Obstetrical outcomes after transvaginal natural orifice transluminal endoscopic surgery for benign gynecological conditions: a prospective cohort study.

Dan Feng, Tianjiao Liu, Zhuangzhuang Li, Jiaxin Chen, Li He, Yonghong Lin

Abstract read

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Article in Surgical endoscopy, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

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5 · Who and what money

Authors and funding

6 authors.

Dan Feng *Department of Gynecology, School of Medicine, Chengdu Women's and Children's Central Hospital, University of Electronic Science and Technology of China, No. 1617, Riyue Avenue, Chengdu, 610091, Sichuan, People's Republic of China.

Tianjiao Liu *Department of Gynecology, School of Medicine, Chengdu Women's and Children's Central Hospital, University of Electronic Science and Technology of China, No. 1617, Riyue Avenue, Chengdu, 610091, Sichuan, People's Republic of China.ORCID http://orcid.org/0000-0001-8279-5924

Zhuangzhuang Li *Department of Gynecology, School of Medicine, Chengdu Women's and Children's Central Hospital, University of Electronic Science and Technology of China, No. 1617, Riyue Avenue, Chengdu, 610091, Sichuan, People's Republic of China.

Jiaxin Chen *Department of Gynecology, School of Medicine, Chengdu Women's and Children's Central Hospital, University of Electronic Science and Technology of China, No. 1617, Riyue Avenue, Chengdu, 610091, Sichuan, People's Republic of China.

Li He *Department of Gynecology, School of Medicine, Chengdu Women's and Children's Central Hospital, University of Electronic Science and Technology of China, No. 1617, Riyue Avenue, Chengdu, 610091, Sichuan, People's Republic of China.

Yonghong LinDepartment of Gynecology, School of Medicine, Chengdu Women's and Children's Central Hospital, University of Electronic Science and Technology of China, No. 1617, Riyue Avenue, Chengdu, 610091, Sichuan, People's Republic of China. linyhcd2011@163.com.

Funding

Chengdu High-level Key Clinical Specialty Construction Project 2021215the Fifth Round of the Chengdu Municipal Science and Technology Research Program 2021-YF05-00627-SNthe Japan-China Sasakawa Medical Fellowship Program 4408

6 · The paper itself

Abstract

backgroundTransvaginal natural orifice transluminal endoscopic surgery (vNOTES) is increasingly used for benign gynecologic conditions; however, evidence regarding subsequent obstetrical outcomes and the optimal interval between surgery and conception remains limited. This study aimed to evaluate pregnancy outcomes after fertility-preserving vNOTES and to assess whether the postoperative interval influences the risk of adverse outcomes.

methodsThis prospective cohort study included 326 women who conceived after fertility-preserving vNOTES performed for benign gynecological diseases with cosmetic considerations between April 2022 and June 2024, along with 326 matched controls without a history of vNOTES during the same period. Post-vNOTES pregnancies were stratified by the interval from surgery to conception (≤ 3, 3-6, and > 6 months). Obstetrical outcomes, including delivery mode, gestational age, neonatal birth weight, maternal complications, preterm birth, and neonatal asphyxia, were compared. Multivariable logistic regression was performed to identify independent risk factors for preterm birth and neonatal asphyxia.

resultsBaseline characteristics were generally comparable, although the control group had higher parity and more prior cesarean deliveries (both p < 0.001). The distribution of surgical indications differed across interval groups (p < 0.001). The vNOTES group had higher rates of assisted reproductive technology and twin pregnancies (both p < 0.001). No significant differences were observed between groups in delivery mode, gestational age at birth, neonatal birth weight, or maternal complications. In regression analyses, twin pregnancy was independently associated with preterm birth (HR 11.736, p < 0.001) and neonatal asphyxia (HR 29.302, p = 0.019), while lower gestational age was also associated with neonatal asphyxia (HR 0.863, p = 0.018). The interval between vNOTES and conception was not associated with adverse outcomes.

conclusionsPregnancy outcomes following vNOTES are comparable to those without prior vNOTES. Early conception after vNOTES does not appear to increase the risk of adverse obstetrical outcomes, supporting vNOTES as a safe fertility-preserving surgical approach without the need for prolonged delay before conception.

trial registrationChiCTR2200059282, registered on April 28, 2022 ( https://www.chictr.org.cn/showproj.html?proj=167900 ).

Indexed as

Genital Diseases, FemaleNatural Orifice Endoscopic SurgeryPregnancy OutcomeAdultFemaleHumansInfant, NewbornPregnancyPremature BirthProspective StudiesFertility preservationMinimally invasive surgeryNeonatal asphyxiaPregnancy outcomesPreterm birthvNOTES

Identifiers

PMID42443682

DOI10.1007/s00464-026-13124-6

What OpenQuestion holds

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.