Posted By CCF Neuro MD MJD on November 28, 1998 at 12:09:11:
In Reply to: Is nerve damage permanent? posted by Deb on November 27, 1998 at 20:08:28:
Hi, in the fall of 97. I saw my OB/GYN for a prolapsed uterus and bladder. I was also having problems with bowel movements. I went for a urodynamics test which showed I had stress and urge incontinence. Surgery was scheduled for 2-11-98.
Surgery was a vaginal hysterectomy, rectocele repair and a bladder sling. My OB/GYN performed the Hys, and rectocele repair. MY urologist performed the bladder sling (not the burch precedure) Upon waking in the hospital, the first thing I noticed was
the extreme pain and numbness in the top of my right thigh. I was unable to stand until 2 days after surgery, because of the pain. I used a cane to walk with for 8 weeks, and could not attempt stairs for a long time. I was referred to a neurologist who performed at EMG test.
The test showed nerve damage. Right leg weakness was significantly greater. He put me on amitryptilene (25mg). I am now up to (75 mg). I had 8 weeks of Physical therapy. They could not do much for me.
The Neurologist told me he sees this happen all the time with bladder surgeries. The urologist told me it was impossible for this to be nerve damage, as I only have a 2 inch incision scar. This Dr has been a problem also. He never saw me before surgery, never informed me
I would have an incision and never followed up with me after surgery. I tried to contact him twice before leaving hospital, and never spoke with him. I was sent home with a catheter and 13 staples closing incision
site. I finally spoke to him 5 days after surgery by phone. I had to see him in office 8 days after surgery to remove catheter and staples. It is now 9 months after surgery and I still have the leg pain and numbness.
I made a return visit to the neurologist and had him perform the EMG test again. I asked him "is this truly nerve damage and is it permanent?" He replied "yes". I was sent to have an MRI this past Wed
the day before Thanksgiving. I do not know results yet. I am not able to keep up with daily chores of being a stay-at-home Mom. I cannot any distance. Even standing causes sharp pain to shoot thru leg.
The surgery was to have been 2 hours long and was actually 3 1/2 hours. The neurologist told me that either the nerve was damaged by positioning during surgery or nerve was pinched hit in some way. My question is,
is this nerve damage permanent? What is the long term prognosis? Where fo I go from here? And do you believe Dr was negligent on caring for me as a patient? Thank you for your time.
You should ask your neurologist what kind of nerve damage he is referring to, but from your description of thigh numbness and weakness, you may have had involvement of the Femoral Nerve which supplies sensation to the thigh and controls hip flexors and quadraceps. This nerve can be compressed both during pelvic surgery (by compression in a retractor blade) or in during lithotomy positioning e.g. during vaginal delivery, vaginal hysterectomy. Prognosis depends on a few factors and an EMG can give an idea of this. Given the fact that this happened last February, it sounds like there was nerve fiber loss and so recovery if it occurs takes many months for the nerve fibers to regrow to the muscles involved. I may be misunderstanding you, but it does seem like some improvement has occurred with your strength and some of the pain. Unfortunatley, at 9 months past the injury, much of the improvement that would have occurred may have already, and there may not be much more. But your neurologist would be able to tell you better. If thigh pain from nerve injury is the major problem now, at least that can be treated with a number of agents for nerve pain. As for your question regarding negligence, it is impossible for anyone without the full story to judge.