"Lack of bladder scan after gynaecology surgery"

About: Crosshouse Hospital / Gynaecology

(as the patient),

I recently had gynaecological surgery, namely a non-mesh Anterior and Posterior repair

Following surgery I was asked to void into liners so that my urine could be measured. I repeated this on four occasions – passing only small amounts each time - 100-150mls. I began having lower front stomach pain and despite pain relief and the assurance that I was constipated the pain continued to escalate. I received no examination but was given Lactulose, Senokot and a suppository to relieve my “constipation” – all to no avail.

I was told early on that I would most probably need an enema and despite asking for this on five occasions over a three day period I was not given one – only reasons and excuses as to why I couldn’t have one. My pain was excruciating and heightened to such an extent that I was given Patient Controlled Analgesia along with a cocktail of other painkillers – they had little impact on my suffering – I was in tears.

In desperation I firmly asked to see my consultant, he came soon afterwards and was shocked by my level of distress – it was clear to him that I was in agony. He asked when I had been last bladder scanned – I hadn’t so he instructed that this be done immediately. The bladder scan showed that I had I had residuals of just under a litre of urine – my usual bladder capacity is 380mls.

I had 600mls of urine drained immediately followed by 500mls two hours later – I then vomited and was also given an enema. My pain was somewhat alleviated almost immediately and the upsetting thing is that this could all have been easily avoided if I had been given a simple bladder scan – it is a portable machine and it takes literally a minute to perform. Why on earth did such low voiding amounts not trigger alarm bells that I may be retaining urine?

I am now on my fourth different antibiotic for a UTI and have been told that the infection I have is very rare, so much so that my consultant has never had a patient with it. I may never know if retaining stagnant urine in my bladder triggered this infection but measures need to be put in place to avoid repeat of this unnecessary suffering happening to others.

As a result of my bladder being stretched and traumatised and along with the resulting infection, I am unable to empty my bladder independently – I have to self-catheterise, much to my distress. My consultant has reassured me that this will only be a temporary situation whilst my bladder rests, recovers and shrinks back to size.

I have a very supportive consultant, uro-gyn nurse and one senior nurse in particular went all out to do what she could to help me and for that I am grateful but in my opinion, my treatment was down to poor training or negligence and certainly needs to be addressed as a matter of high priority.

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Response from Craig White, Assistant Director, Nurse Directorate, NHS Ayrshire and Arran

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Dear Cagney

Thank you for using Patient Opinion to outline what sounds like a dreadful experience.

Can you please make contact with me so that we can agree how to take forward a review to identify what contributed to this - making sure no one else suffers the way you have.

My email is Craig.white@aapct.scot.nhs.uk

Best wishes

Professor Craig White

Assistant Director

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Response from Craig White, Assistant Director, Nurse Directorate, NHS Ayrshire and Arran We are preparing to make a change

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Dear Cagney

Thanks for taking the time to speak with me this morning, it is much appreciated particularly since you are still very much in the midst of the process of coping and recovery from the distressing and debilitating consequences of your recent experiences.

I was pleased to hear of the very positive and supportive relationship that you have with one of our Consultants and his team; and that he has explained to you some of the steps he has been taking to ensure that there is prompt review, reflection and change to make sure that no-one else experiences what you did.

It sounded to me like there was need to improve communication and I have asked that a review of the implementation of SBAR (Situation, Background, Assessment and Recommendation) training and implementation be taken forward for the ward you were in. I have also asked that this be linked with the learning and review your Consultant has initiated.

We agreed that we will let you know when this is done and that I will ensure that this is shared on Patient Opinion so that others can see what has been done. Thank you for providing me personally with positive feedback on your review of NHS Ayrshire and Arran's use of Patient Opinion - we are very much committed to using the site to support our work to support a learning organisation.

With every good wish for your ongoing recovery and renewed heartfelt apologies for the suffering, pain and distress you encountered. We fully recognise our obligation to you to make sure that change occurs in the relevant systems and process that support our staff delivering care and communication,

Best wishes

Craig White

Assistant Director, Healthcare Governance & Assurance

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Update posted by Cagney (the patient)

Dear Craig

Thank you for taking time to speak to me – your concern and understanding is appreciated.

As I mentioned to you, my consultant has had discussion and started the ball rolling with regards to clearer guidelines for fluid intake and bladder scanning, this is positive news and I am heartened to hear that a review of SBAR training and implementation of such will be actioned.

I wasn’t sure if I was doing “the right thing” by posting on Patient Opinion but I am so glad that I did, hopefully lessons will be learned from my experience and maybe others will feel confident enough to share their stories – good or bad.

Kind regards


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