Ureter damage following a hysterectomy

24 July 2019

In the recently reported case of JD V Shrewsbury and Telford Hospital NHS Trust, Ms JD, a 42-year-old woman was awarded £45,000 after she suffered damage to her ureter during a hysterectomy in November 2017.   As a result of the damage she suffered sepsis, required a nephrostomy (the insertion of a tube to drain blocked urine) and suffered from psychiatric injuries as a result of her treatment.

The facts

JD was discharged from hospital the day after her hysterectomy and began to experience pain in her back and kidneys and began to vomit. A few days later she underwent a CT scan and it was identified that the problem was due to the hysterectomy and that the surgeon had either nicked or stitched the left ureter during the operation.  JD was transferred to the urology department and was advised on a range of treatment options to repair the damage caused during the hysterectomy but could not undergo any of them because she had to first recover from the original surgery.  In the event she required a long term nephrostomy tube which she had to retain for six months. 

The claim

JD made a claim against the Trust alleging that they were negligent in that they:

  1. failed to exercise reasonable care during the hysterectomy;
  2. damaged the left ureter during the hysterectomy;
  3. failed to diagnose the left ureteric blockage without delay;
  4. failed to insert the nephrostomy tube without delay.

The Trust admitted that there was a failure to recognise the damage and that there was a risk of injury to JD's left ureter as a result of the treatment they had provided.  The Trust recognised that assistance should have been obtained from the Urology surgeon to assess the left ureter and that the damage could then have been diagnosed and treated straight away.  Thankfully, the long term prognosis was limited and therefore the case settled for £45,000.

But isn’t ureter damage a recognised complication of a hysterectomy?

Yes.  The NHS advises that damage to the ureter occurs in around 1 in every 100 cases.  However, it is usually repaired during the hysterectomy.  Therefore, there may be a claim if there was a failure to recognise and rectify the damage because if left, the damage can lead to further problems such as the case of JD.  If damage occurs, early recognition is key and operating staff can ask a Urologist to deal with  immediate repairs which can minimise any long term problems.

There are potentially many symptoms following a hysterectomy that may suggest damage has been caused to the ureter, such as those experienced by JD but could also include incontinence. 

If, following a hysterectomy you are concerned about the technique used (including robotic assisted techniques, or the ‘da Vinci Surgical System’) or you have unexpected long term consequences, speak to our medical negligence team who have significant experience in dealing with these sorts of claims. 

About the Author

Punam Sood is a Senior Associate in the Clinical Negligence and Personal Injury Department. She has experience of a wide range of claims, including birth injury and acquired brain injury claims, claims relating to fatal accidents, those involving gynaecological injuries following childbirth and those due to the delayed diagnosis of cancer.

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