{"paper_id":"167baab5-049b-431c-b008-5f0ae2ddfc95","body_text":"Abstract\nThe lateral compartment of endometriosis is estimated to be lower than 15% but considered as a critical location of endometriosis for symptoms and complications. The anatomy of this compartment is complex and includes the anterolateral parametrium, mediolateral parametrium, and posterolateral parametrium (i.e., the sacrorectal septum, also known as the visceral pelvic fascia). It may involve multiple structures, such as the ureter, uterine artery, hypogastric artery and nerves, and inferior hypogastric plexus (or pelvic plexus). Therefore, the description of this location is crucial to inform patients undergoing surgery of the necessity of a resection such as parametrectomy, which is associated with a high risk of postoperative complications: ureteral injury causing the possibility of ureteral fistula and/or urinary or anorectal dysfunction due to nerve injury.\nIn this chapter, we will describe the classical anatomy but also the surgical anatomy, explaining potential discrepancies caused by surgical dissection. We will then present radiological definitions and imaging aspects. Finally, radiosurgical correlations will allow us to better understand the surgical impacts of radiological descriptions and the need for a reproductive classification for lateral endometriosis. These radiological descriptions are critical to give patients adequate information on their disease and, if needed, preoperative risks and personalized treatment counseling.\nAccess this chapter\nTax calculation will be finalised at checkout\nPurchases are for personal use only\nSimilar content being viewed by others\nReferences\nBazot M, Jarboui L, Ballester M, Touboul C, Thomassin-Naggara I, Daraï E. The value of MRI in assessing parametrial involvement in endometriosis. Hum Reprod. 2012;27(8):2352–8. https://doi.org/10.1093/humrep/des211.\nThomassin-Naggara I, Monroc M, Chauveau B, et al. Multicenter external validation of the deep pelvic endometriosis index magnetic resonance imaging score. JAMA Netw Open. 2023;6(5):e2311686. https://doi.org/10.1001/jamanetworkopen.2023.11686.\nBallester M, Santulli P, Bazot M, Coutant C, Rouzier R, Daraï E. Preoperative evaluation of posterior deep-infiltrating endometriosis demonstrates a relationship with urinary dysfunction and parametrial involvement. J Minim Invasive Gynecol. 2011;18(1):36–42. https://doi.org/10.1016/j.jmig.2010.08.692.\nTouboul C, Fauconnier A, Zareski E, Bouhanna P, Daraï E. The lateral infraureteral parametrium: myth or reality? Am J Obstet Gynecol. 2008;199(3):242.e1–6. https://doi.org/10.1016/j.ajog.2008.04.003.\nHöckel M, Horn L-C, Fritsch H. Association between the mesenchymal compartment of uterovaginal organogenesis and local tumour spread in stage IB-IIB cervical carcinoma: a prospective study. Lancet Oncol. 2005;6(10):751–6. https://doi.org/10.1016/S1470-2045(05)70324-7.\nErcoli A, Delmas V, Fanfani F, et al. Terminologia Anatomica versus unofficial descriptions and nomenclature of the fasciae and ligaments of the female pelvis: a dissection-based comparative study. Am J Obstet Gynecol. 2005;193(4):1565–73. https://doi.org/10.1016/j.ajog.2005.05.007.\nCeccaroni M, Clarizia R, Roviglione G. Nerve-sparing surgery for deep infiltrating endometriosis: laparoscopic eradication of deep infiltrating endometriosis with rectal and parametrial resection according to the Negrar method. J Minim Invasive Gynecol. 2020;27(2):263–4. https://doi.org/10.1016/j.jmig.2019.09.002.\nSanguin S, Roman H, Foulon A, Gondry J, Havet E, Klein C. Deep infiltrating endometriosis with sacral plexus involvement: improving knowledge through human cadaver dissection. J Gynecol Obstet Hum Reprod. 2021;50(8):102129. https://doi.org/10.1016/j.jogoh.2021.102129.\nRibeiro-Julio GS, Pereira JA, Ribeiro E, Gallo CM, Favorito LA. Anatomy of the lower hypogastric plexus applied to endometriosis: a narrative review. Int Braz J Urol. 2023;49(3):299–306. https://doi.org/10.1590/S1677-5538.IBJU.2022.9980.\nThomassin-Naggara I, Lamrabet S, Crestani A, et al. Magnetic resonance imaging classification of deep pelvic endometriosis: description and impact on surgical management. Hum Reprod. 2020;35(7):1589–600. https://doi.org/10.1093/humrep/deaa103.\nDe Cicco C, Schonman R, Craessaerts M, Van Cleynenbreugel B, Ussia A, Koninckx PR. Laparoscopic management of ureteral lesions in gynecology. Fertil Steril. 2009;92(4):1424–7. https://doi.org/10.1016/j.fertnstert.2008.08.021.\nYabuki Y, Sasaki H, Hatakeyama N, Murakami G. Discrepancies between classic anatomy and modern gynecologic surgery on pelvic connective tissue structure: harmonization of those concepts by collaborative cadaver dissection. Am J Obstet Gynecol. 2005;193(1):7–15. https://doi.org/10.1016/j.ajog.2005.02.108.\nRousset P, Florin M, Bharwani N, et al. Deep pelvic infiltrating endometriosis: MRI consensus lexicon and compartment-based approach from the ENDOVALIRM Group. Diagn Interv Imaging. 2023;104:95–112.\nGuerriero S, Condous G, Rolla M, et al. Addendum to the consensus opinion from the international deep endometriosis analysis (IDEA) group: sonographic evaluation of the parametrium. Ultrasound Obstet Gynecol. 2024;64:275–80. https://doi.org/10.1002/uog.27558.\nMariani LL, Mancarella M, Novara L, Biglia N. Sonographic features of endometriosis infiltrating the lateral parametrium. J Gynecol Obstet Hum Reprod. 2021;50(7):102116. https://doi.org/10.1016/j.jogoh.2021.102116.\nGuerriero S, Martinez L, Gomez I, et al. Diagnostic accuracy of transvaginal sonography for detecting parametrial involvement in women with deep endometriosis: systematic review and meta-analysis. Ultrasound Obstet Gynecol. 2021;58(5):669–76. https://doi.org/10.1002/uog.23754.\nAuthor information\nAuthors and Affiliations\nCorresponding author\nEditor information\nEditors and Affiliations\nRights and permissions\nCopyright information\n© 2025 The Author(s), under exclusive license to Springer Nature Switzerland AG\nAbout this chapter\nCite this chapter\nTouboul, C., Thomassin-Naggara, I., Dabi, Y., Darai, E., Rousset, P. (2025). Antero-, Medio-, and Posterolateral Compartments: Parametrium. In: Thomassin-Naggara, I. (eds) Imaging of Endometriosis: A Comparative Guide of US, MRI and Surgery. Springer, Cham. https://doi.org/10.1007/978-3-031-82750-1_10\nDownload citation\nDOI: https://doi.org/10.1007/978-3-031-82750-1_10\nPublished:\nPublisher Name: Springer, Cham\nPrint ISBN: 978-3-031-82749-5\nOnline ISBN: 978-3-031-82750-1\neBook Packages: MedicineMedicine (R0)","source_license":"CC0","license_restricted":false}