Association of preoperative Enzian score with postoperative fertility in patients with deep pelvic endometriosis.

Introduction: Endometriosis is a chronic inflammatory disease with a negative impact on fertility. The Enzian classification provides a precise description of deep pelvic endometriotic lesions, especially in the retroperitoneal area, from preoperative pelvic MRI scans. However, it is not known if it is correlated with postoperative fertility.

Operative Technique and Experience of One Referral Center With Vaginal Cesarean Delivery.

Background: To report the experience of vaginal cesarean delivery and describe the surgical technique.

Method: This is a retrospective case series from one referral center of patients who underwent vaginal cesarean delivery from 2000 to 2017, presenting a step-by-step operative technique with a video. The operative technique consists of: 1) development of a transvaginal bladder flap by dissecting the bladder off the cervix, thereby exposing the lower uterine segment; 2) making a vertical segment incision up to the highest part of the lower uterine segment, just below the muscular portion of the uterus; 3) extraction of the fetus; and 4) reconstruction of the lower uterine segment and vagina.