UTI Medical Malpractice Lawyers - Urinary Tract InjuryLEGAL HELPLINE: ☎ 855 804 7125
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Urinary Tract Injury During Hysterectomy - Medical Malpractice
Hysterectomies are performed on women who do not wish to become pregnant again and who have uterine prolapse, urinary problems, tumours of the uterus, or heavy bleeding of the uterus. The hysterectomy removes the uterus and sometimes the fallopian tubes and ovaries, depending on the reason for the hysterectomy. The cervix used to be spared in older hysterectomy surgeries but now it is removed along with the rest of the uterus.
Hysterectomies are done in one of two ways. In the case of cancer of the uterus, the surgery is done using a vertical or horizontal incision in the abdomen. The uterus and tubes/ovaries are visualized and the surgery is done using an open abdominal technique. This is called a total abdominal hysterectomy, if the ovaries and tubes are removed as well. Such a technique allows surgeons to see if there is cancer in other areas of the pelvis and if the tumour has spread to the outside wall of the uterus. The recovery time is going to be longer for this type of surgery than with a vaginal hysterectomy. A vaginal hysterectomy is done with an incision made within the vagina. The uterus and sometimes the tubes and ovaries are removed through the vaginal incision. Most hysterectomies are done via this method as it is easier on the patient and you recover more easily.
The visibility in a vaginal hysterectomy isn't as good as with an open hysterectomy, so that the chances of having a urinary tract injury are higher with a vaginal hysterectomy. The bladder is right next to the uterus and the ureter runs right over the uterus. This makes it likely that a misplaced suture or a misplaced cut can damage the ureter or the bladder during the surgery. Other complications of a hysterectomy include an infection of the abdomen or incision, bleeding complications, hematoma formation (blood clots within the pelvic area), deep vein thrombosis and pulmonary embolism.
In one study, 839 patients had a hysterectomy with an incidence of urinary tract injury of about 4.3 percent. Bladder injuries amounted to 2.9 percent of injuries and ureteral injuries amounted to 1.8 percent. A few people had both bladder injuries and ureter injuries at the same surgery. A cystoscopy was used to find out who had injuries and who did not have injuries. The ureter was found mostly to be damaged at the level of the uterine vessels. This was checked out using a scope that was passed up into the ureter through the bladder. The most common injury to the ureter was transection of the ureter and the second most kind of injury was kinking of the ureter during the surgery. In the bladder, the most common injury was puncture of the bladder due to a misplaced suture or a cut through the bladder wall using a scalpel.
Doctors need to find ways to detect urinary tract injuries if they are suspected after a hysterectomy. The cystoscope is usually the best way to determine whether or not there is damage to the bladder wall or to the ureter. The cystoscope is inserted via the urethra and directly visualizes via a camera what is going on inside these structures. Radioopaque dye can be used to insert into the bladder and ureter and if it is shown to leak out of these structures during an x-ray exam, then damage to the structures has happened. Dye can also be placed into the vagina to see if it spreads into the bladder or ureter.
Complications of urinary tract injury during hysterectomy include having an infection of the bladder because the bladder gets bacteria in it through the vagina or through the incision. There can be a chronic abscess within the incision or there can be a tract that constantly leaves the incision open. There can be fever, fatigue or abdominal pain. The bacteria can end up in the kidneys resulting in a kidney infection. If severe, there can be septicaemia or sepsis of the bloodstream.
The urine can constantly leak from the vagina and this drainage can be severe. Leakage can occur only during urination or during the entire time. The treatment of this condition is surgical repair of the hole or fixing of the kinking of the ureter. You can also drain the bladder via a chronic indwelling catheter and allow the hole to heal on its own. If often takes several months.LEGAL HELPLINE: ☎ 855 804 7125