Watery Vaginal Discharge after Pelvic Surgery (Ureter Ligation During Hysterectomy)

Watery Vaginal Discharge after Pelvic/Cervical Surgery/Operation (Ureter Ligation During Radical Hysterectomy):

Today My paying guest came to me and said her aunt has some problem. I took her history and she said, patient has under gone Pelvic surgery a month ago for some pelvic cancer.  Operative notes were saying “radical hysterectomy performed, Cervix was barrel shaped and removed, uterus and ovaries are removed. Uterine artery ligated, Lymph nodes were normal in size shape and consistency. Specimen is sent for lab examination.

Then i read the specimen examination report, it said, “Stage II Cervical Cancer”.

I didn’t find any other abnormality in lab reports except slightly raised serum creatinine and urea

Then i saw Intravenous Urogram where i clearly noticed dilated pelvis of right kidney, left kidney was normal and bladder was normal in size shape and contour no filling defect seen.

Then i asked about her current symptoms, she said that she has fever, pain in right flank, watery vaginal discharge, Doctor has catheterize her but that didn’t give her any relief from discharge and doctor said to her that her cancer has spread to kidneys.

any after the analysis of symptoms and lab reports, i doubted that this is a case of negligence of surgeon during surgery and she has ligated or damaged the right ureter of the patient which resulted in hydronephrosis, pain in flanks, fever and watery vaginal discharge.

So i called the doctor and explained her symptoms, she said,”i think the discharge is coming from the bladder” i said, “if you are right than after catheterization her symptom wouldn't have gone worse, there is greater possibility that ureter has been ligated”. She said, “i know that i am making the necessary arrangements and i will make sure that her surgery will be performed by best doctor in best circumstances and free of cost but i want her to wait for a week at least, there are chances that fistula heals spontaneously” I said to her that okay, so i am referring the patient to you as you will handle this case with more responsibility. She said okay.

I counseled the patient and asked her to wait for sometime.

After half an hour she came back and said the doctor has called her and she told her to come on Monday for surgery. Now i wish and pray that every thing go fine.

Ligation of unilateral or bilateral is not an uncommon mal-practice by surgeon in Third World Countries and i Pakistan Rate of Ureteric ligation is high as compared to developed countries. patients of unilateral ligation or damage of ureter present with same symptoms (discuss above). Bilateral ligation or damage to ureters results in rapidly progressive and worsening symptoms which need immediate and urgent attention. Unilateral or bilateral ligation are usually corrected by performing surgery.

This was about Watery Vaginal Discharge after Pelvic/Cervical Surgery/Operation (Ureter Ligation During Radical Hysterectomy):