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Home E-Weekly August 30, 2016

Morcellation Decline Hasn't Raised Complication Rates

Published: August 29, 2016

There's good news and bad news regarding the FDA's controversial warnings about using power morcellation in hysterectomies. The good news is that although fewer women are having minimally invasive hysterectomies, the overall complication rate hasn't changed, a new study finds.

The bad news is that even though morcellation is being used with far fewer women — the number has decreased from about 14% to about 3% — there's been no corresponding reduction in the prevalence of uterine cancer.

In 2014, amid a swirl of controversy, the FDA began issuing safety communications about power morcellation, which can spread undetected cancer. Eventually the FDA issued a black box warning recommending that morcellation not be used in peri-menopausal and post-menopausal women, or with any women suspected of having cancer.

Since then, many have expressed concern that the trend would result in an uptick in more invasive procedures and a corresponding increase in infections and other serious complications. Although, the proportion of women having minimally invasive procedures has declined since 2014 (from 60% to 56%), the overall complication rate has stayed the same (8.3% versus 8.4%).

But in women who've undergone morcellation since then, the rate of uterine cancer, endometrial hyperplasia, other gynecologic cancers, and uterine tumors, hasn't changed — a finding that "highlights the difficulty in the preoperative detection of uterine pathology," say the authors.

Jim Burger

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