Patient Temporarily Paralyzed After Ureteroneocystostomy

ByJoseph O'Neill

Updated on

Patient Temporarily Paralyzed After Ureteroneocystostomy

Case Overview

The female urology case takes place in Iowa and involves a female patient with a past medical history of recurrent renal calculi. The patient had undergone multiple interventions for stones in the past and developed a stricture of the left ureter. This was treated with an indwelling stent. The stent was not successful and the patient continued to experience pain. The patient underwent a cystoscopy with extraction of ureteral stricture and left ureteroneocystostomy with psoas hitch. Following the surgery, the patient’s lower left extremity was completely paralyzed. It was determined that the cause was a stitch that was placed through the left femoral nerve inadvertently tethering the nerve during the procedure. A subsequent procedure was performed one week later to remove the stitch. The patient has since experienced extreme pain and weakness in her leg continuously since the initial procedure, and has had to pay numerous medical bills for neuromuscular and functional electrical stimulation to gain control of her leg.

Questions to the Urology expert and their responses

Q1

Do you perform ureteroneocystostomy with psoas hitch procedures? If so, how often?

I perform these cases several times per year, usually because someone was referred to me with a ureteral injury.

Q2

What precautions should be taken to prevent injury to the genitofemoral nerves?

The following are precautions to prevent nerve injury: careful control of blood loss, careful identification of psoas tendon, careful placement of stitches into tendon and not the nearby nerve, carefully written and explained informed consent form.

About the expert

This double board certified expert has been practicing for nearly 20 years. Awarded the honor or Fellow of the American College of Surgeons, this expert is widely published and has delivered over 50 national and international presentations. He is the Editor in Chief of a major internet journal of urology, as well as the Associate Editor for the West Virginia Medical Journal, and a peer-reviewer for more than 10 other scientific journals. This expert is currently the Chief of and a Professor in the Division of Urology at a major medical university, and he also serves as the Director of the Urology Residency Program at the same institution.

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About the author

Joseph O'Neill

Joseph O'Neill

Joe is a seasoned expert in online journalism and technical writing, with a wealth of experience covering a diverse range of legal topics. His areas of expertise include personal injury, medical malpractice, mass torts, consumer litigation, and commercial litigation. During his nearly six years at Expert Institute, Joe honed his skills and knowledge, culminating in his role as Director of Marketing. He developed a deep understanding of the intricacies of expert witness testimony and its implications in various legal contexts. His contributions significantly enhanced the company's marketing strategies and visibility within the legal community. Joe's extensive background in legal topics makes him a valuable resource for understanding the complexities of expert witness involvement in litigation. He is a graduate of Dickinson College.

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