Progression of pelvic implants to complex atypical endometrial hyperplasia after uterine morcellation
Abstract
BACKGROUND: Supracervical hysterectomy, a surgical technique that involves removal of the uterus while preserving the cervix, places women at an increased risk for future morbidity. CASE: The patient presented 7 years after laparoscopic supracervical hysterectomy for benign disease, with pelvic pain, urinary frequency, abdominal bloating, and tenderness. Surgical exploration revealed myometrial implants, along with a larger mass on the mesentery of the sigmoid composed of endometrium with complex atypical hyperplasia in a patient without a prior history of complex atypical hyperplasia. The patient was symptom-free 6 months postoperatively. CONCLUSION: Histology found during reoperation after laparoscopic supracervical hysterectomy includes endometriosis, residual endometrium, and leiomyomas. In this case, a woman with no prior history of endometrial atypia later developed complex adenomatous endometrial hyperplasia in a peritoneal implant. This finding adds to the list of possible complications after laparoscopic-assisted supracervical hysterectomy and uterine morcellation.
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After hysterectomy, iatrogenic endometriosis is reported to occur at an incidence of 1.4 percent.
“while after hysterectomy, IE is reported to occur at an incidence of 1.4 percent [13,14].”
From Challenges in Diagnosis and Prevention of Iatrogenic Endometriosis as a Long-Term Surgical Complication after C-Section (2022) · cites this paper as [13]
Existing evidence describes symptom onset of iatrogenic endometriosis after c-section occurring anytime between the first menstruation after surgery and seven years following surgery.
“The existing evidence describes patients with symptom onset of iatrogenic endometriosis after c-section occurring anytime between the first menstruation after surgery and seven years following surgery”
From Challenges in Diagnosis and Prevention of Iatrogenic Endometriosis as a Long-Term Surgical Complication after C-Section (2022) · cites this paper as [13]
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- Authors
- Kill, L. M., Kapetanakis, V., McCullough, A. E., & Magrina, J. F.
- Affiliations
- Mayo Clinic in Arizona (US)
- Venue
- Obstetrics & Gynecology
- Published
- 2011-02
- Volume
- 117
- Issue
- 2
- Pages
- 447-449
- ISSN
- 0029-7844 (ISSN-L)
- OpenAlex
- W2329544695
- Cited by
- 38
- References
- 10
- Citations by year
- 2025: 1 · 2022: 2 · 2020: 4 · 2018: 5 · 2017: 1 · 2016: 3 · 2015: 4 · 2014: 8 · 2013: 8 · 2012: 1
- FWCI
- 7.41
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Obstetrics and Gynecology (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Health Sciences › Medicine › Obstetrics and Gynecology › Uterine Myomas and Treatments
- Health Sciences › Medicine › Obstetrics and Gynecology › Endometrial and Cervical Cancer Treatments
- Health Sciences › Medicine › Reproductive Medicine › Endometriosis Research and Treatment
- Keywords
- uterine morcellation, subtotal hysterectomy, endometriosis, postoperative complications, laparoscopic hysterectomy, leiomyoma
- MeSH terms
- Endometrial Hyperplasia, Endometriosis, Female, Humans, Hysterectomy, Leiomyoma, Middle Aged, Uterine Neoplasms, Treatment Outcome, Prostheses and Implants
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