Hysterectomy Negligence
Over 50,000 hysterectomies are carried out in the UK each year. However, recent research has suggested that some of these operations may not have been necessary, especially when the possible risks of the surgery are significant.
What are the reasons for having a hysterectomy?
A hysterectomy – the surgical removal of the womb – is a very common operation and there are a number of reasons why it may be recommended as a course of action, such as the following:
- Cancer of the womb, ovary or cervix
- Enlarged fibroids, which are non-cancerous growths in the womb
- Uterine prolapse where the womb slips out of place
- Endometriosis where tissue grows outside of the womb instead of inside
- Adenomyosis where the lining of the womb grows into the muscle of the womb
- Uncontrolled bleeding after an operation
Some of these conditions, such as cancer and uncontrolled bleeding are life-threatening scenarios but, as The Hysterectomy Association points out, a hysterectomy is usually an elective operation and chosen only when alternative treatments have failed.
It is interesting that a recent study, commissioned by the All-Party Parliamentary Group on Women's Health, has suggested that a hysterectomy should not be the default choice in the case of some conditions, such as endometriosis, where the operation will not necessarily prevent the condition from recurring.
What are the serious risks involved?
Despite its prevalence, it is important to remember that a hysterectomy is a major operation in a complex area of the body. The womb is located in very close proximity to both the bladder and the bowel as well as several key nerves and blood vessels.
Although usually a safe and successful operation, there are a number of serious risks of a hysterectomy, whether that is an abdominal, vaginal or keyhole hysterectomy, and women need to have a full understanding of these risks before consenting to the operation.
Damage to the bladder or urinary tract
Damage to the bladder is a known risk of a hysterectomy operation due to its proximity to the womb. Whether the operation is carried out via a cut to the abdomen or through the vagina, it is still possible for the bladder or associated structures to be cut. This can lead to urinary incontinence or leakage into the abdomen. In one extreme case, the bladder was accidentally stitched to the vagina during a hysterectomy operation, causing pain, incontinence and the need for further surgery.
The ureter – the tube which carries urine from the kidney to the bladder – is also vulnerable during a hysterectomy, particularly where the operation is carried out through keyhole surgery. The ureter passes very close to the womb and can easily be cut or receive thermal damage during the operation. This can lead to loss of kidney function and the development of a fistula (hole) between the ureter and vagina leading to urinary incontinence.
Damage to the Bowel
Damage to the bowel during a hysterectomy is more likely to occur during a laparoscopic (keyhole) operation where the complex anatomy of this region may be less visible. Whilst a less frequent occurrence, a bowel perforation can have devastating effects as waste products may leak into the abdomen, potentially leading to peritonitis and sepsis. A perforated bowel can be fatal.
Development of a fistula
A vesico-vaginal fistula (bladder to vagina) or uretero-vaginal fistula from the ureter to the vagina are both risks of a hysterectomy and if a woman experiences one of these awful injuries, it is quite likely to have been the result of a hysterectomy operation. If not spotted and repaired during the operation, both injuries are likely to lead to urinary incontinence. This should alert the woman to the likelihood that something has gone wrong during her operation.
A colo-vaginal fistula between the colon and the vagina is also a risk of this operation if the bowel is cut accidentally. This can lead to leakage of faeces via the vagina and is likely to cause discomfort, embarrassment and on-going infections. Again, if faeces leak into the lining of the abdomen, peritonitis can develop.
Damage to the femoral nerve
The femoral nerve carries information to and from the thighs and, as such, is crucial to our ability to stand, walk and run. It travels from the lumbar region of the spine through the abdomen and pelvis and is thus, in close proximity to the womb and bladder. Damage to this nerve can be catastrophic and can occur during a hysterectomy due to compression or direct injury during the dissection.
Deep Vein Thrombosis
Deep Vein Thrombosis (or blood clot in the vein) is a potentially serious complication of a hysterectomy, or any surgery or condition that requires a prolonged period of immobility. Hospital staff are usually very aware of this risk and the patient may need to wear compression stockings and will be encouraged to begin moving as soon as is safe after surgery. If considered to be at risk, the patient may be given medication to reduce the likelihood of a clot.
If a clot occurs but is not identified, however, it can move to block the artery which carries blood between the heart and lungs, causing death.
Haemorrhage (bleeding)
A hysterectomy is a major operation and it has been suggested that up to 5% of women experience significant, post-operative bleeding. This may require a blood transfusion and treatment in an operating theatre.
Recognising Injuries
As we have already stated, a hysterectomy is a substantial operation in a complex anatomical environment. Inevitably, there are risks involved and injuries to surrounding structures sometimes occur. Such events are rare but they do occur, and their consequences can be devastating, even fatal.
Therefore, for medical practitioners to provide a good standard of care, it is vital that any such injuries or complications are identified during the operation and dealt with at the time. A delay in diagnosis of a problem and subsequent delayed treatment can produce a far less favourable outcome for the patient and may be considered to have been substandard care.
Was Your Hysterectomy Substandard?
If you suffered complications due to your hysterectomy which you believe were the product of poor medical care, you may be entitled to make a claim for compensation for your on-going symptoms.
Contact Glynns Solicitors, a specialist medical negligence practice. We can advise you on whether you may have been the victim of substandard care.
Call us free on 0800 234 3300 (or from a mobile 01275 334030) or complete our Online Enquiry Form.
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