Authors Discuss Uterine Morcellation Risks, Alternatives

Progress in the debate on uterine morcellation (see the February 5, 2014, HRC Alerts) will require better definition of the risks of the procedure, evaluation of alternatives, communication of concerns, and systems to build an evidence base, write the authors of a viewpoint article published February 6, 2014, in the Journal of the American Medical Association. Tissue fragments can be dispersed into the peritoneal cavity and implant, possibly requiring surgical intervention. And although it is possible to screen for cervical and endometrial cancer preoperatively, no reliable methods exist for detecting uterine sarcomas before a procedure. In addition, risks of hidden uterine malignancy in women undergoing uterine procedures are hard to estimate because of the complexity and heterogeneity of the data.