£310,000 compensation secured for missed bladder injury following hysterectomy

The claimant (SB) was a healthy mother of five who had previously delivered all her children vaginally without any complications. After several years of heavy menstrual bleeding, she underwent cauterisation of a cervical ectropion (a condition where cells from the cervical canal grow on the outer surface of the cervix) and, later, a hysteroscopy as well as ablation therapy to remove any further abnormal material. When these measures failed to relieve her symptoms, she consented to a vaginal hysterectomy at the defendant hospital.

After surgery, SB complained of severe abdominal pain and was passing blood-stained urine in small amounts. An ultrasound showed 250ml of residual urine remaining in her bladder after voiding – a warning sign of possible bladder injury. Despite this, her symptoms were dismissed as “typical post-procedure,” and she was discharged home the next day.

Within 24 hours, SB was readmitted to A&E with severe pain. A CT scan revealed a posterior bladder wall injury with active urine leakage into the vagina and abdominal cavity. She required emergency open surgery (laparotomy) to repair her bladder and right ureter, followed by treatment in intensive care.

Her recovery was complicated by deep vein thrombosis and urosepsis, and she later developed a vesico-vaginal fistula, an abnormal connection between the bladder and vagina causing continuous urinary leakage. Over the next two years, she underwent multiple surgical repairs, including grafting procedures, before the fistula finally healed.

SB suffered from chronic lower abdominal pain and urinary incontinence for six years before the fistula finally repaired following the fourth procedure. This meant she was unable to return to work. She required long-term antibiotics for recurrent urinary tract infections and had to rely on regular pain medication to manage the discomfort.

SB also experiences ongoing anxiety and panic attacks related to her hospital experiences. She has received a diagnosis of Post Traumatic Stress Disorder (PTSD). These physical and emotional challenges have had a profound impact on her daily life and confidence.

Surgical procedures such as hysterectomies and bladder repairs carry known risks, but medical professionals have a duty to ensure that injuries sustained during surgery are promptly recognised and treated. When complications are missed or dismissed, patients can suffer avoidable harm and long-term disability.

In this case, had the bladder injury been detected and repaired at the time of surgery, SB would not have required emergency operations, nor experienced a DVT/urosepsis, and avoided years of pain and distress from the fistula and the multiple attempts to repair it.

The defendant hospital admitted liability, acknowledging that the bladder injury should have been detected and repaired during the initial operation. SB was awarded £310,000 in compensation for her pain, suffering, loss of amenity, and the permanent impact on her quality of life. This award also reflected her loss of earnings and the gratuitous care and assistance she received from her family during this time.