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Vesicovaginal Fistula After Hysterectomy

A vesicovaginal fistula occurs when a hole links the bladder and the vagina, causing urine to leak uncontrollably out of the vagina. There are various ways in which this can happen, with a hysterectomy being one possible reason. In this article we explore how a hysterectomy can lead to a vesicovaginal fistula, explaining whether or not it amounts to medical negligence.

Does a vesicovaginal fistula after a hysterectomy amount to negligence?

Hysterectomies have a series of risks of which a patient should be well informed before signing a consent form. One of these risks is a vesicovaginal fistula, whereby a hole develops between the bladder and the vagina, allowing urine to pass from one to the other. There are four ways in which this can happen in the context of a hysterectomy operation:-

1. Suture tissue necrosis

Once a uterus has been removed, a surgeon must suture the defect that is left between the vaginal wall and the back of the bladder. These sutures can disrupt the blood flow to the vessels in the surrounding region. Within days or weeks, the lack of blood (and therefore lack of oxygen) will cause the tissue to die or, in medical terms, become 'necrotic'. This will lead to a between the bladder wall and the upper vaginal wall. If tissue necrosis occurs because a surgeon has failed to display due skill and attention when suturing the wound together, this could amount to medical negligence.

2. Diathermy burn to the bladder

During surgery the operating team may use a diathermy, a tool that uses the heat conducted by electricity to seal blood vessels. It must, however, be used with care or a patient may suffer a burn. If such a burn is sustained on the bladder, the tissue will gradually break down, eventually leaving a fistula through which urine can pass. If a patient does suffer a diathermy burn, and this occurred because the standard of care dropped to an unacceptable standard, meaning there will be grounds for a medical negligence claim.

3. Unrecognised bladder injury

It is possible for a surgeon to accidentally nick the bladder during a hysterectomy operation. This is a known risk and in itself does not amount to negligence. Nevertheless, it is important this injury is recognised and repaired made at the time of the procedure. If there is a failure to do so and a vesicovaginal fistula is later diagnosed, a patient will be in a position to make a medical negligence claim.

4. Breakdown of bladder injury repair

If a surgeon does repair a bladder injury at the time of the procedure but this later breaks down, there could be a case of medical negligence. However, this will only be the case if poor surgical technique is to blame.

Making a medical negligence claim

If you have developed a vesicovaginal fistula after a hysterectomy operation and you believe medical negligence is to blame, contact a medical negligence solicitor today. After a short discussion you will be able to find out whether or not you are eligible to make a claim.

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Early legal assistance can be vital so please contact us if you would like to discuss your situation. Please call us free on 0800 234 3300 (or from a mobile 01275 334030) or complete our Online Enquiry Form.

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