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Your guide to gynaecological procedures

Ultrasound pregnancy scan

Although the need for a gynaecological procedure may cause a patient worry and anxiety, most operations are routine and are carried out safely by an experienced and competent surgeon.

However, when things go wrong, the outcome can leave a patient with a long term injury and psychological distress.

From an often complex procedure, many outcomes can be the result of an incorrect diagnosis, sub-standard surgical treatment or poor care.

Common problems include: 

  • Damage from medical instruments
  • Failure to diagnose and treat a pelvic organ prolapse (stretched out of position during pregnancy)
  • Failure to diagnose cervical, ovarian or vaginal cancer
  • Failure to diagnose womb disorders
  • Unnecessary hysterectomy (removal of the womb)
  • Psychological harm caused by failed fertility treatments
  • Errors in fitting a contraceptive device
  • Failed sterilisation
  • Inadequate suturing (stitching), rips and tears
  • Infections
  • Anaesthetic errors
  • Incontinence following surgery

As a patient, you are owed a ‘duty of care’. If there is reason to believe that the standard of your care before, during or after gynaecological treatment fell below an appropriate level and you suffered an injury as a result, you may have a claim for clinical negligence.

Some patients are reluctant to seek legal advice due to embarrassment, but painful symptoms may persist and the injury may worsen over the long term.

Reaching a decision to pursue a claim for clinical negligence due to gynaecological treatment is never easy. Our team of both male and female lawyers understand and are sensitive to the very personal nature of gynaecological claims. If you would prefer a female lawyer, we can of course meet your request.

Your Legal Friend has many years of experience in successfully resolving different types of clinical negligence cases. Our specialist knowledge of both legal and medical issues can provide you with all the expert guidance you will need to help you succeed in making your case heard.

We can help you to find out why something went wrong with a diagnosis, treatment or procedureand obtain financial compensation for the injury or harm caused.

Recent stats

  • 6% – the percentage of gynaecological procedures in 2013/14 that resulted in a clinical negligence claims          (NHS Report, July 2014)
  • Over 40,000 incontinence and prolapse surgeries performed annually in England and Wales.  Of these, one in three patients will need further surgery following complications.
  • Gynaecological cancer rates per 100,000 of the female population are:

          22.3 - ovarian cancer

          24.9 - uterine cancer

          10.4 - cervical cancer

          0.9 - vaginal cancer

          3.7 - cancer of the vulva

  • 71% of ovarian cancer patients survive for one year 
  • 91% of uterine cancer patients survive for one year.          (NHS England, 2013)

Common gynaecological related problems

Although surgery always carries an element of risk, misdiagnosis or a delay in diagnosis can cause further complications during a surgical procedure or a course of treatment.

Here are some of the procedures and failings that can occur and may amount to negligence.

Failure to diagnose and treat a pelvic organ prolapse (POP)

The pelvic organs - bladder, rectum and vagina areas – can become stretched out of position during pregnancy.  Known as a prolapse, this condition may become permanent. It can be surgically corrected by implanting vaginal mesh products, which are either faulty or at risk of failure and early deterioration.

Failure to diagnose or correctly treat Endometriosis

  • Endometriosis misdiagnosis

Endometriosis is a condition where pieces of womb lining appear outside of the womb cavity, causing discomfort and possible fertility problems. A course of hormonal tablets may be prescribed for a mild condition to reduce tissue growth but in severe cases of endometriosis, scar tissue may need to be removed by a type of keyhole surgery known as laparoscopy.

  • Endometrial ablation

A common procedure to stop excessive menstrual bleeding. The procedure involves destroying the womb's inner lining by scarring the tissue using a laser beam or other methods, such as heat, fluid, electricity, freezing or microwaves.

Failure to diagnose cervical, ovarian or vaginal cancer

Early symptoms are often difficult to detect. Abnormal bleeding from the womb should alert the suspicions of a GP to make an immediate referral to a specialist. A complete physical examination and inspection of the vulva, anus, vagina, and cervix is necessary to confirm the presence and spread of the cancer, including analysis of tissue samples (biopsy) and CT scans of the abdomen and pelvis.

Unnecessary hysterectomy (removal of the womb)

A hysterectomy is nearly always necessary if there is a confirmed diagnosis of:

  • Cancer of the cervix or uterus (womb)
  • Fibroids - fibrous tissue that can develop in the wall of the womb causing painful and excessive bleeding
  • Endometriosis
  • Pelvic inflammatory disease
  • Prolapse of the womb

The procedure is also usually recommended when ovarian cancer is diagnosed.

Many hysterectomies are still performed even if cancer is not present. A doctor may strongly advise the procedure where bleeding or pain from the womb is causing increasing difficulties.

A hysterectomy is irreversible and a woman should only consent to the operation if she does not wish to have children in the future.

Complications can include:

  • Heavy bleeding during surgery
  • Post-surgery infection involving the wound or bladder
  • Damage to the bladder or tubes that carry urine from the kidneys to the bladder.

Cervical cerclage (stitch)

A cervical cerclage or stitch may be needed to close the cervix:

  • If a woman has an abnormal cervix, which can cause a ‘cervical insufficiency’.
  • When the cervix starts to shorten and open too early during a pregnancy causing either a late miscarriage or preterm birth.

Bladder or bowel damage caused during removal of an ovarian cyst

Ovarian cysts are fluid-filled sacs, which can grow inside or on the surface of the ovaries and are usually removed by keyhole surgery. Standard surgery will be required if cancerous ovaries are to be removed.

Risks of ovarian surgery include:

  • Bowel or bladder may be damaged during surgery
  • Ovarian cysts may return
  • Pain may not be controlled
  • Scar tissue may form on the ovaries, fallopian tubes or in the pelvis
  • Infection may develop.

Errors in fitting a contraceptive device

Errors made during the insertion of a contraceptive coilcan cause a tear to the uterus.

Hysteroscopy or Laparoscopy errors

Hysteroscopy (an internal examination of the womb) and Laparoscopy (keyhole surgery) are common minor procedures that should present no difficulty. Poor or negligent technique can cause tears or rips to organ tissue, bleeding and further complications.

Failed Sterilisation

A failed sterilisation can lead to an unplanned pregnancy.

Gynaecology claims

A claim for gynaecological negligence can involve any stage during the diagnosis, investigation and treatment of disorders of the female reproductive system.

Gynaecological claims can fall into one of two categories:

  • Failure to treat or diagnose a gynaecological complication

          - a failure to carry out appropriate tests, or

          -  misreading test results after having carried out the correct tests

  • Positive action by a doctor which causes a gynaecological injury

          - carrying out an incorrect procedure in response to a certain set of circumstances, or

          - carrying out the procedure in an incorrect manner after selecting the correct         

            procedure in a certain set of circumstances 

How Your Legal Friend can help you

As experienced clinical negligence specialists, we know the complications and difficulties that can arise from gynaecological treatments.  We also know that you will want to find out why your surgeon failed you or a family member in their duty to provide the expected standard of care and treatment in their diagnosis and treatment.

Your Legal Friend is committed to find out “why the system has failed you and what went wrong.” We ensure your case is properly investigated and your voice heard in order to bring the hospital, health trust or medical practitioner to account for the harm and suffering they have caused, and to prevent others from suffering in a similar way.

Your Legal Friend is committed to ensuring victims of clinical negligence obtain answers and receive appropriate compensation so that their future medical treatment and care needs are properly met.