Damage to Ureter - Negligent Surgery

Sian, 58 year old, Manchester

Sian was referred to gynaecologist because of pelvic pain and pain on passing urine. She underwent a hysterscopy and a large fibroid was diagnosed.

As the  fibroid was thought to be the cause of the pain a hysterectomy was recommended. However, when Sian saw the doctor he explained that it would be a difficult operation and that a urology consultant, would be present at the operation to stent the ureters in order to protect them from damage.

The hysterectomy was eventually undertaken 6 months later. The urologist was not present although Sian was still under the impression that he would be attending. As expected it proved to be a difficult operation as the large fibroid was the size of a large orange.

Postoperatively Sian complained of nausea, right side pain and backache but was nevertheless discharged.

A few days later Sian attended the local A&E department with a history of urinary incontinence and because of the recent surgery the specialist registrar diagnosed a probable vesico-vaginal fistula.

A CT scan was undertaken 5 days later which revealed a right uretero-vaginal fistula. A nephrostomy tube was inserted into the right kidney and retrograde stenting of the damaged ureter was undertaken.  A nephrostogram was then performed and an obstruction of the right ureter was identified 2 cms above the ureteric orifice. Eventually the ureter was successfully re-implanted into the bladder.

JMW Solicitors alleged that had a urologist been in attendance at the hysterectomy operation as was initially planned, and her ureters had been protected by stenting, the damage to the right ureter would not have occurred. It is not considered standard procedure to insert ureteric stents pre-operatively in cases such as this but Sian gave her consent for her operation in the belief that the stenting would occur.

Not surprisingly Sian was psychologically distressed by the whole episode and suffered significant fatigue for some months. She was unable to undertake her duties as a foster carer, until a year after the initial operation.

Following negotiations the matter was settled for £25,000.