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Uterine Morcellation in Hysterectomy--A Warning


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Amy Reed, the subject of this article, is my sister's friend. Amy's husband, Hooman, and my sister's husband went to med school together at the University of Pennsylvania. My sister has been very active in helping Amy in the fight to end uterine morcellation. Even if you don't read the linked article, please know that the uterine morcellation procedure that is sometimes used during a hysterectomy can spread cancer throughout a woman's body, leaving her with very little chance of survival. 

 

http://www.bostonglobe.com/lifestyle/health-wellness/2013/12/17/boston-surgeon-and-physician-wife-push-stop-common-procedure-they-say-worsened-her-cancer/UYUCIz92mtQ0RXVBl3FF1L/story.html

 

If you feel inclined to do so, please sign the petition at Change.org to end uterine morcellation.

 

http://www.change.org/petitions/women-s-health-alert-deadly-cancers-of-the-uterus-spread-by-gynecologists-stop-morcellating-the-uterus-in-minimally-invasive-and-robot-assisted-hysterectomy#share

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I've been reading about uterine morcellation and had already decided not to have laparoscopic surgery if I have to undergo hysterectomy for my uterine fibroids. Thanks for the link...

 

I've always thought that laparascopic hysterectomy is risky, because a fair number of uterine cancer escapes detection until hysterectomy.

 

There is a similar issue with D&C, which is commonly used to screen for EC/UC, because blood and tissue can backflow through the fallopian tubes and seed the abdominal cavity. However, it has a higher rate of cancer detection than endometrial biopsy, so it's kind of a catch-22 situation.

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Given how quick doctors are to make large abdominal incisions to perform a c-section, I am surprised they are so hesitant to make an incision for a hysterectomy. Seems to me the incision would be a lot smaller--a non-pregnant uterus is much smaller than a full-term baby!

 

thank you for sharing, I was not aware of this issue.

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Given how quick doctors are to make large abdominal incisions to perform a c-section, I am surprised they are so hesitant to make an incision for a hysterectomy. Seems to me the incision would be a lot smaller--a non-pregnant uterus is much smaller than a full-term baby!

 

thank you for sharing, I was not aware of this issue.

With fibroids (a common reason for hysterectomies), the incisions can be larger.  My myomectomy scar is hip to hip from the size of the fibroid.  It was supposed to be a normal 1-2" lapy scar. 

 

I agree with you, but I see why they prefer laparoscopy.  There is less issues with scar tissue.  Mine is pretty bad with adhesions. 

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I was just thinking about this the other day.  I have a friend who had several benign ovarian tumors removed via lap surgery.  She had morcellation done, I just didn't know what it was called.  As I face a possible abdominal surgery if PT isn't successful, I was pondering the chances of spreading unknown tumors.  (Yeah, I ponder strange things.)

 

I remember 1990-1991 when Martha Sears presented a session at the national LLL and concurrent ILCA conference in Miami, FL on the resent research re. timing of cancer surgeries in women relative to their menstrual cycles, research which indicated that there was a big difference in survival if surgeries were performed during one part of the woman's cycle vs. another.  Her concern was that LCs would come in contact with a number of women facing health crises, and that LCs should be able to pass on life-saving information that they might not hear from their doctors. 

 

ETA: thank you for posting this, Tara.  May God preserve Amy's life.

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I was under the assumption that most hysterectomies were vaginal. That sounds like a better option for most cases, but I don't know enough about it or have experience in that area so I may be wrong. What a sad story. They need to educate patients better before asking consent of what they are doing.

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:huh: Just watched the linked video of  a hysterectomy.  Even though the uterus was taken out through the vagina, morcellation was used to make it easier to get through the vagina due to large fibroids.  

 

I have never heard of morcellation.  I'm a bit stunned at the moment but so glad to have this information.

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I have been reading quite a lot about uterine morcellation and actual risk of seeding cancer into the abdominal cavity. While the actual risk is quite small, and the recovery time for abdominal hysterectomy signifiicantly longer, I will still most likely choose not to have any procedure that involves morcellation. There are work around procedures such as bagging the uterus and removing it through the vagina, but a diseased/sick uterus is often too large to do so. Sorry I don't have links; it's too close to nap time, but I will post some later today.

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No amount of risk would be worth that to me.  That's crazy! 

 

What are the usual reasons for hysterectomy?  Does anyone know?  It seems, except maybe until more recently, that everyone got hysterectomies.  I just wonder why.  As I said, I had a doc suggest it and I said no way.  In my case I think the risks outweigh the benefits.

Aside from cancer, there are several common reasons for hysterectomy: 1. Fibroid tumours, which are benign growths made of smooth muscle tissue that grow inside or ouside of the uterus and can get very large and cause heavy bleeding; adenomyosis, which is endometrial tissue that grows into the uterine wall, endometriosis, hyperplasia with atypia, which is a precancerous condition where the cells of the endometrial lining in the uterus have undergone changes which greatly increase the likilihood of cancer; women who have the bcra1 and bcra2 genes are recommended to have complete hysterectomies because their likelihood of cancer is very high, and women with Lynch syndrome, which I cannot remember off the top of my head but I think involves carrying genes different than bcra1/2 but also increases risk for uterine cancer. There are other reasons for hysterectomy, but these are the main ones I can remember right now. :o

 

 

SparklyUnicorn, did you say your mom died of ovarian cancer? First of all, I am sorry. :( If you haven't undergone genetic testing, I would recommend doing very thorough research of family history, specifically regarding various types of cancer deaths that might indicate you possess either the bcra genes or Lynch syndrome. Also, perhaps familiarize yourself with the very subtle symptoms of ovarian cancer and make sure you get regular ultrasounds and CA125 blood marker tests. You may already be doing all these things, but if not, please consider it.

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