A Statement on Power Morcellation

Power morcellation, a procedure that uses a morcellator to break up large uterine fibroids or an enlarged uterus before removing them through small incisions, was used on 50,000 women each year until just a few months ago. Since December 2013, the FDA has seen over two dozen incidences of cancer being spread by using the powerful medical device. These reports feature women who have no previous history of the disease, and the results may have revealed a serious threat to women’s health.

Given these circumstances, the FDA strongly recommended that only a certain small segment of the population be given the option to have power morcellation. Because the risks of having pieces of cancer-laden fibroids spread throughout the body increases with age, the FDA approved the use of this technique only in young women who have no prior history or risk factors for having cancer. The agency banned its use in women who are menopausal or beyond as well as those women who are able to have their uterus removed via a small incision or through the vagina.

Until this ban, many women who had bothersome symptoms associated with uterine fibroids such as frequent urination, pelvic pain and pressure, and extended periods of heavy bleeding chose to have them removed using a power morcellator while undergoing a laparoscopic myomectomy or hysterectomy. The appeal of using such as procedure as opposed to an abdominal hysterectomy or myomectomy is that women have a significantly lower risk of infection as well as a reduced recovery time after the surgery.

A well-known surgeon in Boston, Dr. Hooman Noorchashm, was the first to notify the FDA about the issue due to his wife’s end-stage cancer that appeared after she underwent morcellation. He believes this partial ban on power morcellation is not enough. Because Noorchashm’s wife still would have undergone morcellation under the newest guidelines, the surgeon does not believe that the ban goes far enough to protect women such as the one-in-350 women whose fibroids did not show signs of cancer until they were removed.

The ban does not mean that women with uterine fibroids are without options, however. In fact, there are a number of procedures that are still open to women who are in the high risk category for power morcellation. There are still options other than a traditional abdominal hysterectomy and myomectomy, including a mini-laparoscopic procedure, a laparoscopic procedure that does not use a power morcellation or a vaginal hysterectomy.

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