{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,20]],"date-time":"2026-10-20T01:38:55Z","timestamp":1792460335893,"version":"4.5.0"},"reference-count":17,"publisher":"Wiley","issue":"10","license":[{"start":{"date-parts":[[2026,10,12]],"date-time":"2026-10-12T00:00:00Z","timestamp":1791763200000},"content-version":"vor","delay-in-days":11,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2026,10,1]],"date-time":"2026-10-01T00:00:00Z","timestamp":1790812800000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["obgyn.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["J of Obstet and Gynaecol"],"published-print":{"date-parts":[[2026,10]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Objectives<\/jats:title>\n                    <jats:p>The aim of this study is to describe a modified method for applying Shull's technique using the V\u2010NOTES approach and to compare it with the traditional vaginal technique in terms of efficacy, safety, operative duration, recurrence, and patient\u2010reported outcomes at median follow\u2010up.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>The study included 40 women with Stage\u2009\u2265\u2009III uterine prolapse (POP\u2010Q) undergoing conventional vaginal hysterectomy with Shull suspension (vaginal native tissue repair [VNTR] Group A) or V\u2010NOTES hysterectomy with endoscopic Shull suspension (vaginal natural orifice transluminal endoscopic surgery [V\u2010NOTES] Group B) between December 2024 and December 2025. The median follow\u2010up was 6\u2009months. Informed consent was obtained. Outcomes included perioperative parameters, complications, hospital stay, recurrence, and quality\u2010of\u2010life and sexual function.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      The median follow\u2010up was 6\u2009months (5\u20139); 22 patients underwent VNTR (Group A) and 18\u2009V\u2010NOTES (Group B) during hysterectomy and prolapse repair. Both procedures achieved anatomical improvement, with no difference in recurrence (Group A 1 case [4.5%] vs. Group B 0 cases [0%],\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.12). Operative time was comparable (Group A 112\u2009\u00b1\u200925\u2009min vs. Group B 102\u2009\u00b1\u200922\u2009min,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.06), while hospital stay was shorter with V\u2010NOTES (Group A 2\u2009days (2\u20133) vs. Group B 1\u2009day (1\u20132),\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.03). Complications were low (Group A 13.6% vs. Group B 0%,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.05), with two ureteral events only in Group A (4.5% each;\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.21 and\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.22). Sexual function improved (FSFI Group A 29.63\u2009\u00b1\u20091.97 vs. Group B 29.23\u2009\u00b1\u20092.01,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.001), with greater satisfaction in V\u2010NOTES (PGI\u2010I \u201cVery much better\u201d: 68.2% vs. 88.8%;\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.002).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>V\u2010NOTES Shull suspension is a safe and effective alternative with advantages in recovery and patient\u2010reported outcomes.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/jog.70527","type":"journal-article","created":{"date-parts":[[2026,10,13]],"date-time":"2026-10-13T00:55:08Z","timestamp":1791852908000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Hysterectomy and Shull Suspension Using the V\u2010\n                    <scp>NOTES<\/scp>\n                    Technique Versus Traditional Vaginal Surgery: A Prospective Analysis of Short\u2010Term Efficacy and Safety"],"prefix":"10.1111","volume":"52","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-4149-170X","authenticated-orcid":false,"given":"Michele Carlo","family":"Schiavi","sequence":"first","affiliation":[{"name":"Department of Obstetrics and Gynecology \u201cSandro Pertini\u201d Hospital  Rome 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Panico\u201d Hospital  Tricase Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8524-2708","authenticated-orcid":false,"given":"Pierluigi","family":"Palazzetti","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology \u201cSandro Pertini\u201d Hospital  Rome Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4764-544X","authenticated-orcid":false,"given":"Herbert Carmelo Carlo","family":"Valensise","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology \u201cTor Vergata\u201d University  Rome Italy"},{"name":"Department of Obstetrics and Gynecology \u201cCasilino\u201d Hospital  Rome Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0009-6276-6304","authenticated-orcid":false,"given":"Fabio","family":"Manganelli","sequence":"additional","affiliation":[{"name":"Department of 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