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Had Laproscopic Hysterectomy. No Bowel Movement, Given Stool Softener. Cat Scan Showed Pus Sac Attach To Kidney. Suggest?
Question: My 46 yr old daughter had a laproscopy,vaginal robotis hysterectomy 9 days ago. She was sent home the next day & felt pretty good. By five days later she never had a bowel movement & we went to her ssurgeon & she said wait another day & call her after taking such stool softener w laxative. Well she was so uncomfortable we went to another hospital where they exrayed her & she was full of fecal mater in both upper & lower bowel. Sent her home to take citrate of magnesia 2 day in a row & it worked. Now on day eight she had a foul smell coming out of the vaginal area & that night became incontinent with urine. We took her to one hospital & they did a cat scan & sent her back to where she had her original surgery by ambulance. She has a huge pus sack attached t o the right kidney. The right kidney is not connected to the bladder & is draining straight out the vagina. The left kidney is working well & is going out the bladder & uretha. She is having surgery tomorrow to intall a stint & try to reconnect it & drain the right kidney which is healthy but not worliking well at all. What are her chances for a full recovery, how long will it take, will it involve more than one surgery. She is terrified of having to wear a bag or be incontinent forever. We have never heard of this happening to anyone. I feel there was definitely an error during the surgery & aftercare. I can't imagine any other reason for this to be happening. She is bipolar & suffers with great anxiety & depression so this is a terrible situation for her to be in & very scary for us her family with her past history of suicide attempts. What can you tell me.
XXXXXXX Dey
XXXXXXX Dey
Brief Answer:
Urinary tract damage is a known/ rare complication
Detailed Answer:
Hi XXXXXXX Day,
Thanks for consulting us.
I really feel sorry for the situation you & your daughter are in, but, I must say that urinary tract injury or fistula formation is a known complication of major Gynaecological surgeries like hysterectomy. Although, in expert hands & with proper expertise & facilities this is supposed to be very rare. In complicated cases where there are adhesions inside, endometriosis or cases with grossly distorted anatomy due to disease or past surgeries these complications may happen.
All patients undergoing hysterectomies are supposed to be informed pre-operatively of these potential complications.
Now, coming to the point, You did the right thing by taking her back to the surgeon. They will try to deal with the complication & improve her quality of life.
It is difficult to say exactly how much are her chances of recovery & how many surgeries will she need as I have concluded from your question that she is an infected case with a lot of pus inside. Infection has a negative effect on healing & recovery.
I guess doctor must have put her on antibiotics & will try to restore the anatomy as much as possible. Complete situation will come into vision after the surgery & then only you can discuss with the surgeon about her future prognosis.
Best of luck.
Urinary tract damage is a known/ rare complication
Detailed Answer:
Hi XXXXXXX Day,
Thanks for consulting us.
I really feel sorry for the situation you & your daughter are in, but, I must say that urinary tract injury or fistula formation is a known complication of major Gynaecological surgeries like hysterectomy. Although, in expert hands & with proper expertise & facilities this is supposed to be very rare. In complicated cases where there are adhesions inside, endometriosis or cases with grossly distorted anatomy due to disease or past surgeries these complications may happen.
All patients undergoing hysterectomies are supposed to be informed pre-operatively of these potential complications.
Now, coming to the point, You did the right thing by taking her back to the surgeon. They will try to deal with the complication & improve her quality of life.
It is difficult to say exactly how much are her chances of recovery & how many surgeries will she need as I have concluded from your question that she is an infected case with a lot of pus inside. Infection has a negative effect on healing & recovery.
I guess doctor must have put her on antibiotics & will try to restore the anatomy as much as possible. Complete situation will come into vision after the surgery & then only you can discuss with the surgeon about her future prognosis.
Best of luck.
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
The doctors after a cat scan decided it was not a puss pocket. They went in through her back to drain it. The next day did another cat scan & saw a hole in the ureter tube & consequently went in again & placed a stint for probably the next 3 weeks. So she is still on oral antibiotics 2 different kinds 2 x per day. She is uncomfortable & having some blood in the urine. The urine is no longer coming out her vagina but where it should the uretha. It was many days of pain & suffering that were not necessary if they have listened to her in the beginning & followed the urologist who figures this out & wanted to correct it on Tuesday but they fooled around for 3 full days until they went ahead & did this. We are thoroughly disgusted & feel she did not have good care & no doctors really listened until she threw a fit. How long does it take for this to heal & what are the consequences of having to have this shunt it. She feels they really harmed her & is considering a lawsuit for neglegence during surgery & especially in the after care. How often do the cut a hole in the ureter & not realize it for 2 weeks with all the symptoms she had. The nurses knew something was not right & said they had not seen this before & 1 took it upon herself to take a urine soaked pad to pathology so someone would listen. My daughter threw about 16 pads soaked through in less than 12 hours up on a counter for the doctor to see & then she got all upset & started to take this seriously. The day before was sending her home with a catheter & depends for a few weeks. God only knows what would have happended to her if she did not have a melt down & show this to the doctors. It is a very bad outcome for what should have been an easy operation. I have read up on it on my computer & know this was messed up.
Will she ever be normal again?
Will she ever be normal again?
Brief Answer:
Reported incidence of ureteric injury is <1-2%.
Detailed Answer:
Hi XXXXXXX
Thanks for discussing your concerns to us.
This is good to know that there was no pus inside, this is likely to improve the success rate of any subsequent surgery.
Second good thing is that she is now continent. This represent a successful stunt placement. This will allow natural healing to take place.
You have already been informed that stunt will remain inside for three weeks, then probably they will remove it to see the final results.
Complications may include infection, blockage, dislocation, blood in urine, pain or discomfort, frequency or urgency of urine etc. Most of these are temporary side effects & disappear after stunt removal.
Blood in urine may be a sign of damage to the urinary tract, which has already been diagnosed.
I agree that she & you as a parent have been through a lot of suffering & psychological trauma, but hopefully she is now on the right tract of healing.
Reported incidence of ureteric injuries during laparoscopic vaginal surgeries is from < 1% -2%.
There is a delay in diagnosis & treatment & you have a right to discuss this issue with the hospital administration & the concerned doctor in a meeting. They probably can explain the reasons for the delay. They can then explain to you the future prognosis & the next course of action.
Hopefully she will recover fully but this will definitely take time & a lot of patience.
May good help her to get over it.
Best wishes.
Take care.
Reported incidence of ureteric injury is <1-2%.
Detailed Answer:
Hi XXXXXXX
Thanks for discussing your concerns to us.
This is good to know that there was no pus inside, this is likely to improve the success rate of any subsequent surgery.
Second good thing is that she is now continent. This represent a successful stunt placement. This will allow natural healing to take place.
You have already been informed that stunt will remain inside for three weeks, then probably they will remove it to see the final results.
Complications may include infection, blockage, dislocation, blood in urine, pain or discomfort, frequency or urgency of urine etc. Most of these are temporary side effects & disappear after stunt removal.
Blood in urine may be a sign of damage to the urinary tract, which has already been diagnosed.
I agree that she & you as a parent have been through a lot of suffering & psychological trauma, but hopefully she is now on the right tract of healing.
Reported incidence of ureteric injuries during laparoscopic vaginal surgeries is from < 1% -2%.
There is a delay in diagnosis & treatment & you have a right to discuss this issue with the hospital administration & the concerned doctor in a meeting. They probably can explain the reasons for the delay. They can then explain to you the future prognosis & the next course of action.
Hopefully she will recover fully but this will definitely take time & a lot of patience.
May good help her to get over it.
Best wishes.
Take care.
Note: Consult a Urologist online for consultation about prostate and bladder problems, sexual dysfunction, kidney stones, prostate enlargement, urinary incontinence, impotence and erectile dysfunction - Click here.
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
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