Morcellation with Hysterectomy May Spread More Than Cancer

Johns Hopkins researchers recently published information that may increase the number of women who experience complications from morcellation with hysterectomy procedures. The January issue of Obstetrics and & Gynecology details the accounts of three women who submitted to laparoscopic hysterectomy morcellation, ultimately resulting in benign uterine diseases rather than having cancer spread throughout the bodies.

Recently, both patients and the medical community have raised concerns on morcellator complications that may spread uterine cancers that were previously contained in the uterus.

Power morcellators are used to remove uterine fibroids during myomectomy and laparoscopic hysterectomy procedures. Using the device, doctors make a small incision in the abdomen to cut up the uterus or fibroids. Consequently, the tissue is removed through the incision, allowing the patient to enjoy a variety of benefits, including a reduced recovery period, smaller scars and a lower risk of complications, including infections.

Morcellation with hysterectomy risks

Approximately one in 350 women who undergo laparoscopic hysterectomy morcellation to remove uterine fibroids may also unknowingly have sarcoma ─ a type of cancer that can occur in various parts of the body. Doctors are unable to detect or diagnose sarcoma prior to surgery, so many experts have voiced their concerns that power morcellators should no longer be used, due to the high risk of causing the uterine cancer to spread throughout the body.

The new reports from Johns Hopkins researchers imply that power morcellators may pose a risk beyond cancer, having the ability to spread benign diseases that may cause a host of other complications, such as tumor growths.

One of the three cases examined by researchers was that of a 36-year-old mother of four. Numerous soft tissue tumors were found in the woman’s body that had developed after she underwent a laparoscopic hysterectomy. There were so many tumors in her body that her doctors were forced to remove parts of her colon, diaphragm, ovaries, spleen and other organs.

Another case highlight by the Johns Hopkins team was that of a 51-year-old mother of two. After her power morcellation hysterectomy, the woman suffered from nausea, abdominal pain and vomiting. Doctors discovered she had developed a bowel obstruction and a tumor in her pelvis that ultimately resulted in the need to remove her fallopian tubes and right ovaries.

Finally, the third woman ─ another 51-year-old mother of two ─ had developed a 15 centimeter abdominal tumor that attached itself to her bladder, ureters, omentum, colon, fallopian tube and left ovary. All of these organs had to be resectioned to get rid of the tumor, as it caused her to experience painful urination, abdominal pain and pelvic pressure.

FDA warns of power morcellator risks

On November 24, 2014, the FDA released an updated warning on the use of power morcellators in hysterectomy and myomectomy.

“Because of this risk and the availability of alternative surgical options for most women, the FDA is warning against the use of laparoscopic power morcellators in the majority of women undergoing myomectomy or hysterectomy for treatment of fibroids,” stated the FDA.

“Limiting the patients for whom laparoscopic morcellators are indicated, the strong warning on the risk of spreading unsuspected cancer, and the recommendation that doctors share this information directly with their patients, are part of FDA guidance to manufacturers of morcellators,” continued the FDA. “The guidance strongly urges these manufacturers to include this new information in their product labels.”

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