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Case Study: Negligent Treatment of Urethral Diverticulum
Jane, 40 years old, Dudley, £150,000
This case study outlines how we helped a woman secure £150,000 compensation after she was not informed of complications she may experience as a consequence of undergoing the surgical removal of a urethral diverticulum.
If you are looking for information on how JMW can help you to make a claim yourself you can go directly to our obstetrics and gynaecology negligence claims page here.
Named Jane, the woman noticed a lump in her vagina that was not painful. Her gynaecologist diagnosed a urethral cyst, but due to the proximity to the bladder, he referred her to a consultant urologist for treatment.
Jane was advised to undergo surgical removal of what was considered to be a large para-urethral cyst. Jane was informed this was a very straightforward operation and possible complications were not discussed. The surgeon reassured her that once the catheter was removed after seven days, she would be well enough to return to work.
At operation, the supposed cyst was removed, resulting in a defect in the urethra that was then sutured. However, the problem was not a cyst on the outside of the urethral wall, but a bulging of the urethra itself (a urethral diverticulum) just below the bladder neck.
When the catheter was removed a week later, it was noticed that urine was leaking from the vagina. This was due to the presence of a urethrovaginal fistula (a known complication of this type of surgery) that had developed because of the non-healing of the urethral excision. As she had no urinary control whatsoever, Jane had to wear incontinence pads.
Jane underwent a fistula repair using a Martius fat pad technique. However, when the catheter was removed two weeks later, it was obvious that the fistula had not healed, as she was still leaking urine. Things did not improve and she was referred to another urologist. A large fistula was confirmed by cystourogram.
Almost a year after the original surgery, Jane underwent a successful repair. Unfortunately, she was still incontinent post-operatively, as the repeat surgery close to the bladder neck had affected the sphincter. She, therefore, had to continue wearing bulky incontinence pads.
Retention of urine
Further surgery to rectify the incontinence using an autologous sling to support the bladder took place a year later and, although this was successful in rectifying the incontinence, Jane now has retention of urine. She has to regularly self-catheterise to empty her bladder and suffers from recurrent urinary tract infections as a consequence.
Breach of duty of care
JMW Solicitors alleged that the original surgeon had breached his duty of care to Jane by failing to make a correct diagnosis of the urethral diverticulum. Had the correct diagnosis been made, she would have been informed of the possible complications of surgical removal of diverticulum - including the development of fistulae, infection and incontinence.
Had she been aware of these risk factors, Jane would not have consented to the surgery, as she had no pain and could go about her daily activities quite normally.
The hospital admitted partial liability (negligence) and offered to settle the claim.