Main telephone number:
020 8401 3000

Urogynaecology Treatments

Urogynaecology clinics

Four urogynaecology clinics are held every week two at Purley Memorial Hospital and two at Croydon University Hospital. 

The Triage Clinic

To reduce the patient journey from time of referral to initiation of treatment we introduced a nurse led triage clinic to which any health professional can refer directly

The nurse specialist assesses and initiates conservative management and only refers selected cases onward to consultant clinics. Within our approved and implemented care pathways, patients come directly to a dedicated nurse-led clinic in the Lancaster Suite rather than the consultant outpatient clinic. This in itself has reduced administration time, outpatient appointments and the patient journey. All female patients are seen by a nurse specialist who undertakes triage and allocates them within an approved multidisciplinary team framework. If the patient enters the surgical pathway, the nurse specialist performs urodynamic studies and refers on to the consultant.

Bladder retraining and pelvic floor exercises classes

In contrast to conventional practice for the follow up of patients, we introduced the concept of group therapy classes as opposed to a “one to one” therapy (still available on request). This has proved very effective as it enables larger numbers of women to be trained in a shorter space of time without loss of specialist nurse time by non-attenders.

Bowel dysfunction triage clinic

This is a nurse led clinic where patients with bowel dysfunction, (includes faecal incontinence, constipation and obstructive defaecation), are assessed and an appropriate plan of care is established with the patient including biofeedback, lifestyle changes and dietary/fluid advice. These patients are followed up on a one to one basis.

Trial without catheter clinic

This is a nurse led clinic for male and female patients who have a catheter in situ for various reasons but require it to be removed and then establish that they can pass urine adequately without problems. These patients are often very complex and require competent clinical decision making to ensure that the patient receives the most appropriate onward care.

The Pessary Clinic

We have initiated a twice monthly pessary clinic for prolapse where we have access to the largest variety of pessaries in the UK. We have previously trained the community continence advisors so that they could make domiciliary visits to change pessaries in women with health and mobility restrictions. This needs further expansion.

The Perineal clinic

This is a dedicated weekly one-stop postpartum clinic that has facilities for endoanal ultrasound and anorectal physiology tests. It is also open to pregnant women but restricted to postpartum women up to16 weeks after delivery.
Clinical conditions seen in this clinic include:

 

  • Urinary incontinence
  • Anal incontinence
  • Genital prolapse
  • Sexual dysfunction
  • Women who sustain third or fourth degree tears

We also see antenatal patients who have sustained a 3rd or 4th degree tear for counselling regarding mode of delivery. This clinic is an exceptional service model that is being adopted by many units internationally. 

The Pelvic Floor Clinics

Joint evaluation of complex pelvic floor disorders lead to be a more pragmatic approach in treating patients’ physical findings and symptoms. Combined surgery, leads to cost savings and a single recuperation period. Our audit revealed that patients rated this service very highly.

These joint clinics (urogynaecologist, colorectal surgeon and colorectal nurse specialist) are run by 2 teams every month:

 

  1. Mr Abdul Sultan and Mr Muti Abulafi
  2. Miss Ranee Thakar and Mr Ian Swift

Complex Bladder Dysfunction clinic

Consultant lead clinic with nurse specialist to further assess and manage female patients that have complex urinary incontinence problems

Urodynamic clinic

This is a one stop consultant-led service where women who have complex urogynaecology symptoms are assessed and treated. This includes simple cystometry and videourodynamics

Endoanal scan clinic

Males and females with anal incontinence, evacuation problems and perianal sepsis and anal pain are assessed in this clinic. Tertiary referrals are also scanned in this clinic.

Surgical procedures

We have four operating lists per week allowing for a range of urogynaecological operations to be performed. Outcomes of all surgical procedures are audited prospectively in accordance with the requirements of the British Society of Urogynaecology.

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