This article presents an investigation of a series of 95 patients who have undergone laparoscopically assisted radical vaginal hysterectomy at the University of Lille since 1991. In 1996, this technique was modified to include laparoscopic paracervical lymphadenectomy. This change in technique presents the opportunity to study the results of this procedure in 47 women who did, and 48 women who did not, undergo paracervical dissection at the time of modified radical vaginal hysterectomy. Paracervical lymphatic dissection is performed between the anterior and posterior faces of the cardinal ligament. Dissection continues from the superior edge to the lateral rectal ligament and pelvic floor while carefully avoiding the vaginal and inferior vesical arteries, deep uterine veins, vaginal and vesical veins, and hypogastric plexus. After exposure of the cardinal ligament, a 2 cm X 1.5 cm portion is excised to facilitate removal of the cellular tissue surrounding the pudendal and gluteal vessels and the lumbosacral trunk. The average length of follow up was 41 months for the women who did not and 26 months for those who did undergo paracervical dissection. Sixty of the 95 patients, including 28 in the group without and 32 in the group with paracervical lymphadenectomy, were available to complete a questionnaire concerning the impact of their surgery on incontinence and urogenital symptoms. There were no differences in the clinical characteristics or operative data of the two groups. Tumors were less than 2 cm in size in 43 women without and 38 with paracervical dissection. Similar numbers of interiliac nodes (18 and 19) were removed from both groups of patients. The women who underwent paracervical lymphadenectomy had an average of six nodes removed, although no nodes were present at all in some cases. Only one positive node was found, this in one patient whose tumor was larger than 2.5 cm. The women who underwent paracervical lymphatic dissection had significantly longer periods of postoperative urinary retention compared with those who did not. However, long-term urologic results were similar in both groups. Fourteen percent of the women who did not and 12.5% of those who did undergo paracervical dissection reported no long-term urinary symptoms. Thirty-five percent (n = 21) of all patients had continued dysuria, with no patient requiring catheterization and 11 women having only occasional symptoms. Stress incontinence was reported by 59% (n = 35) of the total group. Four women experienced permanent incontinence, and 31 had mild or moderate symptoms requiring one or two pads per day. Nocturnal polyuria and urgency were each reported by 57% of patients. Seven women were awakened three times per night and 29 got up one or two times. Urgency symptoms ranged from less than one episode a day for 16 patients, one a day for 10 patients, more than once a day for three women. Among the patients who had received radiation therapy, the distribution of urinary symptoms was similar to those who had not. Only 1 of the 81 women whose tumor size was less than 2 cm had a recurrence. She was from the group without paracervical dissection and had no known risk factors. In comparison, 6 of the 14 women with tumors greater than 2 cm experienced a recurrence. Of the 12 patients with tumors ranging from 2.0 cm to 3.9 cm, there were three in the group without and one in the group with paracervical lymphadenectomy who recurred. Both of the women with tumor 4 cm or greater recurred.