United Health has changed its policy about how it will cover hysterectomies that use the controversial power morcellator.

United Health says it will require prior authorization for all non-vaginal hysterectomies. And, the insurer says, it will not cover any non-vaginal hysterectomy procedures if they are not medically needed.

Many women who need to undergo a hysterectomy opt for non-vaginal surgical options like those that use power morcellator devices, because the procedure is minimally invasive and requires less hospital time.

The insurance company’s policy change follows a safety announcement by the U.S. Food and Drug Administration (FDA) in November noting the potential risk that powered morcellators carry of spreading uterine cancer. When the power morcellator cuts and removes the uterine fibroids, it can unintentionally rupture a uterine sarcoma that releases cancer cells throughout the body.

While not all women carry uterine sarcomas, it is impossible to determine if the patient carries uterine sarcoma before the surgery.

Overview of Power Morcellator Complications

A uterine hysterectomy procedure is when the patient undergoes a removal procedure of the uterus. There are a number of reasons why women undergo these procedures including uterine fibroid removal, endometriosis, uterine prolapse, pelvic pain, abnormal uterine bleeding, and uterine cancer.

In going through this surgery, many women often opt for power morcellator to be used during the procedure because of the need for only a small incision to be made.

Power morcellators have tiny rotating blades attached to them, which break down the uterine fibroids into small fragments that are then, vacuumed out of the body. The incision made during these procedures is less than two centimeters in size. Due to the smaller entry points, women do not have to recover from large incisions that are normally made in hysterectomy procedures, resulting in short hospital recovery time.

Doctors perform approximately 600,000 hysterectomies a year in the United States. An estimated 11 to 12 percent of these use a power morcellator.

Despite concerns surrounding power morcellators, the FDA has decided not to pull these devices from the market. Instead, the FDA now requires physicians to inform women of the risks of uterine cancer and that uterine sarcoma cannot be diagnosed before the procedure.

However, these warnings may have come too late to many women who underwent uterine fibroid surgery and then were diagnosed with uterine cancer. Many of the women complained that they were not given sufficient safety information before their procedures, and that they never would have used the device if they knew of the risks of uterine cancer.