The Stamey vesical neck suspension has a good early success rate but the results in the longer term are not acceptable. This operation should not be used as a first-line treatment for stress incontinence and should be reserved for specific patient subgroups.

INTRODUCTION: In April 2014, the FDA issued a warning against use of power morcellators. Soon after, their use was banned at many hospitals, including Hartford Hospital. There have been numerous position statements for and against these bans. We sought to examine the effect of this ban on women undergoing hysterectomy at Hartford Hospital. We hypothesized a decrease in minimally invasive hysterectomy after the morcellator ban. METHODS: This was a retrospective cohort study of all women who underwent hysterectomy for benign indications at Hartford Hospital from May 2013 to April 2015. We grouped patients into those who had surgery before 5/1/14 (pre-ban) and those after 5/1/14 (post-ban). Excluded were those women undergoing hysterectomy for gynecologic malignancy or those undergoing surgery for utero-vaginal prolapse and/or incontinence. RESULTS: 1082 women met all inclusion criteria; 578 had hysterectomy pre-ban and 505 post-ban. Power morcellation decreased from 12.6% pre-ban to 0.4% post-ban, p < 0.001. There was no difference in the percentage of open hysterectomies, 13.3% (77) pre-ban and 14.8% (75) post-ban, p=0.47. Supracervical hysterectomies decreased from 9.9% to 3.2% (p < 0.001). There was no increase in conversion to laparotomy (2.4% vs. 1.8%, p=0.47), use of “manual morcellation” (19.3% vs. 23.8%, p=0.12) in minimally invasive procedures, mean length of stay (1.3 vs. 1.2 days, p=0.20) or blood loss (151 vs. 163 mL, p=0.69). 2 leiomyosarcomas were found, both post-ban. CONCLUSION: While we do not disagree with many of the criticisms to the FDA’s morcellator ban, it has not led to a decrease in access to minimally invasive hysterectomy at our institution.