","journal-title":"Abdom. Imaging"},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"528","DOI":"10.21873\/invivo.12734","article-title":"Vesico-uterine Fistula Following C-section\u2014A Case Report and Literature Review","volume":"36","author":"Caraman","year":"2022","journal-title":"Vivo"},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"563","DOI":"10.1055\/s-0038-1666998","article-title":"Vesicouterine fistula (Youssef Syndrome): Case report and literature review","volume":"40","year":"2018","journal-title":"Rev. Bras. Ginecol. Obstet."},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"100062","DOI":"10.1016\/j.xagr.2022.100062","article-title":"Best practices for repair of iatrogenic bladder injury","volume":"2","author":"Zelivianskaia","year":"2022","journal-title":"AJOG Glob. Rep."},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"705","DOI":"10.1111\/aogs.14379","article-title":"Different segmental resection techniques and postoperative complications in patients with colorectal endometriosis: A systematic review","volume":"101","author":"Darici","year":"2022","journal-title":"Acta Obstet. Gynecol. Scand."},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"11804","DOI":"10.3892\/etm.2023.11804","article-title":"Uterovesical fistulas as obstetric complications: Diagnosis, management and prognosis (Review)","volume":"25","author":"Jilaveanu","year":"2023","journal-title":"Exp. Ther. Med."},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"1385","DOI":"10.1148\/rg.2018170167","article-title":"Imaging and surgical management of anorectal vaginal fistulas","volume":"38","author":"VanBuren","year":"2018","journal-title":"RadioGraphics"},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1186\/s13244-019-0812-9","article-title":"Elucidating vaginal fistulas on CT and MRI","volume":"10","author":"Tonolini","year":"2019","journal-title":"Insights Imaging"},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"156","DOI":"10.4103\/jmh.JMH_70_20","article-title":"Management of genitourinary fistulas following benign gynecological and obstetric procedures: A single surgeon experience","volume":"11","author":"Gupta","year":"2020","journal-title":"J. Mid-life Health"},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"104067","DOI":"10.1016\/j.amsu.2022.104067","article-title":"Functional outcomes of surgical treatment of ureteral injury following gynecological and obstetrical surgery","volume":"79","author":"Rahoui","year":"2022","journal-title":"Ann. Med. Surg."},{"key":"ref_11","doi-asserted-by":"crossref","unstructured":"Tozzi, R., Spagnol, G., Marchetti, M., Montan, G., Saccardi, C., and Noventa, M. (2023). Vaginal-Laparoscopic Repair (VLR) of Primary and Persistent Vesico-Vaginal Fistula: Description of a New Technique and Surgical Outcomes. J. Clin. Med., 12.","DOI":"10.3390\/jcm12051760"},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"e000921","DOI":"10.1136\/bmjgast-2022-000921","article-title":"Closure of recurrent colovaginal fistulas using AMPLATZER occluder device","volume":"9","author":"Simmons","year":"2022","journal-title":"BMJ Open Gastroenterol."},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"180","DOI":"10.4103\/0972-9941.141508","article-title":"Laparoscopic repair of urogenital fistulae: A single centre experience","volume":"10","author":"Sharma","year":"2014","journal-title":"J. Minimal Access Surg."},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"1030","DOI":"10.1590\/S1677-5538.IBJU.2014.0391","article-title":"Laparoscopic repair for vesicouterine fistulae","volume":"41","author":"Maioli","year":"2015","journal-title":"Int. Braz. J. Urol."},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"77","DOI":"10.1016\/j.ijgo.2013.06.032","article-title":"Impact of a program of physiotherapy and health education on the outcome of obstetric fistula surgery","volume":"124","author":"Castille","year":"2014","journal-title":"Int. J. Gynecol. Obstet."},{"key":"ref_16","doi-asserted-by":"crossref","unstructured":"Ngongo, C.J., Raassen, T.J., Mahendeka, M., Lombard, L., van Roosmalen, J., and Temmerman, M. (2022). Rare causes of genital fistula in nine African countries: A retrospective review. BMC Women\u2019s Health, 22.","DOI":"10.1186\/s12905-022-02050-z"},{"key":"ref_17","first-page":"129","article-title":"Perceived Causes of Obstetric Fistula and Predictors of Treatment Seeking among Ugandan Women: Insights from Qualitative Research","volume":"24","author":"Nalubwama","year":"2020","journal-title":"Afr. J. Reprod. Health"},{"key":"ref_18","doi-asserted-by":"crossref","unstructured":"Gebremedhin, S., and Asefa, A. (2019). Treatment-seeking for vaginal fistula in sub-Saharan Africa. PLoS ONE, 14.","DOI":"10.1101\/623520"},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"225","DOI":"10.4314\/mmj.v30i4.3","article-title":"Schistosomiasis among obstetric fistula patients in Lilongwe, Malawi","volume":"30","author":"Wilkinson","year":"2018","journal-title":"Malawi Med. J."},{"key":"ref_20","doi-asserted-by":"crossref","unstructured":"Yeshitila, Y.G., Daniel, B., Desta, M., and Kassa, G.M. (2022). Obstructed labor and its effect on adverse maternal and fetal outcomes in Ethiopia: A systematic review and meta-analysis. PLoS ONE, 17.","DOI":"10.1371\/journal.pone.0275400"},{"key":"ref_21","doi-asserted-by":"crossref","unstructured":"Maroyi, R., Moureau, M.K., Brown, H.W., Ajay, R., Byabene, G., and Mukwege, D.M. (2023). Etiology and factors associated with urogenital fistula among women who have undergone cesarean section: A cross-sectional study. BMC Pregnancy Childbirth, 23.","DOI":"10.1186\/s12884-023-05357-3"},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"1348","DOI":"10.1111\/tmi.12771","article-title":"Pregnancy and childbirth after repair of obstetric fistula in sub-Saharan Africa: Scoping Review","volume":"21","author":"Delamou","year":"2016","journal-title":"Trop. Med. Int. Health"},{"key":"ref_23","doi-asserted-by":"crossref","first-page":"6","DOI":"10.1002\/ijgo.13032","article-title":"Challenges in the field of obstetric fistula","volume":"148","author":"Rane","year":"2020","journal-title":"Int. J. Gynecol. Obstet."},{"key":"ref_24","doi-asserted-by":"crossref","first-page":"862351","DOI":"10.3389\/fpubh.2022.862351","article-title":"Development and Pilot Test of a Group Cognitive Behavioral Intervention for Women Recovering From Fistula Repair Surgery in Ethiopia","volume":"10","author":"Gladstone","year":"2022","journal-title":"Front. Public Health"},{"key":"ref_25","doi-asserted-by":"crossref","first-page":"831","DOI":"10.1111\/tmi.13794","article-title":"Factors associated with surgical repair success of female genital fistula in the Democratic Republic of Congo: Experiences of the Fistula Care Plus Project, 2017\u20132019","volume":"27","author":"Mafu","year":"2022","journal-title":"Trop. Med. Int. Health"},{"key":"ref_26","doi-asserted-by":"crossref","first-page":"20503121221079309","DOI":"10.1177\/20503121221079309","article-title":"Urinary tract infection, antimicrobial susceptibility pattern of isolates, and associated factors among women with a post-fistula at public health facilities, Harar, eastern Ethiopia: A cross-sectional study","volume":"10","author":"Marami","year":"2022","journal-title":"SAGE Open Med."},{"key":"ref_27","doi-asserted-by":"crossref","first-page":"3307","DOI":"10.1590\/1413-81232022278.05742022","article-title":"Recent trends in cesarean section reduction in extreme south of Brazil: A reality only in the public sector?","volume":"27","author":"Marmitt","year":"2022","journal-title":"Cienc E Saude Coletiva"},{"key":"ref_28","first-page":"2909","article-title":"Signifi cant differences in cesarean section rates between a private and a public hospital in Brazil Diferen\u00e7a not\u00e1vel nas taxas de parto cesariano em hospital p\u00fablico e hospital privado no Brasil","volume":"24","author":"Barbieri","year":"2008","journal-title":"Medicina"},{"key":"ref_29","doi-asserted-by":"crossref","first-page":"e24176","DOI":"10.1097\/MD.0000000000024176","article-title":"Defensive medicine and cesarean sections in Brazil","volume":"100","author":"Rudey","year":"2021","journal-title":"Medicine"},{"key":"ref_30","doi-asserted-by":"crossref","first-page":"791","DOI":"10.1007\/s11255-006-9076-7","article-title":"Minimal invasive treatment of vesicouterine fistula: A case report","volume":"39","author":"Tarhan","year":"2007","journal-title":"Int. Urol. Nephrol."},{"key":"ref_31","doi-asserted-by":"crossref","first-page":"8688","DOI":"10.11604\/pamj.2014.18.94.4401","article-title":"Fistule v\u00e9sico-ut\u00e9rine","volume":"18","author":"Kehila","year":"2014","journal-title":"Pan. Afr. Med. J."},{"key":"ref_32","doi-asserted-by":"crossref","first-page":"1361","DOI":"10.1111\/j.1464-410X.2007.07067.x","article-title":"Vesico-uterine fistula: Report of 14 cases","volume":"100","author":"Pejcic","year":"2007","journal-title":"BJU Int."},{"key":"ref_33","doi-asserted-by":"crossref","first-page":"353","DOI":"10.1016\/S0020-7292(00)00247-2","article-title":"Clinical classification of vesicouterine fistula","volume":"70","author":"Jozwik","year":"2000","journal-title":"Int. J. Gynaecol. Obstet."},{"key":"ref_34","doi-asserted-by":"crossref","first-page":"1344","DOI":"10.1111\/j.1471-0528.2012.03461.x","article-title":"Factors influencing choice of surgical route of repair of genitourinary fistula, and the influence of route of repair on surgical outcomes: Findings from a prospective cohort study","volume":"119","author":"Frajzyngier","year":"2012","journal-title":"BJOG: Int. J. Obstet. Gynaecol."},{"key":"ref_35","doi-asserted-by":"crossref","first-page":"864","DOI":"10.1080\/14767058.2017.1387899","article-title":"Delivery through cervicovaginal fistula\u2014Literature review and case report","volume":"32","author":"Watrowski","year":"2019","journal-title":"J. Matern. Neonatal Med."},{"key":"ref_36","first-page":"349","article-title":"Endometriosis still a challenge","volume":"7","author":"Mehedintu","year":"2014","journal-title":"J. Med. Life"},{"key":"ref_37","doi-asserted-by":"crossref","first-page":"67","DOI":"10.1016\/j.ejogrb.2016.07.513","article-title":"Surgery versus hormonal therapy for deep endometriosis: Is it a choice of the physician?","volume":"209","author":"Berlanda","year":"2017","journal-title":"Eur. J. Obstet. Gynecol. Reprod. Biol."},{"key":"ref_38","doi-asserted-by":"crossref","first-page":"1601","DOI":"10.1093\/humrep\/deaa131","article-title":"Faculty Opinions recommendation of Risk of bowel fistula following surgical management of deep endometriosis of the rectosigmoid: A series of 1102 cases","volume":"35","author":"Roman","year":"2020","journal-title":"Hum. Reprod."},{"key":"ref_39","doi-asserted-by":"crossref","first-page":"100083","DOI":"10.1016\/j.eurox.2019.100083","article-title":"Post-operative complications and recurrence rate after treatment of bowel endometriosis: Comparison of three techniques","volume":"4","author":"Spagnolo","year":"2019","journal-title":"Eur. J. Obstet. Gynecol. Reprod. Biol. X"},{"key":"ref_40","doi-asserted-by":"crossref","first-page":"172","DOI":"10.1016\/j.fertnstert.2017.10.001","article-title":"Postoperative complications after bowel endometriosis surgery by shaving, disc excision, or segmental resection: A three-arm comparative analysis of 364 consecutive cases","volume":"109","author":"Abo","year":"2018","journal-title":"Fertil. Steril."},{"key":"ref_41","doi-asserted-by":"crossref","first-page":"453","DOI":"10.1016\/j.jmig.2020.08.015","article-title":"Surgical Outcomes after Colorectal Surgery for Endometriosis: A Systematic Review and Meta-analysis","volume":"28","author":"Bendifallah","year":"2021","journal-title":"J. Minim. Invasive Gynecol."},{"key":"ref_42","doi-asserted-by":"crossref","unstructured":"Hsu, M.-W., Chen, W.-C., Wei, T.-N., and Huang, C.-P. (2023). Management of Enterovesical Fistula in a Patient with Crohn\u2019s Disease: A Case Report and Literature Review. Diagnostics, 13.","DOI":"10.3390\/diagnostics13091527"},{"key":"ref_43","doi-asserted-by":"crossref","first-page":"166","DOI":"10.1016\/j.ejogrb.2013.08.011","article-title":"Surgical repair of rectovaginal fistulas in patients with Crohn\u2019s disease","volume":"171","author":"Nosti","year":"2013","journal-title":"Eur. J. Obstet. Gynecol. Reprod. Biol."},{"key":"ref_44","first-page":"e3510","article-title":"Complications and Patient-reported Outcomes in Transfemale Vaginoplasty: An Updated Systematic Review and Meta-analysis","volume":"9","author":"Bustos","year":"2021","journal-title":"Plast. Reconstr. Surg.-Glob. Open"},{"key":"ref_45","doi-asserted-by":"crossref","first-page":"609","DOI":"10.21037\/atm-20-6429","article-title":"Imaging evaluation for the diagnosis and management of complications of gender-affirming surgeries","volume":"9","author":"Stowell","year":"2021","journal-title":"Ann. Transl. Med."},{"key":"ref_46","doi-asserted-by":"crossref","first-page":"263","DOI":"10.1590\/s1677-5538.ibju.2020.0338","article-title":"Vaginoplasty tips and tricks","volume":"47","author":"Li","year":"2021","journal-title":"Int. Braz. J. Urol."},{"key":"ref_47","doi-asserted-by":"crossref","first-page":"563","DOI":"10.1111\/aogs.12618","article-title":"Sex reassignment of transsexual people from a gynecologist\u2019s and urologist\u2019s perspective","volume":"94","author":"Trum","year":"2015","journal-title":"Acta Obstet. Gynecol. Scand."},{"key":"ref_48","doi-asserted-by":"crossref","unstructured":"Yang, L., Zhang, B., Xing, G., Du, J., Yang, B., Yuan, Q., and Yang, Y. (2017). Neoadjuvant chemotherapy versus primary debulking surgery in advanced epithelial ovarian cancer: A meta-analysis of peri-operative outcome. PLoS ONE, 12.","DOI":"10.1371\/journal.pone.0186725"},{"key":"ref_49","doi-asserted-by":"crossref","first-page":"928","DOI":"10.1016\/S1470-2045(15)00086-8","article-title":"Standard chemotherapy with or without bevacizumab for women with newly diagnosed ovarian cancer (ICON7): Overall survival results of a phase 3 randomised trial","volume":"16","author":"Oza","year":"2015","journal-title":"Lancet Oncol."},{"key":"ref_50","doi-asserted-by":"crossref","unstructured":"Li, Y., Kong, Q., Wei, H., and Wang, Y. (2021). Comparison of the complications between minimally invasive surgery and open surgical treatments for early-stage cervical cancer: A systematic review and meta-analysis. PLoS ONE, 16.","DOI":"10.1371\/journal.pone.0253143"},{"key":"ref_51","doi-asserted-by":"crossref","first-page":"115","DOI":"10.1016\/j.ygyno.2019.10.032","article-title":"Effect of laparoscopic versus abdominal radical hysterectomy on major surgical complications in women with stage IA-IIB cervical cancer in China, 2004\u20132015","volume":"156","author":"Liang","year":"2020","journal-title":"Gynecol. Oncol."},{"key":"ref_52","doi-asserted-by":"crossref","first-page":"975","DOI":"10.1007\/s00192-011-1375-6","article-title":"A multicenter study of vesicovaginal fistula following incidental cystotomy during benign hysterectomies","volume":"22","author":"Duong","year":"2011","journal-title":"Int. Urogynecol. J."}],"container-title":["Medicina"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/1648-9144\/59\/8\/1455\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,10]],"date-time":"2025-10-10T20:32:00Z","timestamp":1760128320000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/1648-9144\/59\/8\/1455"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2023,8,12]]},"references-count":52,"journal-issue":{"issue":"8","published-online":{"date-parts":[[2023,8]]}},"alternative-id":["medicina59081455"],"URL":"https:\/\/doi.org\/10.3390\/medicina59081455","relation":{},"ISSN":["1648-9144"],"issn-type":[{"value":"1648-9144","type":"electronic"}],"subject":[],"published":{"date-parts":[[2023,8,12]]}}}