Parametrial Endometriosis: The Occult Condition that Makes the Hard Harder

Mohamed Mabrouk, Mabrouk M, Diego Raimondo, Alessandro Arena, Arena A, Raffaella Iodice, Iodice R, Michele Altieri, Sutherland N, Neveta Sutherland, Paolo Salucci, Salucci P, Moro E, Elisa Moro, Renato Seracchioli
Journal of minimally invasive gynecology · 2018 · vol. 26(5) , pp. 871–876 · doi:10.1016/j.jmig.2018.08.022 · PMID:30176361 · W2889317961
article OA: closed CC0 ⤵ 42 in-corpus citations
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⚙ AI-generated summary by claude@2026-06, 2026-06-07 ⓘ

This paper discusses parametrial endometriosis, a less commonly recognized form of endometriosis that can complicate gynecological surgeries.

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Abstract

Study objectiveDespite 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.DesignRetrospective cohort study (Canadian Task Force classification II-2).SettingEndometriosis tertiary level referral center, Sant'Orsola Academic Hospital, Bologna, Italy.PatientsWe 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.InterventionWe retrospectively compared data records on the demographic features, preoperative data, and surgical outcomes of the 2 groups.Measurements and main resultsThe 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).ConclusionsLPE is a condition that reflects a more severe manifestation of endometriosis, requiring more aggressive surgery.

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Condition tags

dysmenorrheaendometriosis

MeSH descriptors

Constipation Dysmenorrhea Endometriosis Laparoscopy Ureter Adult Constipation Dysmenorrhea Endometriosis Female Humans Intraoperative Period Italy Laparoscopy Postoperative Period Prevalence Rectum Rectum Retrospective Studies Treatment Outcome

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