Hysterectomy Procedure May Have Added Risk

Uterine tumor risk was higher for older women during morcellation procedure

/ Author:  / Reviewed by: Joseph V. Madia, MD Beth Bolt, RPh

(RxWiki News) Many women choose to undergo morcellation when they get a hysterectomy, a minimally invasive procedure in which the uterus is divided into pieces and removed. However, for some women, the procedure may come with added risks.

Researchers used data from hospital visits to determine how frequently surgeons discovered uterine tumors during morcellation procedures. These researchers found that uterine tumors identified during these procedures were relatively rare, but the risk increased among older women.

The authors of this study suggested that doctors counsel women about cancerous and precancerous conditions before undergoing morcellation.

"Learn the risks associated with morcellation and other procedures."

Jason D. Wright, MD, of the Columbia University College of Physicians and Surgeons, and colleagues conducted this study.

Some medical professionals have raised concerns that morcellation allows cancer-causing tumors to spread undetected.

This study attempted to determine how common malignancies were among women undergoing hysterectomies through morcellation.

The researchers used an insurance database of more than 500 hospitals to identify 232,882 women who had minimally invasive hysterectomies between 2006 and 2012. Of those women, 15.7 percent, or 36,470, underwent morcellation.

The researchers identified 99 cases in which uterine cancer was discovered during the procedure. In other words, the researchers found uterine cancer 27 times per 10,000 women undergoing morcellation.

Additionally, 26 other malignancies and 368 cases of endometrial hyperplasia (excessively thick lining of the uterus) were found.

The researchers also found that the prevalence of uterine malignancies increased with age.

Compared to women who were younger than 40, women aged 50 to 54 were 4.97 times more likely to have a uterine malignancy. Women who were 65 or older were 35.97 times more likely to have a uterine malignancy.

The researchers concluded that uterine cancers occurred among some women undergoing morcellation. They noted that the prevalence of uterine malignancies was significantly higher among older women.

The authors of this study suggested that patients considering morcellation should talk with their doctors about risks.

This study was published online July 22 in JAMA.

The research was funded by grants from the National Cancer Institute. The authors disclosed no conflicts of interest.

Review Date: 
July 21, 2014
Last Updated:
July 24, 2014