The ureters are the muscular tubes that carry urine from the kidneys to the bladder. Because they are in the pelvis, any surgery in that area, particularly on female reproductive organs like the uterus, can cause injury to the ureters. Like many other specific injuries where surgeons cut a structure they don’t mean to, whether this constitutes medical malpractice depends on at least two things:
- Did the surgeon record in his or her operative report that the ureters were identified and protected from injury?
- Was the injury spotted during the operation, or not found till later?
When the ureters were not described in the operative report, and especially when the injury is not discovered until days later, this can be a malpractice issue.
Standard surgical practice requires the doctor to locate and identify the ureters during the operation by visual inspection and touch. When the surgeon encounters extensive adhesions or other distortions of the anatomy that make it hard to identify the ureters, it’s also standard practice to stop and ask a urologist to help in the operation, or to put a catheter into the ureters to help locate them with dye. Also, lighted stents have become available to help identify the location of the ureters during laparoscopic surgery to help prevent surgical injury. All these techniques are available to protect the ureters from unnecessary injury.
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