{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,20]],"date-time":"2026-10-20T03:09:17Z","timestamp":1792465757380,"version":"4.5.0"},"reference-count":28,"publisher":"Galenos Yayinevi","issue":"2","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Facts Views Vis ObGyn"],"published-print":{"date-parts":[[2022,6,30]]},"abstract":"<jats:p>Background: Deep endometriosis (DE) usually creates a distortion of the retroperitoneal anatomy and may infiltrate the parametria with an oncomimetic pathway similar to cervical cancer. The condition represents a severe manifestation of endometriosis that may result in a functional impairment of the inferior hypogastric plexus.\nAn extensive surgical resection may be required with an associated risk of increased neurogenic postoperative pelvic organ dysfunction.\n\nObjectives: To evaluate the post-operative function and complications following hysterectomy with posterolateral parametrial resection for DE.\n\nMaterials and Methods: In total, 23 patients underwent radical hysterectomy for DE with the parametria involved. The severity of pain was assessed by the Visual Analogue Scale (VAS) score. The KESS, GQLI, BFLUTS and FSFI were used to examine the gastrointestinal, urinary and sexual functions respectively. Intra and post-operative complications were recorded.\n\nMain outcome measures: The main outcomes were gastrointestinal, urinary and sexual function and intra and post-operative complications.\n\nResults: Dyschezia, dyspareunia and chronic pelvic pain were significantly reduced following hysterectomy. Furthermore, an improvement of gastrointestinal function was observed, while sexual functions, examined by FSFI and urinary symptoms, examined by BFLUTS, was not shown to be significant.\n\nConclusion: The modified nerve-sparing radical hysterectomy for DE results in an improvement of symptoms. Nevertheless, despite the nerve-sparing approach, this procedure may be associated with a not-negligible risk of post-operative bladder voiding deficit.\n\nWhat is new? This is the first study that focuses on parametrial endometriosis using validated questionnaires to assess functional outcomes following radical hysterectomy for DE.<\/jats:p>","DOI":"10.52054\/fvvo.14.2.016","type":"journal-article","created":{"date-parts":[[2022,7,2]],"date-time":"2022-07-02T12:21:41Z","timestamp":1656764501000},"page":"121-127","source":"Crossref","is-referenced-by-count":18,"title":["Surgical and functional impact of nerve-sparing radical hysterectomy for parametrial deep endometriosis: a single centre experience"],"prefix":"10.52054","volume":"14","author":[{"given":"A","family":"Rosati","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"M","family":"Pavone","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"F","family":"Campolo","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"A","family":"De Cicco Nardone","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"D","family":"Raimondo","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"R","family":"Serracchioli","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"G","family":"Scambia","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"M.M.","family":"Ianieri","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"2811","published-online":{"date-parts":[[2022,7,1]]},"reference":[{"key":"ref0","doi-asserted-by":"publisher","unstructured":"Ballester M, Dubernard G, Wafo E, et al. Evaluation of Urinary Dysfunction by Urodynamic Tests, Electromyography and Quality of Life Questionnaire before and after Surgery for Deep Infiltrating Endometriosis. Eur J Obstet Gynecol Reprod Biol. 2014;179:135-40.","DOI":"10.1016\/j.ejogrb.2014.05.041"},{"key":"ref1","doi-asserted-by":"publisher","unstructured":"Ballester M, Santulli P, Bazot M, et al. Preoperative evaluation of posterior deep-infiltrating endometriosis demonstrates a relationship with urinary dysfunction and parametrial involvement. J Minim Invasive Gynecol. 2011;18:36-42.","DOI":"10.1016\/j.jmig.2010.08.692"},{"key":"ref2","doi-asserted-by":"publisher","unstructured":"Brookes ST, Donovan JL, Wright M, Jackson S, e et al. A Scored Form of the Bristol Female Lower Urinary Tract Symptoms Questionnaire: Data from a Randomized Controlled Trial of Surgery for Women with Stress Incontinence. Am J Obstet Gynecol. 2004;191:73\u201382.","DOI":"10.1016\/j.ajog.2003.12.027"},{"key":"ref3","doi-asserted-by":"publisher","unstructured":"Ceccaroni M, Clarizia R, Roviglione G, et al. Neuro-Anatomy of the Posterior Parametrium and Surgical Considerations for a Nerve-Sparing Approach in Radical Pelvic Surgery. Surg Endosc. 2013;27:4386\u201394.","DOI":"10.1007\/s00464-013-3043-z"},{"key":"ref4","doi-asserted-by":"publisher","unstructured":"Ceccaroni M, Pontrelli G, Spagnol E, et al. Parametrial Dissection during Laparoscopic Nerve-Sparing Radical Hysterectomy: A New Approach Aims to Improve Patients\u2019 Postoperative Quality of Life. Am J Obstet Gynecol. 2010;202:320.e1-2.","DOI":"10.1016\/j.ajog.2009.12.019"},{"key":"ref5","doi-asserted-by":"publisher","unstructured":"Ceccaroni M, Roberto C, Francesco B et al. Nerve-Sparing Laparoscopic Eradication of Deep Endometriosis with Segmental Rectal and Parametrial Resection: The Negrar Method. A Single-Center, Prospective, Clinical Trial. Surg Endosc. 2016;26:2029\u201345.","DOI":"10.1007\/s00464-012-2153-3"},{"key":"ref6","doi-asserted-by":"publisher","unstructured":"Chiantera V, Petrillo M, Abesadze E, et al. \u00abLaparoscopic Neuronavigation for Deep Lateral Pelvic Endometriosis: Clinical and Surgical Implications\u00bb. J Minim Invasive Gynecol. 2018;25:1217-23.","DOI":"10.1016\/j.jmig.2018.02.015"},{"key":"ref7","doi-asserted-by":"publisher","unstructured":"D\u2019Avout-Fourdinier P, Lempicka M, Gilibert A, et al. Posterior rectal pouch after large full-thickness disc excision of deep endometriosis infiltrating the low\/mid rectum and relationship with digestive functional outcome. J Gynecol Obstet Hum Reprod. 2020;49:101792.","DOI":"10.1016\/j.jogoh.2020.101792"},{"key":"ref8","doi-asserted-by":"publisher","unstructured":"Darai E, Thomassin I, Barranger E, et al. Feasibility and Clinical Outcome of Laparoscopic Colorectal Resection for Endometriosis. 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Segmental bowel resection for deep infiltrating endometriosis. BJOG. 2016;123:1368","DOI":"10.1111\/1471-0528.14030"},{"key":"ref16","doi-asserted-by":"crossref","unstructured":"Kyo S, Kato T, Nakayama K, et al. Current concepts and practical techniques of nerve-sparing laparoscopic radical hysterectomy. Eur J Obstet Gynecol Reprod Biol. 2016;207:80-8.","DOI":"10.1016\/j.ejogrb.2016.10.033"},{"key":"ref17","doi-asserted-by":"publisher","unstructured":"Landi S, Ceccaroni M, Perutelli A, et al. Laparoscopic nerve-sparing complete excision of deep endometriosis: is it feasible? Hum Reprod. 2006;21:774-81.","DOI":"10.1093\/humrep\/dei324"},{"key":"ref18","doi-asserted-by":"publisher","unstructured":"Luka R, Halaska M, Robova H. Nerve-Sparing and Individually Tailored Surgery for Cervical Cancer. Lancet Oncol. 2010;11:292\u2013301.","DOI":"10.1016\/s1470-2045(09)70191-3"},{"key":"ref19","doi-asserted-by":"publisher","unstructured":"Mabrouk M, Raimondo D, Arena A, et al. Parametrial Endometriosis: The Occult Condition That Makes the Hard Harder. J Minim Invasive Gynecol. 2019;26:871-6.","DOI":"10.1016\/j.jmig.2018.08.022"},{"key":"ref20","doi-asserted-by":"publisher","unstructured":"Nezhat C, Nguyen K, Ackroyd E, et al. Nerve-Sparing Modified Radical Hysterectomy for Severe Endometriosis and Complex Pelvic Pathology. Cureus. 2020;12:e9882.","DOI":"10.7759\/cureus.9882"},{"key":"ref21","doi-asserted-by":"publisher","unstructured":"Nieveen Van Dijkum EJ, Terwee CB, Oosterveld P, et al. Validation of the Gastrointestinal Quality of Life Index for Patients with Potentially Operable Periampullary Carcinoma. Br J Surg. 2000;87:110\u20135","DOI":"10.1046\/j.1365-2168.2000.01307.x"},{"key":"ref22","doi-asserted-by":"publisher","unstructured":"Querleu D, Cibula D, Abu-Rustum NR et al. Update on the Querleu-Morrow Classification of Radical Hysterectomy. Ann Surg Oncol. 2017;24:3406-12.","DOI":"10.1245\/s10434-017-6031-z"},{"key":"ref23","doi-asserted-by":"publisher","unstructured":"Raspagliesi F, Bogani G, Spinillo A, et al. Introducing nerve-sparing approach during minimally invasive radical hysterectomy for locally-advanced cervical cancer: A multi-institutional experience. Eur J Surg Oncol. 2017;2150-6.","DOI":"10.1016\/j.ejso.2017.08.015"},{"key":"ref24","doi-asserted-by":"crossref","unstructured":"Revised American Society for Reproductive Medicine classification of endometriosis: 1996. Fertil Steril.1997;67:817-21.","DOI":"10.1016\/S0015-0282(97)81391-X"},{"key":"ref25","doi-asserted-by":"publisher","unstructured":"Riiskj\u00e6r M, Forman A, Kesmodel US, et al. Pelvic Pain and Quality of Life Before and After Laparoscopic Bowel Resection for Rectosigmoid Endometriosis: A Prospective, Observational Study. Dis Colon Rectum. 2018;61:221-9.","DOI":"10.1097\/dcr.0000000000000970"},{"key":"ref26","doi-asserted-by":"publisher","unstructured":"Uccella S, Gisone B, Serati M et al. Functional outcomes of nerve-sparing laparoscopic eradication of deep infiltrating endometriosis: a prospective analysis using validated questionnaires. Arch Gynecol Obstet. 2018;298:639-47.","DOI":"10.1007\/s00404-018-4852-z"},{"key":"ref27","doi-asserted-by":"publisher","unstructured":"Zakhari A, Mabrouk M, Raimondo D, et al. Keep Your Landmarks Close and the Hypogastric Nerve Closer: An Approach to Nerve-Sparing Endometriosis Surgery. 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