Hysterectomy Urinary Tract Injury - Medical Negligence Solicitors Claims

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Hysterectomies can be done using an open incision on the abdominal wall, just above the pubic bone. A hysterectomy can also be done using a vaginal approach. Both approaches have their risks; however the vaginal approach causes a greater chance for a urinary tract injury because of the confined space and the proximity of the bladder to the uterus and the vaginal wall. Any injury to the urinary tract can result in a solicitors medical negligence claim for financial compensation.

Hysterectomy Negligence Solicitor

Our gynaecology surgery negligence solicitors deal with personal injury compensation claims for urinary tract injuries arising during a hysterectomy operation due to medical negligence by a healthcare practitioner. Our medical negligence solicitors deal with claims using the no win no fee scheme. For advice at no cost on urinary tract injuries arising during a hysterectomy operation just email our lawyers offices or complete the contact form or call our solicitors helpline.

Urinary Tract Injury - Hysterectomy

The incidence of urinary tract injury during hysterectomy is about 4.3 percent for all types of hysterectomy. The rate of bladder injury was 2.9 percent and the rate of ureteral injury is 1.8 percent. Transection and kinking injuries are the most common types of injuries. The kinking injuries were exclusive to the ureters, which kinked during the operative procedure but most of the time were successfully unkinked on their own without intervention. The level of injury to the ureters was primarily at the level of the uterine artery. This occurred in 80 percent of injuries to the ureter.

In other cases, the ureters are accidentally transected. In one study, the transection also occurred at the level of the uterine artery—the artery that needs to be ligated at the time of the hysterectomy. Ureteral injuries can result in blockage of the ureter, which leads to back up of urine in the kidneys. Eventually, the increased pressure in the kidneys will unkink the ureter and the injury will resolve itself. If the ureter is instead transected, the urine may leak out of the ureters into the abdominal cavity and may not be discovered for a period of time.

Injury to the bladder is the most common injury to the urinary tract in cases of hysterectomy. In most cases, a puncture wound or slice is made into the urinary bladder and the bladder begins to leak into the pelvic space. This may not be noted right away but eventually, there may be a vesico-vaginal fistula, which is an inflammatory fistula that constantly drains urine into the vagina, leading to chronic drainage and incontinence of urine. It can be big enough that there may be no voiding of the urinary bladder whatsoever and only drainage of the urine through the vagina occurs. This can fortunately be repaired surgically in many cases so the bladder functions normally again. Sometimes a woman needs to have a catheter placed in the urinary bladder for several weeks time to allow for healing of smaller vesico-vaginal fistulas.

Urethral injuries are non-existent in abdominal hysterectomies but do happen on rare occasions in the vaginal hysterectomy. The urethra can be crushed with instrumentation and can take some time to decompress. Transections of the short female urethra are extremely rare and would be truly accidental.

One way doctors go about assuring themselves that there is no bladder or ureteral injury is to perform a post procedure cystoscopy. A cystoscopy will look directly at the bladder and will be able to tell if there is any injury to the bladder. In addition, dye can be passed up the ureters to make sure the ureter is patent and is not kinked at all. Dye can be inserted into the bladder and the doctor can look for passage of dye into the vagina in cases of suspected vesico-vaginal fistulas. If the dye is seen in the vagina, then a fistula exists that must be addressed by the surgeon.

Fortunately, injuries to the bladder, ureters and urethra are not common and most women have their hysterectomy without complication. This is true of both abdominal hysterectomy and vaginal hysterectomy. If an injury to the bladder or ureters does occur, the surgeon can either repair the injury or allow it to heal secondarily.

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