Uterovesical fistulas as obstetric complications: Diagnosis, management and prognosis (Review)

Jilaveanu,Anca; Socea,Bogdan; Bohiltea,Roxana; Stiru,Ovidiu; Al Aloul,Adnan; Ursut,Bogdan; Savu,Cornel; Filipescu,Alexandru; Balescu,Irina; Bacalbasa,Nicolae

doi:10.3892/etm.2023.11804

Uterovesical fistulas as obstetric complications: Diagnosis, management and prognosis (Review)

Authors:
- Anca Jilaveanu
- Bogdan Socea
- Roxana Bohiltea
- Ovidiu Stiru
- Adnan Al Aloul
- Bogdan Ursut
- Cornel Savu
- Alexandru Filipescu
- Irina Balescu
- Nicolae Bacalbasa
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Affiliations: Department of Obstetrics and Gynecology, ‘I. Cantacuzino’ Clinical Hospital, 030167 Bucharest, Romania, Department of Surgery, ‘Carol Davila’ University of Medicine and Pharmacy, 020021 Bucharest, Romania, Department of Obstetrics and Gynecology, ‘Carol Davila’ University of Medicine and Pharmacy, 020021 Bucharest, Romania, Department of Cardiovascular Surgery, ‘Prof. Dr. C. C. Iliescu’ Emergency Institute for Cardiovascular Diseases, 022322 Bucharest, Romania, Department of Surgery, Ramnicu Sarat County Hospital, 125300 Ramnicu Sarat, Romania, Department of Thoracic Surgery, ‘Carol Davila’ University of Medicine and Pharmacy, 020021 Bucharest, Romania, Department of Surgery, ‘Ponderas’ Academic Hospital, 021188 Bucharest, Romania
Published online on: January 23, 2023 https://doi.org/10.3892/etm.2023.11804
Article Number: 105

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Abstract

Urogenital fistulas are abnormal communications between the female genital and urinary tract; while such fistulas, which are the most commonly encountered, are located between the vagina and urinary bladder and are caused by the local extension of a tumoral process. Another frequently encountered cause is represented by the obstetric one, leading to the development of uterovesical fistulas. However, many questions regarding the diagnosis and management of uterovesical fistulas remain unanswered. Therefore, the aim of this article was to review the existent data so far, with special attention being focused on the pathogenic mechanisms leading to this complication, on the modalities of diagnosis, and on the possible therapeutic strategies. Therefore, according to the time of diagnosis, uterovesical fistulas can be classified as early fistulas, diagnosed in the first months postoperatively and late fistulas, diagnosed within several years from the initial surgical procedure. For early fistulas, a conservative therapeutic strategy can be taken in consideration, while in cases diagnosed after a longer period of time, a surgical approach should be taken into consideration. Meanwhile, although a surgical approach can cure most of the cases, attention should be given towards preventive strategies such as provision of quality obstetric care with improvements of surgical skills.

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