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Poor Quality Prostatectomy Causes Fistula

After a routine operation to remove his prostate gland, Henry was horrified to find he was leaking faeces through his penis.

After three years of problems with his prostate, Henry was diagnosed with prostate cancer and attended hospital to have a keyhole prostatectomy.

Coming round from an apparently successful operation, he noticed a brown discharge from his penis. He alerted nurses to this fact twice but was told that this was normal and due to having had a catheter fitted. However, once the catheter had been removed, faeces continued to leak from both his rectum and his penis.

After being discharged from hospital, Henry continued to try - unsuccessfully - to alert medical practitioners to the pain he was experiencing and the continuing discharge from his penis. Eventually, three weeks after his operation, Henry's wife rang NHS Direct and explained his continuing symptoms and associated pain. She was advised that Henry might have a fistula and this was confirmed with a cystoscopy two days later. It appeared that Henry had a hole between his bowel and urethra. It is likely that this was caused during the operation to remove his prostate gland.

It was decided that Henry required further surgery to repair the fistula and, the following week, this was undertaken. The hole in the rectum was sewn up and a loop ileostomy was carried out to create a stoma and divert waste out of the bowel, whilst the bladder and bowel recovered. However, the operation notes show that the tissue around the site of the fistula was delicate and, in fact, this was too soon after the prostatectomy for this operation to have been performed.

Henry began to experience an adverse reaction to the stoma which was causing him pain, sickness and swelling. He was unable to eat and had to be fed intravenously. He remained in hospital for three weeks during which time it was realised that the stoma was too tight, causing all these symptoms and it had to be re-fashioned in order to work effectively.

Furthermore, Henry's catheter was not functioning correctly requiring several hospital visits. It was then noted that there continued to be discharge via the catheter and, yet another month later, it was recognised that the fistula still existed.

It was decided to leave Henry's catheter in place, hoping that the fistula would heal itself. At the same time, Henry was finally referred to a urology specialist who successfully repaired the fistula allowing the ileostomy to be eventually reversed two years after the original prostatectomy operation.

As a result of his poor quality prostatectomy and subsequent care, Henry has been left unable to pursue many of the social and personal activities that he had previously enjoyed. He tires easily and has been left with a hernia at the site of the wound.

Henry contacted Glynns to investigate the quality of his care and we found that a catalogue of poor care had caused Henry's problems. In the first instance, Henry had not been warned that damage to the bowel was a risk of a prostatectomy. Had he been advised of this, he might have chosen a different course of action, thereby avoiding all subsequent issues.

We further found that not only had damage been caused by the operation but that it had not been identified at the time, leading to Henry's on-going symptoms. The subsequent ileostomy had not been an appropriate method for dealing with Henry's leakage problems, had been undertaken too soon after his operation and had caused him to suffer infection, pain and a need for extensive further surgery.

We supported Henry in his claim against the NHS Trust and he was awarded in excess of £85,000 compensation.

(Details which might identify our client have been changed.)

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