Urogynaecology

 The conditions we treat

• Stress incontinence – leaking on activity, coughing, sneezing, laughing or lifting.
• Urgency/overactive bladder – the feeling of needing to go to the loo many times a day or unable to hold the urine after getting the desire to pass urine, sometime with leakage of urine before reaching the toilet.
• Prolapse – a bulge coming from the vagina due to a weakness in the walls of the vagina or the support of the uterus.  The prolapse might reveal itself by inability to empty the bladder completely leading to double voiding, recurrent urinary tract infections and going more frequently to the toilet passing small amounts.  Also if the bowel is affected it could cause inability to empty the bowels and soiling.

The treatments we offer

When you are referred to our department, we will assess your symptoms fully by asking you to complete a questionnaire.  You will usually be referred for physiotherapy first as this often helps enough to avoid the need for further treatments.

We work in a multi-disciplinary team, which includes physiotherapists, continence advisors, a urologist and gynaecologist.  According to your presenting symptoms, we offer a wide range of non-invasive treatments varying from physiotherapy and bio-feedback to advice on lifestyle and products you can buy yourself.

We can use a pessary for prolapse and incontinence, as well as nerve stimulation for overactive bladder.  If surgery is needed, however, we will offer you procedures appropriate for your condition and help you decide by informing you of the risks, recovery and likely benefit.  We perform surgery including:

Incontinence

• Burch colposuspension
• Autologous fascial sling

Prolapse

• Vaginal hysterectomy and pelvic floor repair
• Sacrospinous colpopexy
• Sacrospinous hysteropexy

We work with experienced anaesthetic teams and your surgery may be performed under a general anaesthetic.  We can treat most women under spinal or epidural (regional anaesthetic), depending on age and fitness, so that you are awake and have a safer and faster recovery.

We want your treatment to be as safe as possible and for you to return to normal daily activities as quickly as possible. We aim to treat you with the minimal number of visits to hospital and for your convenience, we will assess your symptoms after treatment by telephone.

Further information

Our key clinical staff

• Mr Rami Atalla – lead consultant for urogynaecology
• Amanda Digweed – urogynaecology nurse specialist
• Amy Stanton – secretary to Mr Rami Atalla/urogynaecology support (01438 286172)
• Ann-Marie De Paula – secretary to Mr Rami Atalla/nurse-led specialist support (01438 288478)