Woman who underwent alleged unsuitable TVT surgery settles negligence claim

It was alleged that medical staff working for University Hospitals of North Midlands NHS Trust did not obtain the correct information about the symptoms suffered by the woman, who we have called Laura, and failed to identify that she was suffering from two urinary conditions – stress urinary incontinence and detrusor overactivity.  

Laura first attended hospital for treatment in 2011 after suffering from frequent urinary tract infections (UTI) and struggling to empty her bladder.  

Laura underwent urinary tests, the results were abnormal and showed she had detrusor overactivity as well as stress urinary incontinence. She was provided with a leaflet about TVT surgery. 

Laura’s legal team say medication and specialist physiotherapy are the usual first line treatments. It was wrongly noted that Laura had undergone specialist pelvic physiotherapy. Medication was not trialled. Laura couldn’t proceed with treatment because of family circumstances. 

She was referred to the hospital again in 2014 as her symptoms continued. The previous diagnosis of detrusor overactivity was not noted, and the doctor focused on stress urinary incontinence only.  

TVT surgery was recommended, and she was given a consent form to sign along with a standard TVT information sheet, which focussed on stress urinary incontinence only.  

On the morning of the surgery in May 2014, a doctor finally noted that Laura was suffering from detrusor activity, but it is alleged that she was not warned that the surgery she was about to undergo could make her condition worse. She claims she was not told she was suffering from detrusor overactivity at this stage.  

Immediately after surgery, Laura met a consultant and explained to them that her symptoms included difficulty emptying her bladder and that she sometimes needed to stand to pass urine. He informed her that this meant it was likely her urinary symptoms would be worsened by the surgery she had just undergone.  

After surgery, Laura’s symptoms were significantly worse. She was sent home with a catheter in place, and then had to self-catheterise up to five times a day once this was removed. She was in pain, having to go to the toilet every 20 minutes and experienced a lot of UTIs. 

Over a year after her surgery, Laura underwent a cystoscopy to investigate the ongoing issues. This showed that the TVT tape was cutting through the edge of her urethra. Laura underwent a subsequent procedure that showed the TVT tape was not placed under the right tension. These two procedures showed that either the TVT tape was negligently placed in Laura’s urethra, or the fact it was placed under the wrong tension causing it to erode through her urethra. 

A year and nine months after her initial surgery, Laura had a further procedure in which the TVT tape was removed, and her urethra was reconstructed. Laura’s symptoms improved, but she continues to suffer urinary symptoms. She now treats this with medication and Botox treatment. She continues to suffer abdominal/pubic pain and painful sexual intercourse. She developed depression, which has become recurrent, and a partial PTSD.  

Laura was represented by Leigh Day solicitors Emmalene Bushnell and Felicity Cottle and barrister Paul Reynolds of 1 Crown Office Row.  

It was argued that Laura was not sufficiently warned about the risks of surgery, particularly the risk that it could make her symptoms worse, and, regardless of this, the surgery was unsuitable. It was also argued that medication and physiotherapy should have been tried first. In addition, it was alleged that the surgery was negligently performed.  

The Trust formally denied any negligence. Following negotiations, the claim was settled for a six-figure sum at a settlement meeting.  

Laura said: 

 “Emmalene and Felicity acted in a highly professional and friendly manner, responding positively to my questions and concerns and supported me through the process”. 

Emmalene Bushnell said:  

“As a result of the surgery, Laura suffered devasting injuries requiring lifelong treatment. This settlement will permit her to access the medical treatment she needs swiftly and on her own terms.”