{"paper_id":"4e27ff52-edcc-4352-bb04-3899df62d10b","body_text":"Abstract\nObjectives\nThis study sought to quantify the risks of urinary retention following different levels or degrees of nerve preservation during parametrectomies for deep endometriosis (DE).\nMethods\nWomen undergoing laparoscopic and robotic nerve-sparing DE surgeries were studied. The cases were divided into 6 groups according to the degree of preservation of parasympathetic parametrium fibers on each side: P1 (P1 left /P1 right—Excellent preservation: presacral and pararectal fascia bilateral preservation), P2 (P1/P2 or P2/P1, P2/P2—Regular preservation: fascia violation with local fat visualization—either of both sides; and P3 (P1/P3 or P3/P1, P2/P3 or P3/P2, P3/P3)—Poor preservation: musculature and pelvic floor exposure—even if only unilateral.\nResults\nOf a total of 151 women eligible for the study, 110 (72.8%) had excellent nerve preservation; 24 (15.8%) had regular nerve preservation, and 17 (11.2%) had poor-nerve preservation. The incidence of elevated PVR was higher in the P3 group. Thirty-five patients were catheterized post-operatively, more common in the P3 group. In four cases from the P3 group, prolonged intermittent self-catheterization after discharge was necessary. The calculated risk of needing intermittent catheterization in the P3 group was 23.1% up to 8 weeks and 7.7% up to 8 months post-surgery.\nConclusion\nParametrectomy with poor-nerve preservation can lead to urinary retention, even with excellent contralateral preservation.\nSimilar content being viewed by others\nData availability\nAll relevant data are within the paper and its Supporting Information files.\nAbbreviations\n- ASRM:\n-\nAmerican Society of Reproductive Medicine\n- DE:\n-\nDeep endometriosis\n- ESHRE:\n-\nEuropean Society of Human Reproduction and Embryology\n- IHP:\n-\nInferior hypogastric plexus\n- PVR:\n-\nPost-void residual urine\n- P1:\n-\nExcellent preservation\n- P2:\n-\nRegular preservation\n- P3:\n-\nPoor preservation\n- P1/P1:\n-\nExcellent preservation, left side and right side\n- P1/P2:\n-\nLeft excellent preservation and regular right preservation\n- P2/P1:\n-\nLeft regular preservation and excellent right preservation\n- P2/P2:\n-\nRegular preservation bilateral\n- P1/P3:\n-\nExcellent left preservation and poor right preservation\n- P3/P1:\n-\nPoor left preservation and excellent right preservation\n- P2/P3:\n-\nRegular left preservation and poor right preservation\n- P3/P2:\n-\nPoor left preservation and regular right preservation\n- P3/P3:\n-\nPoor preservation left and right\nReferences\nde Freitas Fonseca M, Aragao LC, Sessa FV, Dutra de Resende JA Jr, Crispi CP (2018) Interrelationships among endometriosis-related pain symptoms and their effects on health-related quality of life: a sectional observational study. 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The publication fee was funded by a grant from the Brazilian Ministry of Education: CAPES-PROAP grant number 001/2021 VPEIC to the Post-graduate Program in Applied Research of the Fernandes Figueira National Institute of Women, Children and Adolescents.\nAuthor information\nAuthors and Affiliations\nContributions\nAll authors contributed to the study conception and design. Material preparation, data collection and analysis were performed by Mauro Poggiali Gasparoni Junior. The first draft of the manuscript was written by Mauro Poggiali Gasparoni Junior; all co-authors commented on it and successive iterations. All authors read and approved the final manuscript. Gasparoni Jr MP, Fonseca MF, Resende Jr JAD: Manuscript writing/editing. Gasparoni Jr MP, Fonseca MF, Resende Jr JAD, Favorito LA: Protocol/project development. MP Gasparoni Jr, LA Favorito, AL Diniz, FH Gomes, MF Schuh: Data collection or management. MF Fonseca, LA Favorito, FS Salles: Data analysis.\nCorresponding author\nEthics declarations\nConflict of interest\nNone declared. None of the authors have any competing interest that could be perceived to bias this work. In the same way, there was no influence of any of the financial support in the results presented.\nEthical approval\nThe study was approved according to the ethical standards of the hospital’s institutional committee on experimentation with human beings [CAAE 31050120.2.0000.5259]. The study has also been registered in the Brazil Platform, maintained by the National Research Ethics Commission for Studies with Human Subjects, a commission of the National Health Council of the federal Ministry of Health. We affirm that all methods used in this study were carried out in accordance with relevant guidelines and regulation in compliance with the Declaration of Helsinki. Informed consent was obtained from all individual participants included in the study.\nConsent to participate\nInformed consent was obtained from all individual participants included in the study.\nAdditional information\nPublisher's Note\nSpringer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.\nRights and permissions\nSpringer Nature or its licensor (e.g. a society or other partner) holds exclusive rights to this article under a publishing agreement with the author(s) or other rightsholder(s); author self-archiving of the accepted manuscript version of this article is solely governed by the terms of such publishing agreement and applicable law.\nAbout this article\nCite this article\nGasparoni, M.P., de Freitas Fonseca, M., Favorito, L.A. et al. Unilateral nerve preservation during parametrectomy is not sufficient to prevent persistent urinary retention after cytoreductive endometriosis surgery. Arch Gynecol Obstet 310, 3267–3278 (2024). https://doi.org/10.1007/s00404-024-07842-2\nReceived:\nAccepted:\nPublished:\nVersion of record:\nIssue date:\nDOI: https://doi.org/10.1007/s00404-024-07842-2","source_license":"public-domain-us","license_restricted":false}