1803 Post Morcellation Endometriosis: Is it Real?

Abstract

Study Objective To describe the clinical characteristics of patients diagnosed with endometriosis following laparoscopic supracervical hysterectomy (LSH) with uncontained power morcellation. Design A systematic retrospective chart review was performed. The clinical presentation and histopathology were reviewed in each case for the incident and subsequent procedures. The menstrual phase at the time of LSH was determined from the pathology reports. Descriptive statistics were performed for the cohort. Setting N/A. Patients or Participants Patients who underwent LSH with uncontained power morcellation at Kaiser Permanente Southern California Medical Centers between 2006-2013. From a total of 47,010 hysterectomies, 5154 were LSH with uncontained power morcellation. We focused on the 261 LSH patients who then underwent a subsequent surgery. Interventions N/A. Measurements and Main Results The mean age and BMI of patients undergoing second surgery were 43.2 yrs. ± 0.8 and 29.4±0.7 respectively. Of the 261 patients who underwent subsequent surgery, a pathological diagnosis of endometriosis was confirmed in 58 patients: this was a new diagnosis in 93% (54/58). Patients with endometriosis were more likely to present with new onset pelvic pain and a mass (p Conclusion Morcellation seems to contribute to the development of endometriosis in some patients through an unknown mechanism. While uncontained power morcellation is no longer a common clinical scenario, it may still be necessary to consider that manual morcellation has potentially adverse consequences. Further study of the sequelae of non-power morcellation is warranted.