Urogynaecology / Anterior repair
Voiding dysfunction as a result of anterior repair
Aileen was 45 when she presented with stress incontinence and voiding difficulty in 2005. After investigation and conservative treatment, she underwent an anterior and posterior vaginal repair. The next day she developed retention of urine and returned to theatre for urethral dilation. She was still unable to pas urine, and so was taught intermittent self-catheterisation. A further urethral dilation was performed a month later, but the bladder was still not emptying fully. Aileen was concurrently suffering chronic constipation which was treated with a number of laxatives. She continued to complain of prolapse and underwent a vaginal hysterectomy and pelvic floor repair in 2008. Following this the bowels improved but she was advised to continue with self-catheterisation. Aileen alleged that the anterior and posterior repair operation in 2005 was not appropriate and worsened her bladder problems. PMS Expert Report concluded that the failure to carry out full urodynamic studies before recommending surgery was a clear breach of duty. Inappropriate treatment worsened Aileen's condition, meaning that she is not unable to empty her bladder spontaneously, and suffers from 3 to 4 urinary tract infections per year. The case settled, and Aileen has received compensation.
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