Know the Risks of Your Uterine Fibroid Surgery

Electromechanical morcellation in myomectomy did not raise uterine cancer risk, but older patients may have a raised risk

(RxWiki News) Not all patients face the same risks from the same surgeries. Such is likely the case with surgeries to remove benign uterine tumors.

A recent study found that electromechanical morcellation (EMM) use during a myomectomy had little effect on adverse outcomes like cancer. Older patients undergoing this surgery may face a raised cancer risk, however.

A myomectomy is a surgical procedure to remove a benign uterine tumor. An EMM tool is sometimes used during the procedure to break up tissue, but the use of EMM has been questioned.

Lead study author Jason D. Wright, MD, of the Department of Obstetrics and Gynecology at Columbia University in New York City, and colleagues wrote that "The frequency of use of electric power morcellators for gynecologic surgery first increased rapidly with a relative lack of data and then abruptly decreased after an adverse outcome in a young woman. These events highlight the difficulty of evaluating, using and marketing surgical devices."

Uterine fibroids can cause a variety of symptoms, such as heavy menstrual bleeding and discomfort. There are some noninvasive treatments, but surgery is sometimes the best option. A myomectomy is often preferred over a hysterectomy (removal of the entire uterus) to preserve fertility.

To study the risks of using EMM, Dr. Wright and team looked at the outcomes of myomectomies with and without EMM. Nearly 42,000 women were included in this study. Of these, more than 3,200 had EMM used in their procedure. These procedures took place from 2006 to 2012.

Uterine cancer occurred in 0.19 percent of women who underwent myomectomy without EMM (1 in 528). It occurred in 0.09 percent of women with EMM (1 in 1,073).

"The prevalence of cancers and precancerous abnormalities of the uterus in women who undergo myomectomy with or without electric power morcellation is low overall, but risk increases with age," rather than EMM use, Dr. Wright and team wrote.

Dr. Wright and team said doctors should use EMM with caution in older women.

This study was published online Feb. 19 in JAMA Oncology.

National Cancer Institute grants and a fellowship funded this research. Dr. Wright and team disclosed no conflicts of interest.

Review Date: 
February 19, 2015