There’s growing concern that minimally invasive surgery to remove fibroids by cutting up tissue into small pieces (morcellation) may lead to dissemination of undetected malignancies. A study of >1000 instances of uterine morcellation at 1 institution found 9 of 14 patients, or 64.3%, with benign and malignant uterine tumors experienced dissemination! The problem is that symptoms and imaging findings associated with uterine sarcoma vs. benign fibroids are often identical. Plus, endometrial sampling for uterine sarcoma only has a sensitivity of 38% to 62%. One proposed solution to the dissemination risk involves grasping fibroids through a minilaparotomy incision or the vagina and then shelling the fibroids inside a bag before morcellating them.
This past weekend, surgeons at the University of Gothenburg, in Sweden, performed not one but two mother-to-daughter uterus transplants! Both recipients are in their 30s and had IVF started before surgery, so that their own eggs can be implanted in their new uteruses (the ones that they themselves were born from!). Though the donors and recipients are recovering well, doctors are careful to say that they will not consider the operations complete successes “until this results in children.” One recipient was born without a uterus and the other had hers removed because of cervical cancer. These aren’t the first uterus transplants, nor the first with live donors, but they are the first mother-to-daughter transplants. Very cool.