Generally speaking, gynecologic surgery accounts for over 50% of all ureteral injuries resulting from operations. Hysterectomy of any type is usually a safe procedure, but any surgery has risks, such as blood loss, blood clots, infection, damage to surrounding organs, and reactions to anesthesia. Surgery involving the organs in the pelvis puts the surrounding organs at risk of injury as well.
Bladder, ureter, and bowel injuries are relatively common and known complications of hysterectomy, whether total abdominal, vaginal, laparoscopic, or laparoscopically-assisted. Injuries can be due to stapling/sutures, thermal injury, or aberrant anatomy. Subsequently, plaintiff claims of negligence as a result of these types of injuries are not uncommon in the realm of medical malpractice negligence. The following case study examines the visual strategy of the defense in an interesting case of ureteral injury after vaginal hysterectomy.