WHEN PELVIC AND VAGINAL SURGERY RESULT IN KIDNEY DAMAGE

Bladder injuries are the most frequent urologic injury inadvertently caused by a surgeon, as explained on the Washington University School of Medicine in St. Louis website. Fortunately, bladder injuries can usually be recognized and repaired immediately.  What is not usually recognized immediately are ureteral injuries. These have the potential to be life-threatening or to result in permanent kidney damage.

The ureters are a pair of tubes that carry urine away from the kidneys to the bladder. In the bladder, the urine is stored and then emptied by urination. An adult ureter is as wide as a pencil, roughly 30 centimeters long. Injury to the ureters is a potential complication of any open or laparoscopic gynecologic surgery to the pelvis.

Particular procedures that have the risk of ureteral injury include:

• hernia of the bladder
• prolapse
• ovary removal
• fallopian tube removal
• caesarian section

“The majority of reported ureteral injuries have occurred in patients with no identifiable risk factors. In fact, more than 75 percent of ureteral injuries due to gynecologic surgeries occur during procedures that surgeons describe as uncomplicated and routine and where pelvic anatomy is normal,” is the startling conclusion of the Washington University School of Medicine researchers.

How do you know if your ureters were damaged during surgery?

• Prolonged bowel obstruction
• Abdominal pain
• Pain in the side between ribs and hip
• Abdominal mass
• Elevated blood urea nitrogen
• Prolonged and persistent drainage from the vagina

How can you tell if there are grounds for a malpractice lawsuit against the doctor who performed gynecological surgery?

“Merely because there was a bad result does not necessarily mean there was malpractice,” Stuart Dimartini writes in Avvo. “Damage to a ureter during a gynecological surgical procedure will most likely be due to the surgeon’s misidentification of the structure,” he explains.  At the law firm of Ramey & Hailey, we help our clients explore each of the following issues:

• What caused the misidentification?
• Was it avoidable?
• Did the surgeon use accepted intra-operative techniques?
• Were there appropriate and necessary pre-operative testing and consultations?
• Was the injury to the ureter recognized during the procedure?
• If so, what steps were taken?

In a National Institutes of Health article on the subject, this statement appears:

”All pelvic surgeons eventually will encounter ureteral problems.  The gynecologic surgeon must devote time and study to the management of urinary tract injuries before their occurrence.”

Medical malpractice occurs when a hospital, doctor or other health care professional, through a negligent act or omission, causes an injury to a patient. That negligence might be the result of errors in diagnosis, treatment, aftercare or health management. Injuries to the urinary tract, particularly the ureter, are the most common cause for medical malpractice lawsuits against gynecologic surgeons.

An experienced attorney can be an invaluable asset in determining the appropriate course of action to take regarding a medical malpractice issue. Because the provision of medical care is a highly technical and specialized field, expert testimony is often required to establish the connection between the actions of the medical practitioner and the resulting injury. At Ramey & Hailey, we help navigate the intricacies of the Indiana Medical Malpractice Act  and Contributory Negligence rules.

When pelvic or vaginal surgery results in kidney damage, that’s tragic, and the patient and her family may well deserve to be at least monetarily compensated.