The US Food and Drug Administration (FDA) is warning women and doctors about the risks of a certain technique used in surgery for uterine fibroids. The procedure, called laparoscopic power morcellation, uses a medical device to break uterine fibroids into small pieces, so they can be removed through a small incision in the abdomen. According to the FDA, if the woman also has uterine cancer, this procedure can risk spreading the cancer within the abdomen and pelvis, making it harder to treat.
Uterine fibroids are non-cancerous growths in the uterus. They are very common and often do not cause symptoms. However, fibroids sometimes do cause problems such as heavy or prolonged menstrual bleeding, pelvic pressure or pain, and frequent urination. If these symptoms are severe enough, the fibroids may need to be treated.
One option has been surgery to remove the uterus (hysterectomy). One way to do this is through a large incision in the lower abdomen. Another option is to remove the uterus (or the fibroid) using laparoscopy, which only requires a few small incisions. The smaller incisions mean a much shorter recovery time for the patient. It may not be possible, though, to remove the uterus (or fibroid) through a small incision without first breaking it up into small pieces. In rare cases, a doctor may discover after the procedure that the woman doesn’t just have fibroids – she also has uterine sarcoma, a type of cancer. There is currently no reliable method for predicting whether a woman with fibroids may have uterine sarcoma.
The FDA looked at studies about the use of power morcellation to find out how often problems occur. They found that anywhere from 1 in 225 to 1 in 580 women treated for fibroids by having their uterus or fibroids removed was later found to have uterine sarcoma. Diagnosis was made when the tissue removed at surgery was examined under a microscope.
The FDA is discouraging the use of this procedure to treat fibroids in most women, and is urging women to discuss the risks and benefits with their doctor when choosing how to treat fibroids:
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