A comprehensive review of iatrogenic rectovaginal fistula after rectal cancer surgery.

Iatrogenic rectovaginal fistula (RVF) following total mesorectal excision for rectal cancer is an uncommon but profoundly disabling complication, imposing major physical, functional, sexual, and psychosocial burdens. Its pathogenesis is multifactorial, often arising in an inflamed, irradiated, or fibrotic pelvis, and compounded by coexisting anastomotic defects. This review is based on a narrative synthesis of the available literature; its aim is to provide an updated overview of current knowledge and clinical practice in the management of RVF, a highly specialised and technically demanding field with limited high-quality evidence.