Parametrial Endometriosis: The Occult Condition that Makes the Hard Harder
Abstract
Study objective Despite the enormous impact of lateral parametrial endometriosis (LPE), only a few studies have evaluated its diagnosis, prevalence, and clinical features. Our aim was to estimate the intraoperative prevalence of LPE in patients affected by deep infiltrating endometriosis (DIE) and to analyses clinical and surgical data associated with LPE.Design Retrospective cohort study (Canadian Task Force classification II-2).Setting Endometriosis tertiary level referral center, Sant'Orsola Academic Hospital, Bologna, Italy.Patients We included 1360 consecutive women submitted to surgery for DIE between 2007 and 2017. Patients were divided into 2 groups according to the presence (study group, n = 231) or absence (control group, n = 1129) of LPE.Intervention We retrospectively compared data records on the demographic features, preoperative data, and surgical outcomes of the 2 groups.Measurements and main results The intraoperative prevalence of LPE was 17%. Preoperatively, LPE patients complained of having a more severe intensity of dysmenorrhea (p <.001), more frequent voiding symptoms (p <.001), and more constipation (p = .02). At surgery, significant correlations were found with rectovaginal septum, vaginal, rectal, and ureteral involvement (p <.001). LPE patients intraoperatively presented a concomitant posterior nodule with a larger transverse diameter (p <.001). The operation time and hospital stay were longer for patients with LPE. Postoperatively, the LPE group needed self-catheterization more often than the control group at discharge (p <.001) and at the 1-month follow-up evaluation (p = .001).Conclusions LPE is a condition that reflects a more severe manifestation of endometriosis, requiring more aggressive surgery.
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Patients with lateral parametrial endometriosis reported more frequent constipation and voiding symptoms.
“Patients with LPE reported more frequent constipation and voiding symptoms [42].”
From Endometriosis: Epidemiology, Classification, Pathogenesis, Treatment and Genetics (Review of Literature) (2021) · cites this paper as [42]
Associations exist between lateral parametrial endometriosis and straining to void, the feeling of incomplete emptying, intermittency, abnormal residual urine and bladder outlet obstruction.
“Associations exist between LPE and straining to void, the feeling of incomplete emptying, intermittency, and abnormal residual urine and bladder outlet obstruction.”
From Endometriosis: Epidemiology, Classification, Pathogenesis, Treatment and Genetics (Review of Literature) (2021) · cites this paper as [42]
The presence of lateral parametrial endometriosis can be considered a reflection of more severe disease, ureteral stenosis and dilatation, and voiding dysfunctions, mainly because of involvement of the inferior hypogastric plexus.
“The presence of lateral parametrial endometriosis (LPE) can be considered a reflection of a more severe disease, ureteral stenosis and dilatation, and voiding dysfunctions, mainly because of the involvement of the inferior hypogastric plexus.”
From Endometriosis: Epidemiology, Classification, Pathogenesis, Treatment and Genetics (Review of Literature) (2021) · cites this paper as [42]
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Self-citation
- Authors
- Mabrouk, M., Raimondo, D., Arena, A., Iodice, R., Altieri, M., Sutherland, N., Salucci, P., Moro, E., & Seracchioli, R.
- Affiliations
- IRCCS Azienda Ospedliero-Universitaria di Bologna Policlinico di Sant'Orsola (IT)
- University of the West Indies System (JM)
- Corresponding author
- Raimondo, Diego
- ORCID
- Venue
- Journal of Minimally Invasive Gynecology
- Publisher
- Elsevier BV
- Published
- 2019-07
- Volume
- 26
- Issue
- 5
- Pages
- 871-876
- ISSN
- 1553-4650 (ISSN-L)
- OpenAlex
- W2889317961
- Cited by
- 59
- References
- 18
- Citations by year
- 2026: 2 · 2025: 5 · 2024: 13 · 2023: 5 · 2022: 13 · 2021: 14 · 2020: 5 · 2019: 2
- FWCI
- 5.60
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Journal of Minimally Invasive Gynecology (publishedVersion)
- PubMed (publishedVersion)
- Archivio istituzionale della ricerca (Alma Mater Studiorum Università di Bologna) (submittedVersion)
- Topics
- Health Sciences › Medicine › Reproductive Medicine › Endometriosis Research and Treatment
- Health Sciences › Medicine › Obstetrics and Gynecology › Gynecological conditions and treatments
- Health Sciences › Medicine › Obstetrics and Gynecology › Endometrial and Cervical Cancer Treatments
- Keywords
- deep infiltrating endometriosis, surgical outcomes, rectovaginal septum, voiding symptoms, dysmenorrhea, constipation, self-catheterization, operative time, length of hospital stay
- MeSH terms
- Adult, Constipation, Dysmenorrhea, Endometriosis, Female, Humans, Intraoperative Period, Italy, Laparoscopy, Postoperative Period, Rectum, Retrospective Studies, Ureter, Prevalence, Treatment Outcome, Young Adult
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