Parasitic Myomas and an Adenomyoma Obstructing the Ureter After Power Morcellation of Myomas and Endometriotic Nodule Resection

J Obstet Gynaecol Can. 2016 Apr;38(4):362-5. doi: 10.1016/j.jogc.2016.02.011. Epub 2016 Apr 23.

Abstract

Background: The use of power morcellation (PM) in abdominal and pelvic surgery has been discouraged and even banned in some institutions because of the risk of spreading malignant cells, although some authorities maintain that PM can be an appropriate tool for selected patients deemed to be at low risk of malignancy.

Case: A 42-year-old woman developed parasitic myomas and an adenomyoma obstructing the right ureter after laparoscopic excision of multiple myomas and deep infiltrating endometriosis using PM. Laparoscopic excision of the parasitic myomas and removal of the adenomyoma relieved the obstruction of the ureter.

Conclusion: Although there is reasonable concern about the use of PM spreading malignant disease, benign disease can also be spread by PM and can cause significant complications. Use of PM should be restricted as much as possible.

Keywords: Morcellation; adenomyosis; endometriosis; hydronephrosis; laparoscopy; leiomyoma.

Publication types

  • Case Reports

MeSH terms

  • Adenomyoma / complications*
  • Adenomyoma / surgery*
  • Adult
  • Endometriosis
  • Female
  • Humans
  • Laparoscopy*
  • Leiomyoma / complications*
  • Leiomyoma / surgery*
  • Morcellation / methods*
  • Neoplasm Seeding*
  • Postoperative Complications / etiology*
  • Postoperative Complications / surgery*
  • Reoperation
  • Risk Factors
  • Ureteral Neoplasms / surgery*
  • Ureteral Obstruction / etiology*
  • Ureteral Obstruction / surgery*
  • Uterine Neoplasms / complications*
  • Uterine Neoplasms / surgery*