Research and Publications
Original research into;
(i) the outcome of intrauterine intravascular fetal blood transfusions in a District General Hospital in 1992
(ii) I the incidence of gential papilloma virus infectionin a large Genitourinary medicine clinic serving an inner city population
(iii) the effect of mild protein and calorie malnutrition on macro and microscopic placental development and flow in animals
(iv) and a retrospective analysis of medico-legal claims using the Human Error Theory.
In additon to this peer reviewed publications on varied topics from Rhinitis in pregnancy, Perineal suturing, subarachnoid haemorrhage in pregnancy, screen for Down syndrome with nuchal translucency and cervico-vaginal fibronectin.
About 10-15% of all gynaecological referrals are enquires about problems with menstruation. These problems are varied and can have a significant effect on personal relationships, mood and overall quality of life. Menorrhagia, intermenstrual bleeding, heavy or prolonged bleeding can all be managed with a variety of treatments including; the Mirena IUS, polypectomy, Novasure endometrial ablation, endometrial resection, and different types of hysterectomy.
Pelvic Pain/ endometriosis
There are numerous causes of pelvic pain which occurs in 10-12% of women. Endometriosis, pelvic infection, pelvic congestion, ovarian cyst accidents, adenomyosis & fibroids are possible causes. It can present as primary or secondary dysmenorrhoea or as painful intercourse. All modalities of treatment and investigations are available including ultrasound scans, medical treatments, diagnostic laparoscopy, laparoscopic adhesiolysis, laparoscopic treatment for endometriosis & laparoscopic ovarian cystectomy.
Fibroids are benign growths in the muscle of the womb. They occur more commonly in the 30s to 40s and most of the time they do not give rise to symptoms. However they can cause periods to be heavy or prolonged and if they are large they can cause discomfort/ pressure symptoms in the pelvis. Myomectomy and Transcervical resection of fibroids are also available to treat fibroids.
Pelvic organ prolapse occurs when the organs of the pelvis are displaced through the pelvic floor. The causes are multi-factorial but genetics and some lifestyle attributes play significant roles. The prevalence of prolapse increases with age and there are a number of conservative and surgical approaches to management. Repair of vaginal prolapse, vaginal hysterectomy, sacrospinous fixation can be used to treat rectocoele, cystocoele, uterine prolapse and vaginal vault prolapse.
Involuntary leakage of urine can affect around 10% of the population. Although it is more common with increasing age it does affect a significant number of younger women. However, not all urinary incontinence has the same cause and determining the cause is the most important aspect of successful treatment. Management of Stress Urinary Incontinence using a Tension Free Vaginal Tape (TVT) and Overactive Bladder are also standard treatments on offer.
Symptoms and problems of the menopause are acknowledged to have a significant effect on the quality of life. Since modern women spend 35-40% of their lives in the menopause the importance of appropriate and well informed management cannot be over emphasised. Post reproductive gynaecology has is an integral part of modern gynaecological practice. Full discussions on the risks and benefits of various types of HRT with monitoring and regular assessments are also available.
Post childbirth problems
Problems after childbirth (the postpartum period) have traditionally been given little medical attention. In the past it was always left to midwifery staff to identify any problems. There is now an increasing realisation that there are a significant number of problems that warrant specialist review and assessment. Reviews are available after 3rd/4th degree vaginal tears, labial tears, pain/ discomfort relating to the perineum and urinary incontinence. Repairs of labial tears, labial reduction, removal of painful scar tissue in the perineum and other similar treatments are available.